Understanding Type 1 Diabetes: Causes, Symptoms, and Management

Overview, Signs, and Care for Type 1 Diabetes

Type 1 Diabetes accounts for roughly 5-10% of all diabetes cases and is less common than type 2. It usually develops before age 30, predominantly affecting younger individuals.

What is Type 1 Diabetes?

This form of diabetes is an autoimmune condition where the body's immune system attacks the insulin-producing beta cells in the pancreas. Over time, this destruction leads to a significant insulin deficiency, making individuals reliant on external insulin sources.

Autoimmune diseases occur when the body mistakenly targets its own cells, in this case, the beta cells, for destruction.

While the exact trigger is unknown, genetic factors combined with environmental influences are believed to initiate the autoimmune response. This process involves immune cells producing antibodies that recognize and destroy the beta cells, with T cells playing a key role in this attack.

Progression of the Disease

Initially, individuals may experience a phase called pre-diabetes, where the pancreas compensates by increasing insulin production to maintain blood glucose levels. During this stage, markers like GAD, ICA, and IAA antibodies can be detected, along with signs of beta cell damage. As the disease advances, insulin production drops sharply, and blood sugar levels rise significantly when beta cell mass decreases below 25%, resulting in diagnosed diabetes.

Typical symptoms include increased urination, frequent thirst, hunger, weight loss, blurred vision, fatigue, nausea, vomiting, and frequent infections. The classic signs of diabetes are the three P’s: polyuria (excessive urination), polydipsia (excessive thirst), and polyphagia (hunger). These arise due to dehydration and the body’s attempt to rid itself of excess glucose. Both high and low blood sugar levels can provoke hunger.

Managing Type 1 Diabetes

Diagnosis requires lifelong insulin therapy. Starting doses usually range from 0.4 to 1.0 units per kilogram of body weight daily, tailored to individual needs.

Insulin Therapy

Insulin can be administered via injections in long-acting, intermediate, short-acting, or rapid-acting forms.

Typically, long-acting insulin handles basal needs, while rapid-acting insulins are used around mealtimes.

Basal and Bolus Regimen

The basal dose, making up about half of daily insulin, is provided through long-acting insulin.

The remaining half is divided into three bolus doses, given as rapid-acting insulin with each meal.

Calculating Insulin

For example, a person weighing 60 kg and prescribed 0.5 units per kg would require approximately 30 units of insulin daily. To split this between basal and bolus doses, half is given as long-acting insulin, and the other half is divided into three rapid-acting doses at mealtimes.

Injecting Insulin

Administer at a 90-degree angle, hold for 10 seconds before removing the needle.

Injection sites include the abdomen, thighs, back of arms, and buttocks. Rotate sites within each area to ensure consistent absorption and prevent skin issues.

Storing Insulin

Keep insulin refrigerated for long-term storage.

Insulin can be kept at room temperature for up to one month.

Avoid exposing insulin to excessive heat.

Possible Side Effects

Hypoglycemia, caused by too much insulin or inadequate food intake.

Weight gain.

Skin issues at injection sites from improper rotation.