Type 1 Diabetes Symptoms

What Is Type 1 Diabetes?

Type 1 Diabetes is also known as insulin-dependent diabetes. The pancreas produces one of the most important hormones in the body, which is insulin. This insulin helps the cells in the body take up glucose in the bloodstream, thus regulating sugar levels in the blood.

In Type 1 Diabetes, the pancreas doesn’t make the hormone insulin. Or it makes very little insulin. Thus the high glucose levels in the body can be damaging, resulting in the symptoms and complications associated with the disease. [¹]

Type 1 Diabetes is an organ-specific autoimmune disease, which means that the autoimmune system responds against the beta cells in the pancreas. [²] The body still breaks down carbohydrates into glucose, but there is no insulin to direct the glucose into the cells, which means that more glucose starts building up in the bloodstream.

Type 1 Diabetes is called insulin-dependent diabetes because the patients need to inject insulin every day to survive. This type of diabetes is also sometimes referred to as juvenile diabetes because it commonly develops in younger individuals, children between 4 to 7 years of age.

About 5 to 10 per cent of people have type 1 Diabetes, which makes it a less common type of diabetes than type 2. Currently, there is no cure for type 1 Diabetes, but the disease can be treated by managing blood sugar levels, self-management the disease, and getting proper health checkups.

Types of Type 1 Diabetes

Type 1 Diabetes is subdivided into two categories;

Type 1A Diabetes

Type 1A diabetes is the most common type 1 diabetes. It is a cellular-mediated autoimmune disease. Autoantibodies production occurs, which results in the destruction of beta cells and hence, insulin deficiency. Almost 85 to 90 percent of type 1 diabetes patients are classified as having type 1A diabetes. [³]

Type 1A diabetes can affect individuals from when they are toddlers until age 60. Certain genes and environmental factors are now linked to influence the development of type 1A diabetes. Other autoimmune disorders that are associated with type 1A diabetes patients are Addison’s disease, hyperthyroidism, hypothyroidism, Celiac disease, and pernicious anemia. [⁴]

Type 1B Diabetes

Type 1A diabetes, or idiopathic type 1 diabetes, is not associated with autoantibodies, but a patient still needs insulin treatment to stay alive. When patients with type 1 diabetes test negative for autoantibodies, they are classified as having type 1B diabetes. [⁵]

This form of type 1 diabetes most commonly occurs in African American individuals who are also obese and live in large urban areas. The typical sign of type 1B diabetes is ketoacidosis, which is why the affected individuals are most often treated with diet and oral agents that are used for type 2 diabetes. [⁶]

How Is Type 1 Diabetes Diagnosed?

When people start showing the obvious symptoms of type 1 diabetes, healthcare professionals use certain tests to confirm the diagnosis.

A random plasma glucose test is used to diagnose diabetes, which measures the blood glucose level. Another test known as the A1C blood test is used to find out how long a patient has had high blood glucose levels.

The healthcare professionals then order further tests to confirm the type of diabetes so that an appropriate treatment plan is devised.

Type 1 diabetes can show the presence of autoantibodies in the blood. Type 1 diabetes also runs in families, so your doctor may also test your family members with this blood test. [⁷]

Type 1 Diabetes Staging

It is widely accepted that type 1 diabetes is a progressive disease which develops at a variable but predictable rate via identifiable stages before the onset of symptoms.

This staging classification is developed using insights and research studies involving individuals at a higher risk of developing type 1 diabetes. It helps in the designing of clinical trials and therapies that can prevent symptomatic disease, promote a suitable and precise medicine, and allow the adoption of interventions in early stages that can prevent symptomatic disease.

The staging of pathological changes that progresses to type 1 diabetes is as follows;

Stage 1

Stage 1 is a presymptomatic stage and is considered the start of type 1 diabetes. It is identified by the presence of beta cell autoimmunity. Individuals at risk for type 1 diabetes test positive for two or more islet (diabetes-related) autoantibodies, which means that the immune system of the body has started attacking the beta cells in the pancreas that produce insulin. However, there is normoglycemia, with no signs or symptoms yet.

Stage 2

In stage 2, again, the individual tests positive for beta cell autoimmunity. But this time, there is dysglycemia, which means the sugar levels in the body are now abnormal. This stage is presymptomatic, just like stage 1.

Stage 3

Stage 3 marks the onset of clinical diagnosis of the symptomatic disease. There is a significant loss of beta cells, and signs and symptoms of type 1 diabetes are now evident. [⁸]

Is Type 1 Diabetes Hereditary?

Researchers are looking for the exact cause of type 1 diabetes but believe that genes play a major role in causing this disease. There are some high-risk genes that increase the chances of developing type 1 diabetes. However, only genetic makeup isn’t responsible for causing this type of diabetes, and researchers believe that environmental factors are also playing their part in the higher number of cases that are emerging lately. [⁹]

In the majority of cases of type 1 diabetes, affected individuals inherit the risk factors from both parents. Many people had certain autoantibodies in their blood, which resulted in the development of this disease later in life. [¹⁰]

Type 1 Diabetes Symptoms

The symptoms of type 1 diabetes can take weeks or months to develop. But once they start appearing, they can grow severe. This means that once you start noticing symptoms of diabetes, you must see a doctor immediately and get your blood sugar tested.

What Are the Symptoms of Type 1 Diabetes?

The following are the major symptoms related to type 1 diabetes.

Polyuria

The initial symptom of type 1 diabetes is increased urination because the body is trying to eliminate excess glucose through the kidneys. When the body urinates excessively and produces large amounts of urine, it is known as polyuria.

