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Type 1 diabetes

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Type 1 diabetes

Reviewed by Professor Ian Campbell, consultant physician and Dr Soon Song, consultant physician

Term watch

The pancreas lies at the back of the abdomen and has two main functions:

to produce a juice that flows into the digestive system to help us digest food

to produce the hormone called insulin.

Insulin is the key hormone that controls the flow of glucose (sugar) in and out of the cells of the body.

Type 1 diabetes is caused by a lack of insulin output because of damage to the pancreas gland.

Type 1 diabetes used to be called 'insulin dependent diabetes'.

This is because this type of diabetes always requires insulin treatment.

As some people with Type 2 diabetes now also require insulin, the term Type 1 is preferred.

Auto-immune diseases

There are other auto-immune diseases, for example of the thyroid gland.

They are more frequent in people who have Type 1 diabetes.

This may reflect an inherited tendency to developing auto-immune disease that is triggered by some other factor in the environment.

Exactly what that trigger can be is still unclear, but there is some evidence to suggest that a virus infection could start the process off.

What are the symptoms of Type 1 diabetes?

Glucose is one of the key fuels used by the cells of the body for its energy needs.

The brain and nervous system use only glucose, while most other cells can also utilise fat for energy.

As a result of the lack of insulin output in Type 1 diabetes, the blood sugar level climbs and glucose starts to appear in urine.

Because glucose use becomes very inefficient, a person with untreated Type 1 diabetes develops symptoms such as:

Good advice If you experience any of these symptoms on a regular basis, you should see your GP and be tested for diabetes.

How is Type 1 diabetes treated?

Diabetes is treated by:

regular injections of insulin. These are given daily or several times a day, depending on the type of insulin used. Insulin is now also available as an inhaler, but it's likely that most people for who this is suitable will still need insulin injections as well.

staying physically active and getting plenty of exercise

maintaining a steady weight

eating a proper diet containing a controlled amount of carbohydrates.

The goal of insulin treatment is to control the amount of insulin in the bloodstream so glucose levels are normal, or near normal.

Treatment for diabetes depends on the individual. It starts the first time you give yourself an insulin injection, and continues through starting an exercise programme and eating the right types and amounts of food.

Your healthcare team dietician, GP and diabetes nurse are all on hand to give advice and guidance.

Ways to help yourself

Keep an eye on any signs indicating either high or low glucose levels.

Learn how to measure glucose levels and do it regularly. The most important piece of equipment is the home blood glucose meter, which enables you to measure your blood sugar levels and control your insulin dose.

Try to follow your diet as carefully as possible.

Learn how to give yourself insulin injections.

Always carry glucose for the treatment of hypoglycaemia (low blood glucose). Occasionally, a glucagon injection may be necessary for severe hypoglycaemia.

See your doctor on a regular basis to evaluate your blood glucose levels, carry out check-ups on your eyes, kidneys and feet, and check for any late stage diabetic symptoms.

See your doctor early on if you become ill because it may cause your diabetes to become unstable.

Note down glucose levels in a 'diabetes diary', which you can then discuss with your doctor.

Physical activity

Physical activity will help reduce the associated risks of diabetes such as heart disease and cholesterol, as well as improve your general wellbeing.

But you may need to adjust your insulin dose according to the amount of exercise you do. Too much insulin and exercise may lower your blood sugar level and lead to hypoglycaemia.

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