Type 1 Diabetes (T1D) is an autoimmune condition in which the body stops making insulin. An autoimmune disease is a condition that develops because the body mistakenly attacks and destroys its cells. In T1D, your body destroys its insulin-producing cells, called beta cells.
Insulin is a hormone made by the pancreas that allows your body to utilize the food you eat as energy. When you eat most foods, it is broken down into glucose (sugar) and released into the bloodstream. Insulin is like a key that allows the glucose into your cells so your body can use them for energy. Without insulin, glucose builds up in the bloodstream and doesn’t get into the cells, so the body starts breaking down your body fat as energy, called ketosis. This process can lead to very high blood sugars and a life-threatening condition, diabetic ketoacidosis.
Symptoms of diabetes can occur very suddenly, and often include:
- An increase in thirst
- A need to urinate frequently
- Feeling very hungry
- Weight loss that is unintentional
- Fatigue or weakness
- Blurry vision
- For children, bed-wetting can occur for those who previously didn't wet the bed at night
T1D diabetes management involves blood sugar management. Blood sugar’s target range is typically between 70 to 120 mg/dL. Blood sugar goals include avoiding high blood sugars, called hyperglycemia, and low blood sugars, called hypoglycemia, as much as possible.
To manage diabetes, treatment options may involve:
- Taking multiple daily insulin injections or wearing an insulin pump
- Monitoring blood sugar throughout a day or wearing a continuous glucose monitor
- Balancing the types of food with the insulin, also known as carbohydrate counting
- Participation in physical activity
- Stress management
High blood sugar causes and symptoms
Hyperglycemia, or high blood sugar, over 180mg/dL, occurs in type 1 diabetes when too much glucose (sugar) or too little insulin is present.
Reasons for high blood sugar include:
- Needing more insulin
- Having a larger meal than is normal for the individual
- Eating earlier than usual
- Food with a higher glucose content that isn’t balanced with extra insulin
- Injecting insulin at a site where the absorption rate is slower or at an overused site
- A missed insulin dose
- A clog in the insulin pump tubing
- Less exercise than normal
- Illness or injury
- Other hormones
High blood sugar symptoms include:
- Thirst and dehydration
- Urinating frequently
- Stomach pain
- Blurry vision
- Increased hunger
- Drowsiness and exhaustion
- Nausea or vomiting
- Feeling confused
- An odor on the breath that is fruity, sweet, or wine-like
- Difficulty concentrating
- Weight loss
High blood sugar doesn’t cause immediate danger. However, consistently high levels over a long period may put someone at risk for complications involving diseases of the small blood vessels, called microvascular disease, including eye disease, kidney disease, and nerve disease, or of large blood vessels (macrovascular) including heart disease and stroke.
Managing high blood sugar
Options for managing high blood sugar levels include:
- Following the doctor’s recommendations on administering insulin.
- Drinking water or another glucose-free drink.
- Checking blood sugar frequently until it reaches the target range.
- Consider speaking to the doctor if blood glucose levels are 300 mg/dl and accompanied by high ketones.
Low blood sugar causes and symptoms
Hypoglycemia, also known as low blood sugar, is defined as blood sugar below 70 mg/dl. It is the most common and most dangerous condition for people living with diabetes. Extremely low blood sugar may lead to unconsciousness, which can be life-threatening if not immediately treated.
Common reasons for low blood sugar include too much insulin, not eating as much as normal, a missed or delayed meal, exercising more than normal, illness, or injury.
- Dizziness/ Shakiness
- Blurry vision
- Personality change or irrational behavior
- Poor coordination
- Erratic responses to questions
- Inability to concentrate
Managing low blood sugar
If blood sugar levels are slightly low but you are alert and coherent, consider implementing the following plan:
- Avoid exercise.
- Immediately eat or drink a fast-acting source of glucose, such as soda, juice, glucose gel, or glucose tablets. Fast-acting sources of glucose do not have fat or protein in them, which slows the absorption of the food.
- Check blood glucose levels to make sure it is within the target range.
A suggestion to consider is checking blood glucose levels 10 to 15 minutes after treating low blood sugar. If the blood glucose level is still low, consider eating another 15 grams of carbohydrates and retesting the blood glucose in another 10 to 15 minutes.
If blood sugar is low and you are unconscious, convulsing, or unable to swallow, you will need assistance.
Whoever is assisting you should:
- Avoid feeding you.
- Administer emergency glucagon; it may take up to 10 minutes for it to work. Glucagon can cause some people to vomit, so the person should turn you to your side to prevent choking in case of vomiting.
Living with type 1 diabetes
Doctors, friends, and family can all play a role in supporting you throughout your journey. And, there are plenty of great resources available to help best manage a diabetes diagnosis. Through education, research, and your practitioner’s recommendations, you can develop a treatment plan that works best for you.
American Diabetes Association Professional Practice Committee (2022). Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes. Diabetes Care.
Mayo Clinic. Type 1 Diabetes.