Insulin and Type 1 Diabetes
Medically Reviewed by Dr Sravya, MBBS, MS
You will know that there are two types of diabetes: type 1 and type 2. As their names suggest, both have causes, signs, and symptoms, as well as treatments. It is essential to have a better understanding of these types for proper diagnosis and treatment plans.
If you have type 1 diabetes, you should know that your body is attacking your insulin-producing cells in the pancreas, causing you to have no or little insulin production and increasing blood sugar levels. Studies show that Type 1 diabetes makes up 10–15% of all diabetes cases.
In This Article
- What are insulin and type 1 diabetes?
- How do you get type 1 diabetes?
- Who is prone to type 1 diabetes?
- What are the signs and symptoms of type 1 diabetes?
- How do you know if you have type 1 diabetes?
- How to treat and manage type 1 Diabetes
- More advancements in treatment for type 1 diabetes without insulin
What are insulin and type 1 diabetes?
Diabetes type 1 (T1D), also called insulin-dependent or juvenile diabetes, is a lifelong autoimmune condition that occurs when the only insulin-producing beta cells in the body, which are present in the islets of Langerhans of the pancreas, are attacked by the immune system, causing progressive insulin deficiency and persistent hyperglycemia (high blood sugar levels). Insulin is a hormone that helps blood sugar enter the body’s cells so it can be used for energy and induces glucose storage in the liver, muscles, and adipose tissue, resulting in overall weight gain.
How do you get type 1 diabetes?
Diabetes type 1 (T1D), also called insulin-dependent or juvenile diabetes, is a lifelong autoimmune condition that occurs when the only insulin-producing beta cells in the body, which are present in the islets of Langerhans of the pancreas, are attacked by the immune system, causing progressive insulin deficiency and persistent hyperglycemia (high blood sugar levels). Insulin is a hormone that helps blood sugar enter the body’s cells so it can be used for energy and induces glucose storage in the liver, muscles, and adipose tissue, resulting in overall weight gain.
- Environmental: Many aspects of life and environmental factors trigger the beta cell's autoimmunity; however, in most cases, the reasons for the slight increase in the risk of developing diabetes type 1 are unclear. An increased risk is seen in children whose mothers are obese or older than 35, or in children born by cesarean section, due to the child’s weight gain in the first year of life and dietary sugar intake.
- Genetical: Diabetes type 1 can also be due to genetics; for a child whose parent has type 1 diabetes, the risk rises. In some cases, if one of the siblings or one of the twins has type 1 diabetes, there is an increased risk.
- Chemicals and drugs: Some antiviral, antiprotozoal, and cancer therapy drugs can reduce insulin production or damage cells, increasing the risk of type 1 diabetes.
Who is prone to getting Type 1 diabetes?
What are the signs and symptoms of type 1 diabetes?
Its symptoms usually start very mild and get worse within weeks or months as you have no or little insulin production in the body. The sooner your condition is diagnosed, the better for the prevention of any further complications. If you experience the following symptoms, visit a healthcare provider for further assistance.
- Frequent urination: If you are urinating more than eight times a day or more than two times at night, which is affecting your sleep, it's abnormal and could be a sign of diabetes. This is known as polyuria.
- Increased thirst—the persistent and extreme thirst also called polydipsia—could be a warning sign. The excessive sugar leaving the system through urine can lead to the loss of increased amounts of water from the body. This can, in turn, cause increased thirst.
- Increased hunger: This is when you have intense hunger and don’t feel full even after a meal. Most people tend to overeat, and it is called polyphagia.
- Weight loss: If you notice a sudden and significant weight loss over a short period of time, This is when your body burns fat and muscle tissues for energy as you have no insulin to use the glucose in your body.
- Fatigue and weakness occur Fatigue and weakness occur when your body cells are not getting enough glucose.
- Bed-wetting in children The condition in which the child has been dry for over 6 months starts bedwetting suddenly (secondary nocturnal enuresis). This occurs in a child with type 1 diabetes when excessive sugar enters the urine and pulls out more water, which leads to frequent urination and bedwetting.
- Recurrent skin infections: The high blood sugar levels make the skin dry, hard, and thick, which can make it prone to more skin rashes.
- Candidiasis infection of the perineum: Yeast infections are very common in diabetes patients as the high blood glucose, as well as the sugar passing through the urine, can feed the growth of yeast very quickly.
- Irritability and performance issues at school Diabetes can affect both mental and physical health. Rapid changes in sugar levels can affect a person's mood. This can lead to irritability, stress, feeling low, and burnout.
- Chemicals and drugs: Some antiviral, antiprotozoal, and cancer therapy drugs can reduce insulin production or damage cells, increasing the risk of type 1 diabetes.
Untreated or delayed diabetes can lead to further complications, like diabetes-related ketoacidosis. This is a condition when your body starts to use fat for energy production when insulin is not available to convert sugar into energy for a long period of time. This fat breakdown causes the release of ketones. Excessive ketones turn the blood acidic. This is a life-threatening condition.
