Type 1 diabetes is a chronic autoimmune condition that is treated with insulin and technologies such as insulin pumps and continuous glucose sensors.
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In type 1 diabetes the immune system in the body mistakenly attacks the cells in the pancreas that are responsible for producing insulin so that very little or none at all is made. Insulin is essential for regulating blood sugar levels and a lack of it causes rising sugar levels in the bloodstream that can cause serious health complications.
Around 8% of people in the UK who have diabetes have type 1 diabetes. Although type 1 diabetes most frequently occurs in children, there is now increasing recognition that adults can present with type 1 diabetes.
Type 1 diabetes is an autoimmune reaction but it’s not clear why this happens or what triggers it. Certain genetic changes can make some people more likely to develop type 1 diabetes, along with other autoimmune conditions. While exposure to viruses and other environmental factors is also thought to be a potential trigger, diet and lifestyle habits are not a cause of type 1 diabetes.
Symptoms of type 1 diabetes can come on very quickly – over just a few days or weeks - but may also present more gradually, particularly in adult presentations. Common signs and symptoms of type 1 diabetes to look out for include:
Type 1 diabetes is usually diagnosed by the presence of high glucose levels with typical symptoms and sometimes, measurement of pancreatic auto-antibodies.
It’s important to start and continue treatment as soon as type 1 diabetes is confirmed. If left untreated without insulin, people will be at risk of developing diabetic ketoacidosis, which is a life-threatening complication. Therefore prompt insulin treatment is necessary.
Over the longer term the aim is to try to control glucose levels in a safe range without frequent low levels (hypoglycaemia) and high levels (hyperglycaemia). When glucose levels remain higher than target (as monitored using HbA1c) the condition can lead to a number of health complications affecting the heart, blood vessels, nerves, eyes and kidneys.
Life-long self-managed insulin therapy is critical in treating and controlling type 1 diabetes. Blood sugar levels need to be checked regularly throughout the day or by using continuous glucose sensors and insulin must be delivered at intervals either via insulin injections or through an insulin pump or pod. Hybrid closed loop systems, automating insulin delivery with glucose sensing in real-time, is now available and achieves good outcomes for some individuals.
The goal of type 1 diabetes management is to empower the person living with type 1 diabetes to self-manage glucose levels safely and in a way that maintains their quality of life and gives freedom in dietary choices. This can be achieved through training, support and use of technology.