Type 1 Diabetes: Symptoms and Causes

In the early 1980’s, a breakthrough occurred in the understanding of diabetes. Researchers discovered antibodies in the blood of some people with diabetes which targeted the beta cells making insulin. This discovery revealed that Type 1 diabetes, which was then called childhood diabetes, was actually an autoimmune disease where the body destroyed its own beta cells because they appeared to be foreign. The presence of these antibodies distinguished it from Type 2 or adult onset diabetes.

The immune system is designed to defend the body against attack from foreign substances. In Type 1 diabetes, however, a massive error occurs and the immune system begins attacking the body’s own beta cells. Destructive antibodies targeted against the beta cells appear in the blood long before enough damage has occurred to create symptoms. Testing for these antibodies allows early diagnosis, but a definitive way to stop the attack has not been developed as yet.

Type 1 diabetes is an autoimmune disease similar to Lupus, pernicious anemia, or rheumatoid arthritis. Type 1 can start at any age but many cases begin in childhood, adolescence or the early adult years.

Medical experts have not yet discovered what triggers the attack by the immune system. Researchers believe certain viruses and environmental toxins trigger the immune system’s attack by changing the beta cells so they appear foreign to the body.

Type 1 diabetes begins when the beta cells in the pancreas are so severely damaged that they can no longer make insulin. Destruction of beta cells is usually gradual, taking place over several years. When only 10 percent of the beta cells remain, the symptoms of Type 1 diabetes can begin abruptly with the blood sugar rising to dangerous levels. A child or adolescent may feel fine up to this point, but then rapidly develop the extreme symptoms typical of Type 1.

In adults, the same destruction occurs but often progresses more slowly with insulin production typically continuing for many years. Some adults with early Type 1 diabetes, sometimes referred to as Type 1.5, are able to manage with relatively normal blood sugars for several ears using only oral medications. Insulin eventually becomes necessary as the cell destruction continues.

Symptoms of Type 1 Diabetes

Symptoms of Type 1 are easy to identify because they are specific and severe, and because they usually start in otherwise healthy children, young adults or even a few older adults. The child or adult becomes tired, very thirsty, and starts to urinate frequently during the day and night. Even though the person eats more, he or she loses weight.

Insulin is a hormone that helps cells produce glucose transporters and move them onto the cell wall so glucose enters the cell where it can be turned into energy. Because insulin is low, the glucose can not enter the cells for use as fuel so it backs up in the blood causing the blood sugar to rise. More fat is released for use as fuel, making levels of fat and ketones, a by-product, rise in the blood.

As ketones build in the blood, the blood becomes more acidic and the person develops the symptoms already mentioned and becomes quite ill. Abdominal pain, dehydration, nausea and vomiting ensue. Once the very serious and life-threatening condition called ketoacidosis starts, immediate hospitalization is required to save the person’s life.

Type 1 occurs in one of every ten people with diabetes. It has both strong and weak genetic subgroups. Genetics is important, but in most cases is not a dominant factor. When both parents have Type 1 diabetes, there is only a 20% chance that a child will get it. Most Type 1’s, about 75%, have a weak or nonexistent inheritance pattern. They are often the only one in the family with Type 1 diabetes. But in about one out of four there is a strong inheritance pattern with several members of the family having the disease. A person with Type 1 will have a parent, aunt, uncle, brother or sister or two, or several cousins who have Type 1 diabetes. There seems to be little or no link between Type 1 and Type 2 diabetes.

Once the attack has destroyed the beta cells, life depends on replacing natural insulin with injected insulin. Good health depends on how well this is done. Insulin is ideally given to act at the same time and in the same amount as the pancreas’ normal release of insulin. When insulin injections mimic the pancreas, Type 1 diabetes turns out to be a very manageable disease.

If insulin is delivered in this flexible way to match need, blood sugars can be normalized. Add to this a healthy diet and regular exercise, and the person can look forward to a normal, healthy life.