Insulin is a hormone that acts as a 'key' to move glucose, our body's energy building block, from the bloodstream into the body’s cells where it is used to provide energy. In type 1 diabetes, little or no insulin is made by the pancreas, so the glucose stays in your bloodstream giving you high blood glucose, or hyperglycaemia. Your cells become short of glucose, so they try to use fats to provide energy – this can lead to a dangerous build-up of waste products called ketones.
Ketones are a type of acid that is produced when the body burns fat for energy instead of glucose. This happens when there isn't enough glucose or insulin circulating in the bloodstream. Using fat for energy some of the time is normal. However, if it goes on for too long high levels of ketones in the bloodstream are dangerous and can lead to coma or even death.
Treating type 1 diabetes means replacing insulin to 'unlock' your cells, letting glucose in, and keeping your blood glucose level stable. Successful management of type 1 diabetes involves having insulin injections and balancing what you eat with how active you are each day.
The exact cause of type 1 diabetes is unknown, but it is thought to be an autoimmune condition. In autoimmune conditions, our body's immune system is confused and attacks our own cells. In type 1 diabetes, the cells that are damaged are the beta cells in the pancreas that make insulin.
When first diagnosed with type 1 diabetes, a person may still be producing some insulin. Over time more insulin producing cells are damaged, until the body can no longer produce any of it's own.
Only about 10% of all people with diabetes have type 1 diabetes. Type 1 diabetes is most common in children or young adults, however it can occur at any age.
You have a slightly higher chance of developing type 1 diabetes if you have a closely related family member who also has it. This suggests that genetic factors may also play a part.
Symptoms of type 1 diabetes are caused by high blood glucose levels (hyperglycaemia) and can come on very quickly. People can get quite sick when they first get type 1 diabetes and often need to be in hospital for a few days. Symptoms can include:
If a diagnosis is not made quickly, severe dehydration can occur.
While there is no cure for diabetes, since the development of artificial insulin, type 1 diabetes can be well managed and controlled. The aim of treatment is to give the right amount in insulin to balance what you eat with how much energy you need throughout the day. Successful management of type 1 diabetes involves:
You can reduce any cardiovascular risk factors by working with your healthcare team (doctor, nurse or pharmacist) to:
Although people with type 1 diabetes are trying to keep their blood glucose level from going too high, it is also important to stop it going too low. If the blood glucose drops below 4 mmol/L this is called low blood glucose or hypoglycaemia. This can be caused by, for example, injecting too much insulin or not eating enough of the right food at the right time.
Symptoms include sweating, shakiness, light-headedness, and can lead to unconsciousness if not treated. Low blood glucose must be raised urgently, with quick-acting carbohydrate such as glucose tablets (or glucagon injections if the person is unconscious).
To test your blood glucose level throughout the day, we use a small finger prick test to obtain a drop of blood which can be put onto a testing strip. The testing strip is inserted into a blood glucose meter and gives a result within seconds.
We all need some carbohydrate foods. The important difference for people with diabetes is a greater need to balance what they eat with how active they are.
Cut back on:
Managing stress is especially important. Blood glucose levels are more difficult to control if you are under stress, so you may need to monitor them more frequently.
In the long term, poor diabetes control increases the risk of serious complications such as:
With good control of your diabetes, many of these complications can be prevented or slowed down so make sure to have your regular check-ups with your doctor or nurse so that potential problems can be detected and treated early.
Most people cope well with support from health professionals, partners, family/whanau, diabetes support groups and diabetes educators. With a clear understanding of the condition, you can lead a normal, fulfilling life.
Kiwis living well with diabetes Diabetes NZChildren with diabetes Diabetes Youth New Zealand
Regional diabetes support
There is a wealth of information now about living well with diabetes. The following websites are places to start.
Living with type 1 diabetes Diabetes New ZealandType 1 diabetes NHS Choices (UK)Diabetes Projects Trust