Seek medical care if any of these signs of diabetic ketoacidosis are noticed:
- The fruity smell on the breath
- Rapid breathing
- Loss of consciousness
- Stomach pain
- Nausea
- Vomiting
- To feel more disoriented and confused The high blood
How do you know if you have type 1 diabetes?
A simple blood test can help anyone find out if they have diabetes. Furthermore, specific tests are done to identify the type of diabetes.
- In random blood sugar tests, a blood glucose level of 200 mg/dL or higher suggests diabetes. Blood is taken at random times from the patient for this test.
- In fasting blood sugar tests, a blood glucose level of 100–125 mg/dL is pre-diabetes, and more than 126 mg/dL is when you have diabetes. The blood is taken after fasting overnight.
- Glycated hemoglobin tests measure the blood sugar level for 2 to 3 months. A value of A1C greater than 6.5% suggests diabetes.
To find out about type 1 diabetes, your physician will ask you to get tested for autoantibodies. In urine tests, the presence of ketone bodies shows type 1 diabetes, and high ketone bodies will cause acetone or a fruity smell on your breath. The physician will also check your A1C (glycated hemoglobin) levels. Your A1C goal may vary depending on your age and various other factors. It helps to know better whether the treatment plan is properly working for the patient.
How to treat and manage type 1 Diabetes
To manage type 1 diabetes means keeping the blood sugar level normal to prevent or delay any complications. You have to keep the blood glucose level between 80 and 130 mg/dL before the meal and not greater than 180 mg/dL two hours after the meal.
The main ways to manage the condition are:
- By taking the proper dose of insulin
- A healthy diet and regular exercise are essential for maintaining a healthy weight.
- Constant Monitoring of the blood glucose levels
If you are a person with type 1 diabetes, you have to be on insulin throughout your life. There is no treatment without insulin for type 1 diabetes.
There are different types of insulin available. According to one’s medical condition, physicians will prescribe suitable insulin combinations.
The types of insulin for diabetes are:
- Short-acting insulin, or regular insulin, starts working within 30 minutes of the injection and will last up to 4 to 6 hours. Examples are Novolin R, Humulin R, and Afrezza.
- Intermediate-acting insulin, or NPH insulin, starts working around 1 to 3 hours after injection and will last up to 6 to 8 hours. Examples include Novolin N and Humulin N.
- Rapid-acting insulins start working 15 minutes after injection and will last up to 4 hours. Examples include glulisine, lispro, and aspart.
- Long- and ultra-long-acting insulins can act for 14 to 40 hours. Examples are glargine, detemir, and degludec.
These insulins have to be taken through injections and insulin pumps, as oral insulin will get broken down during digestion, thus preventing insulin from working properly.
- Insulin syringe The insulin injection for type 1 diabetes has to be taken under the skin using an insulin pen or syringe. Syringes will have markings, making them easier to use and more accurate. You will have to take the dose according to what is prescribed for you.
- Insulin pen The insulin pen is available as disposable or refillable. It is more comfortable to use for children. The needles will be very thin and small. They are pre-filled and require no prior training to use. It is portable and cheaper than an insulin pump. But not all types of insulin can be used with an insulin pen.
- Insulin pump Insulin pumps are devices attached outside your body for constant delivery of insulin into the body system through a thin plastic tube when the blood glucose level rises after every meal in type 1 diabetes. The plastic tube is semi-permanently attached to your fatty layer under the skin, usually in the stomach area or the back of your upper arm. It can deliver insulin more accurately. Patients may experience weight gain and infections while using it, and they will also have high blood glucose if the machine stops functioning. It's more expensive than other methods.
- Insulin inhaler With the help of an oral inhaler, ultra-rapid-acting insulin is delivered into the system before meals. It can cause mild to severe coughs, and it is expensive too.
Depending on the type of insulin and the severity, patients will have to monitor and record the glucose level daily at least four times.
There are two main ways to do it:
- A continuous glucose monitoring system (CGM) continuously monitors blood glucose and prevents any sudden changes in glucose levels. It helps lower the A1C.
- In a closed-loop monitoring system, a device will be implanted in the patient’s body that will connect the insulin pump and the glucose monitor. This will help deliver the right amount of insulin at the right time, whenever the patient is in need.
More advancements in treatment for type 1 diabetes without insulin
- Pancreas Transplant: Pancreas transplantation is rare due to the few available donor organs and the need for lifelong immunosuppressive therapy in patients to prevent transplant rejection.
- In an islet cell transplant, the Pancreatic islet cells are isolated from the donor pancreas and then injected into the recipient's portal vein, from which they implant onto the recipient's liver.
Preventing type 1 diabetes is impossible, but the symptoms can be delayed if you are a person with a higher risk of getting the condition and have a healthy lifestyle. Getting proper checkups, good exercise, a healthy diet, and medication will help you overcome your life with type 1 diabetes.
- A continuous glucose monitoring system (CGM) continuously monitors blood glucose and prevents any sudden changes in glucose levels. It helps lower the A1C.
- In a closed-loop monitoring system, a device will be implanted in the patient’s body that will connect the insulin pump and the glucose monitor. This will help deliver the right amount of insulin at the right time, whenever the patient is in need.