Type 1 diabetes
Type 1 diabetes is a long-term condition. It can lead to serious health problems.
But making changes to your lifestyle and taking insulin can help you live a long
and healthy life.
We’ve looked at the best and most up-to-date research to produce this information.You
can use it to talk to your doctor and decide which treatments are right for you.
What is it?
If you have diabetes, you have too much glucose in your blood. Glucose is a kind of
sugar that your body uses for energy. But if it builds up in your blood, it can make you
ill.
There are two main types of diabetes: type 1 and type 2. This information is for people
with type 1 diabetes. Type 1 diabetes usually starts when you are a teenager.
Everyone needs a hormone called insulin to keep their blood glucose at a healthy level.
But when you have type 1 diabetes, your body stops making insulin or makes very little
of it. This kind of diabetes used to be called insulin-dependent diabetes, because it can
be controlled by taking insulin.
Type 1 diabetes is an autoimmune disease. This means that the cells in your immune
system, which normally fight germs, attack some of your own cells by mistake. In type
۱ diabetes, your immune system attacks the cells that make insulin. Doctors don’t know
why this happens. It may be triggered by viruses, or by your genes, but no one knows
for certain.
What are the symptoms?
If you have type 1 diabetes, you will probably get symptoms quite suddenly, over a few
days or weeks.
These are some of the symptoms of diabetes:
• Needing to urinate more often
• Feeling very thirsty
• Feeling very hungry or tired
• Losing weight without trying.Your cells can’t use the glucose in your blood without
insulin. So, they start to burn up fat instead.
If you have symptoms of diabetes, it’s important to see a doctor.Your doctor will do a
test to see how much glucose (sugar) is in your blood.You will also need hospital tests
to see how your body reacts to glucose.
© BMJ Publishing Group Limited 2009. All rights reserved.
What treatments work?
There isn’t a cure for type 1 diabetes. But treatment can help you stay healthy by keeping
the amount of glucose in your blood close to normal.You will need to take insulin, probably
several times a day. And you will need to check your blood glucose levels regularly, to
make sure they don’t get too high or too low.
Insulin
Insulin is a hormone that keeps the amount of glucose in your blood steady. If you have
type 1 diabetes, you’ll probably need to start taking insulin as soon as you get diagnosed.
The insulin you take for diabetes is made in a laboratory. It is designed to be as much
like natural human insulin as possible. It works in the same way to keep your blood sugar
under control.
You can’t take insulin as a tablet, because the digestive juices in your stomach would
destroy the insulin. It’s usually taken as an injection.You might worry about the idea of
giving yourself an injection. But there are special devices made for people with diabetes.
These devices make injecting insulin much easier. And the needles are very thin. So it
shouldn’t hurt and you will probably find you soon get used to it.
The type of insulin you take will depend on how your body responds to insulin.Your
doctor or diabetes nurse will help you work out which type of insulin is best for you, and
work out a dosing schedule that suits you.
It might take some time to get your dosing schedule to fit well with how you live. Different
people need different schedules. The amount of insulin you need changes according to
how much you eat and how much exercise you take.
Some people manage their blood sugar by having an insulin injection just before they
eat, and then another injection of long-acting insulin at night.You adjust your dose of
insulin if you plan to eat, or exercise, more or less than usual.
How much insulin you need also changes if you have an infection, you’re stressed or
your body is having hormone changes from puberty or pregnancy.You will need to be
extra careful during these times.Your doctor or diabetes nurse can help.
The biggest challenge is getting a good balance between your insulin dose and your
eating and activity. If you take too much insulin, you could get hypoglycaemia. This
happens because your blood glucose drops too low.
If you don’t take enough insulin, your blood glucose goes too high. Then you get
hyperglycaemia. Both of these things can be medical emergencies.You need to check
your blood glucose regularly to avoid this happening.
Some people go on very strict treatment programmes to keep their blood sugar as close
to normal as possible, all the time. This is called intensive treatment. It’s different to the
standard treatment which is a more relaxed approach. Intensive treatment may help
avoid health problems (complications) caused by diabetes, for example, problems with
© BMJ Publishing Group Limited 2009. All rights reserved.
Type 1 diabetes
your heart and kidneys. But the risk is that you might have more episodes of very low
blood glucose (hypoglycaemia), which can be dangerous.
Your doctor can teach you how to keep your glucose under strict control. For example,
it may involve testing your blood at least four times a day, taking insulin three times a
day or more (or using an insulin pump), calling your clinic often to adjust your insulin
dose, watching what you eat, and exercising regularly.
An insulin pump is a device that gives your body a constant supply of insulin.The pump
looks a bit like a pager. It’s about the same size and shape as a pack of cards.You can
put the pump in your pocket or you can hang it from your belt.You need to keep it with
you all the time.
Inside the pump is a store of insulin. It is pumped out through a long tube and into your
body through a special kind of needle that stays in your skin.
You might not like the idea of having something attached to you all the time. But most
people get used to it. And you can disconnect it for short periods (for example, while
you’re having a shower, going swimming, getting dressed, or having sex).
Using an insulin pump can help you control the level of glucose in your blood better than
having injections and you may also feel happier with life if you don’t have to give yourself
injections. But it does have some disadvantages. If the tubing comes off the needle, you
might stop getting insulin without realising, which can be serious. The needle can also
cause infections.
Education about diabetes
Learning about type 1 diabetes is likely to help you control your diabetes and make you
feel better about your life. This is especially true if you are a child or teenager.
Learning about diabetes in an educational programme teaches you how to handle your
diabetes and how to be healthier. There are lots of different types of programme. Some
take place at summer camps.
An educational programme for teenagers and young adults can include a variety of topics
and activities.You might learn about:
• Checking your blood glucose and why it’s important
• Injecting insulin correctly
• Solving problems
• Improving social skills
• Improving communication skills.
You might also have counselling about coping with diabetes, either on your own or with
your family. Ask your doctors which education programmes are available for you.
© BMJ Publishing Group Limited 2009. All rights reserved.
Type 1 diabetes
What will happen to me?
If you have type 1 diabetes, you should be able to lead a normal life.You’ll need to:
• Take insulin regularly
• Watch what you eat
• Exercise regularly
• Check your blood glucose level throughout the day.
You should be able to take part in all your normal activities. But you must inform the
Driver and Vehicle Licensing Agency (DVLA) about your diabetes, and if you get a
complication that could affect your driving, such as a problem with your eyes. If you don’t,
your driving licence and car insurance may no longer be valid.
When you’ve had diabetes for a long time, you’re likely to get some extra health problems.
Your eyes, kidneys, feet and heart are the parts of your body most likely to be affected.
This happens because the extra sugar in your blood can damage your blood vessels.
Doctors call these problems complications. Not everyone with diabetes gets complications.
Some people have diabetes for 40 or 50 years without getting complications. If you
carefully control your blood glucose level, you are more likely to stay healthy. The closer
your blood glucose is to normal, the less likely you are to get complications
You should always be on the lookout for signs of hyperglycaemia or hypoglycaemia. If
your blood glucose level shoots up very high or drops very low, see your doctor or go to