What is type 1 diabetes and what causes it?
Type 1 diabetes can happen at any age, although the condition usually develops in children, teenagers, and young adults. Some people are more likely to develop this type of diabetes if other people in their family have the condition, or if they were exposed to an environmental trigger, such as a virus. Diet and lifestyle habits do not cause type 1 diabetes.
Like other autoimmune conditions, the body attacks itself and destroys cells that are needed for the body to function. In type 1 specifically, the body attacks insulin-making beta cells located in the pancreas, an organ that’s located under the liver and next to the stomach.
Type 1 diabetes symptoms include increased thirst, appetite, and urination as well as weight loss, irritability, mood changes, and fatigue. Symptoms can come on suddenly and when blood sugar is at very high levels it can be life-threatening, causing brain swelling, mental confusion, unconsciousness, and coma.
The difference between Type 1 and Type 2
Unlike type 1 diabetes, type 2 — a much more common condition that usually occurs later in life due to a combination of genetic, dietary, and lifestyle factors — is not an autoimmune condition.
Instead, the body usually makes insulin, but loses its sensitivity to it so that cells don’t absorb glucose from the blood.
“When the body can’t use insulin efficiently, this is called insulin resistance,” said Camilla Levister at the Division of Endocrinology, Metabolism, and Bone Disease and Icahn School of Medicine at Mount Sinai.
Type 2 diabetes risk factors include:
- Higher weight
- Being 45 or older
- Belonging to certain races or ethnicities, including people who are Black, Hispanic, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander.
- Family history
- Sedentary lifestyle
- Personal history of gestational diabetes (diabetes that occurs during pregnancy and goes away after pregnancy)
- Polycystic ovarian syndrome (PCOS)
Unlike people with type 1, people with type 2 diabetes generally can make lifestyle changes or take oral medications to get blood sugar levels to healthy levels. For example, losing weight (if necessary) and carefully managing intake of protein, fat, and carbohydrates can help.
Exercise can be as effective as a dose of medication when it comes to lowering blood sugar in people with type 2. (That’s not the case for people with type 1, who need to inject insulin to lower blood sugar.)
Just about any physical activity can help people with type 2 control blood sugar.
“Not everyone can exercise, go to a gym, or join a gym,” said Jodi Lavin-Tompkins, a certified diabetes care and education specialist and director of accreditation/content development at the Association of Diabetes Care & Education Specialists, said lifestyle habits such as making healthy food choices and being. “So we say, Be as active as you can, move more, and eat healthy.”
Because elevated blood sugar is toxic and can damage organs, people with diabetes are also at risk for health problems like heart disease, hypertension, kidney failure, nerve damage, and vision loss. Blood-pressure lowering medications, aspirin for preventing blood clots, and statins for lowering cholesterol levels may help reduce the risk of diabetes complications that can be caused by elevated blood sugar.
“There’s actually several classes of medications that people can take that work in different ways in the body, but people with type 2 can also take insulin,” Lavin-Tompkins said. “They might also need insulin eventually. The bottom line with diabetes is about managing blood sugar.”
Long-term management of type 1 diabetes
Although there’s no cure or way to prevent type 1 diabetes, treatment options are available to mimic normal insulin levels.
People with type 1 diabetes need to measure their blood sugar multiple times daily either by pricking their finger for a drop of blood and checking it with a glucose monitor or using a continuous glucose monitor to do the same job. Depending on the results, they either inject insulin or get it delivered via an insulin pump. (They can also calculate the amount of insulin they will need depending on the carbohydrates found in a meal.)
“Diabetes care and education specialists can help people with diabetes to manage their diabetes because that is our specialty,” Lavin-Tompkins said. “There’s lots of technology out there that can help people and we can help them onboard the technology and use it safely and effectively.”
Moss seems to be coping with her diagnosis — and the need for the lifesaving equipment — with a sense of humor. “Honestly, I’ve come to live with it. It’s kind of fun. I call myself a robot with all my little things,” Moss said.