Type 1 diabetes

Type 1 diabetes occurs most often in children, adolescents or young adults, and most often at puberty. With type 1 diabetes, the body produces little or no insulin.

Approximately 10% of people with diabetes have type 1 diabetes.

Causes

The exact causes of type 1 diabetes are still unknown. In most cases, the insulin-producing beta cells in the pancreas are destroyed by the body’s immune system. We don’t know what triggers this attack or why it begins. Researchers believe that a genetic predisposition and certain environmental factors contribute to type 1 diabetes.

Type 1 diabetes used to be called insulin-dependent or juvenile diabetes. People with type 1 diabetes are dependent on daily insulin injections for their survival.

Symptoms

Type 1 diabetes symptoms can appear suddenly or progressively:

• fatigue, drowsiness
• frequent urination
• extreme thirst
• excessive hunger
• weight loss
• blurred vision
• cuts and bruises slow to heal
• genital infections
• tingling or numbness in hands or feet
• mood swings

Diabetes doesn’t always present the same way, with the same intensity or with all these symptoms. If you have one or more of these symptoms, consult your doctor. A blood test can accurately determine whether or not you have the disease. If the symptoms are severe, go to the hospital.

Diagnosis

The only way to accurately determine whether or not you have diabetes is with a laboratory blood test. It measures the level of glucose (sugar) in your blood.

The Clinical Practice Guidelines for the Management of Diabetes in Canada provide these blood glucose levels as a reference:

Diabetic:

 Blood glucose, fasting: 7 mmol/L or more
 Blood glucose, 2 hours after drinking 75 g of glucose: 11 mmol/L or more
 Blood glucose, at any time: 11 mmol/L or more, with classic symptoms

Non-diabetic:

 Blood glucose, fasting: Less than 6.1 mmol/L
 Blood glucose, 2 hours after drinking 75 g of glucose: Less than 7.8 mmol/L
 Blood glucose, at any time: —

Sometimes, a second blood test is necessary to confirm the results.

Treatment

While there is no cure for diabetes, it can be controlled.

The treatment for type 1 diabetes includes an individualized meal plan, exercise and, in every case, daily insulin injections. Good stress management also helps control the disease.

The type of treatment can vary from person to person. You and your doctor will decide what’s best for you. A variety of factors can affect your treatment: age, weight, stress and how you manage it, the amount of daily exercise and the type of work you do.

Complications

All the complications from diabetes have a common source: an excess of blood glucose. Over time, too much glucose in the blood can damage the kidneys (nephropathy), eyes (retinopathy), nervous system (neuropathy), heart (heart attack) and blood vessels (hypertension, arteriosclerosis, etc.).

However, other factors contribute to the onset of complications: age, heredity, the duration of the disease and lifestyle. Diabetes complications can have a major impact on a diabetic’s life. Proper management and control of blood glucose can delay the onset and often limit the complications.

Prevention

Unfortunately, it is still impossible to prevent type 1 diabetes. Ongoing research is focused primarily on understanding the mechanisms leading to the destruction of beta cells. Researchers are also trying to find a way to protect these cells. Any discoveries are useful for all types of diabetes since they further our understanding of how diabetes starts and develops.

Sources: Diabetes Quebec, Canadian Diabetes Association, Canadian Medical Association, American Diabetes Association. March 2001. Revised in February 2004.