The normal output of urine daily is 1 to 2 liters, but polyuria can result in the passing of more than 3 liters of urine per day. Polyuria is the major symptom of type 1 and type 2 diabetes, and it can lead to severe dehydration and thus affects kidney function. [¹¹]

Polyphagia

Polyphagia, or increased hunger, is another major sign of diabetes mellitus. The abnormal hunger can be caused by one of two reasons;

1. Hyperglycemia

The glucose levels in the blood are excessively high, but the glucose cannot enter body cells. This means that there is no energy for the body, and the lack of energy causes increased hunger. When polyphagia is caused by hyperglycemia, eating more food will only increase the already high glucose levels in the blood, so consulting with a doctor to manage your hunger is highly recommended.

2. Hypoglycemia

People with type 1 diabetes regularly inject insulin, which can increase the chances of developing severe hypoglycemia. In this condition, increased apatite and low blood glucose must be treated by eating something sweet as glucose readings in blood fall below 4mmol/l. [¹²]

Polydipsia

The third major symptom of type 1 diabetes is polydipsia. Polydipsia means excessive thirst and prolonged dryness of the mouth. Feeling thirsty all the time can be due to the high levels of glucose in the blood. To identify whether the increased thirst is due to diabetes, it is essential to recognize the following characteristics of this particular symptom;

Feeling thirsty even if you drink enough water
Passing large amounts of urine each day (more than 5 liters.) [¹³]

Other Symptoms

The other symptoms of type 1 diabetes include;

Blurred vision
Weight loss
Fatigue
Diabetic ketoacidosis symptoms (flushed skin, trouble breathing, feeling confused, etc.)

What Are Some Signs of Type 1 Diabetes?

Doctors monitor the hemoglobin A1c levels and blood glucose to diagnose and manage type 1 diabetes. When the characteristic symptoms start appearing, the following clinical presentations confirm the diagnosis of type 1 diabetes. [¹⁴] [¹⁵]

Fasting Plasma Glucose

The fasting plasma glucose test is a simple and fast way to diagnose diabetes. The normal levels of FPG are less than 100mg/dl, but a diabetic patient will have an FPG of 126mg/dl or higher.

Random Plasma Glucose

Random or casual plasma glucose test checks blood glucose levels at any given time of the day. Random plasma glucose ≥ 200mg/dl diagnose type 1 diabetes.

Hemoglobin A1C

Hemoglobin A1c or HbA1c is another test recommended by American Diabetes Association to diagnose type 1 diabetes. The hbA1c test allows doctors to measure blood sugar levels for the past two or three months. An A1C of greater than or equal to 6.5% confirms the diagnosis of diabetes.

Symptoms of Type 1 Diabetes in Women vs Symptoms of Type 1 Diabetes in Men

Males are more frequently affected by type 1 diabetes, and females show higher insulin sensitivity. [¹⁶] However, women having type 1 diabetes are at a greater risk of death from heart disease as compared to men1 with type 1 diabetes. [¹⁷]

1 Note that here, we are using the terms “women” and “men” to refer to female and male biological sex at birth, respectively.

The symptoms of type 1 diabetes in women may also include;

Vulvovaginal candidiasis: Those women who have type 1 diabetes have higher colonization rates of Candida than those women having type 2 diabetes. [¹⁸]
Urinary tract infections: Women with type 1 diabetes are more prone to UTI. [¹⁹]
PCOS: One in four women with type 1 diabetes can have PCOS, the most common and frequent comorbidity in such women. [²⁰]

The symptoms of type 1 diabetes in men may also include;

Sexual problems: Men with diabetes are more likely to have erectile dysfunction due to damaged blood vessels, neuropathy or limited blood flow. [²¹]
Retrograde Ejaculation: Retrograde ejaculation means when semen enters the bladder, which results due to neuropathy of the bladder. [²²]

Risk Factors for Type 1 Diabetes

The known risk factors of type 1 diabetes include:

Having a close family member like a parent, sister or brother with type 1 diabetes.
Children, teens and young adults are more likely to develop type 1 diabetes.
White people are more likely to have type 1 diabetes as compared to Hispanic or African American people. [²³]

Type 1 Diabetes Prevention

Type 1 diabetes cannot be prevented, but it can be treated. Doctors recommend getting regular health checkups and monitoring blood sugar levels to achieve a healthy lifestyle.

Type 1 Diabetes Prognosis and Treatment

Type 1 diabetes is a challenging disease and has severe complications, including eye problems, heart disease, and kidney disease. Type 1 diabetes requires daily monitoring of blood sugar levels, taking insulin properly, and achieving a lifestyle that takes care of the physical and mental well-being of the patient.

The Type 1 Diabetes Survival Rate

The introduction of insulin therapy has dramatically increased the survival rates of people who have type 1 diabetes. According to a study published in JAMA, an individual at the age of 20 lives just 12 years less than an individual without the disease. Another study demonstrated that patients who have better control over their blood sugar live longer than those who have poor control over blood sugar levels. [²⁴]

Type 1 Diabetes Treatment Options

The treatment of type 1 diabetes involves taking insulin every day, sometimes multiple times a day, in order to survive. The patients need to control their intake of sugar to keep their blood glucose levels within a normal range.

Conclusion

Takeaway

Type 1 diabetes doesn’t have a cure yet, but scientists are actively working on ways to slow down the disease or prevent it altogether. Meanwhile, those people who have type 1 diabetes should manage their disease properly to avoid as many complications as possible.