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Type 1 diabetes is a chronic (lifelong) disease that occurs when the pancreas does not produce enough insulin to properly control blood sugar levels.

See also:

• Diabetes
• Gestational diabetes
• Type 2 diabetes

Insulin-dependent diabetes; Juvenile onset diabetes; Diabetes - type 1

There are several forms of diabetes. Type 1 diabetes used to be called juvenile or insulin-dependent diabetes. Type 1 diabetes can occur at any age, but it is most often diagnosed in children, adolescents, or young adults.

Insulin is a hormone produced by special cells, called beta cells, in the pancreas, an organ located in the area behind your stomach. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. In type 1 diabetes, these cells produce little or no insulin.

Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to the symptoms of type 1 diabetes.

Within 5 - 10 years, the insulin-producing beta cells of the pancreas are completely destroyed and the body can no longer produce insulin.

The exact cause is unknown, but most likely there is a viral or environmental trigger in genetically susceptible people that causes an immune reaction. The body's white blood cells mistakenly attack the insulin-producing pancreatic beta cells.

Some people will have no symptoms before they are diagnosed with diabetes.

Others may notice these symptoms as the first signs of type 1 diabetes, or when the blood sugar is high:

• Feeling tired or fatigued
• Feeling hungry
• Being very thirsty
• Urinating more often
• Losing weight without trying
• Having blurry eyesight
• Losing the feeling or feeling tingling in your feet

For others, warning symptoms that they are becoming very sick may be the first signs of type 1 diabetes, or may happen when the blood sugar is very high (see: diabetic ketoacidosis):

• Deep, rapid breathing
• Dry skin and mouth
• Flushed face
• Fruity breath odor
• Nausea or vomiting, unable to keep down fluids
• Stomach pain

Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Symptoms typically appear when the blood sugar level falls below 70. Watch for:

• Headache
• Hunger
• Nervousness
• Rapid heartbeat (palpitations)
• Shaking
• Sweating
• Weakness

Diabetes is diagnosed with the following blood tests:

• Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL on two occasions
• Random (nonfasting) blood glucose level -- diabetes is suspected if it is higher than 200 mg/dL, and the patient has symptoms such as increased thirst, urination, and fatigue (this must be confirmed with a fasting test)
• Oral glucose tolerance test -- diabetes is diagnosed if the glucose level is higher than 200 mg/dL after 2 hours.

Ketone testing is also used in type 1 diabetes. Ketones are produced by the breakdown of fat and muscle. They are harmful at high levels. The ketone test is done using a urine sample. Ketone testing is usually done at the following times:

• When the blood sugar is higher than 240 mg/dL
• During an illness such as pneumonia, heart attack, or stroke
• When nausea or vomiting occur
• During pregnancy

The following tests will help you and your doctor monitor your diabetes and prevent complications of diabetes:

• Check the skin and bones on your feet and legs.
• Check the sensation in your feet.
• Have your blood pressure checked at least every year (blood pressure goal should be 130/80 mm/Hg or lower).
• Have your glycosulated hemoglobin (HbA1c) checked every 6 months if your diabetes is well controlled; otherwise, every 3 months.
• Have your cholesterol and triglyceride levels checked yearly (aim for LDL cholesterol levels below 100 mg/dL).
• Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
• Visit your ophthalmologist at least once a year, or more often if you have signs of diabetic retinopathy.
• See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.

For additional information and resources, see diabetes support group.

Outlook (Prognosis)

Possible Complications

When to Contact a Medical Professional

Prevention

References

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