What is Type 1 Diabetes?
Diabetes mellitus occurs when the body cannot produce insulin, or the body makes insulin but it does not work properly.
There are two main types of diabetes mellitus as well as some other less common forms, and the treatment required for each type of diabetes may differ:
- Type 1 diabetes
- Type 2 diabetes
- Cystic Fibrosis related diabetes
- Steroid/ medication induced diabetes
What is insulin?
The pancreas is a gland which is located behind the stomach in the abdomen. Insulin is a hormone which is produced by cells known as beta cells in the pancreas.
When we eat food, it is digested in our stomach and small intestine and the nutrients from that food pass into the bloodstream. Any food that contains carbohydrates (sugar and starches) is changed into glucose during digestion, and the glucose then passes into the bloodstream. Insulin is produced by the pancreas, and assists the glucose to get from the blood into the cells of the body to be used for energy. Without insulin the glucose cannot get into the cells and the body cannot make the energy it needs to function.
Type 1 diabetes
In type 1 diabetes the body's immune system, which normally helps us to fight infection, starts attacking the beta cells in the pancreas and destroys them. This is the process of an autoimmune disease.
The reason why this happens is not fully understood but we know that it is a result of a combination of a person's genes and environmental triggers. The triggers are not completely understood but they may be common things such as viruses that are harmless to most people.
Once the immune system is triggered, the process of beta cell (insulin making cells) destruction in the pancreas begins. The symptoms of diabetes do not happen until approximately 90% of the beta cells are destroyed.
Type 1 diabetes is not caused by eating too much or poor choices of food. There is nothing that you as a parent can do to prevent its onset.
The following link takes you to a video produced by Diabetes UK that helps to explain diabetes in more detail. https://www.diabetes.org.uk/Guide-to-diabetes/What-is-diabetes/Diabetes-and-the-body/
What are the symptoms of type 1 diabetes?
The common signs and symptoms of type 1 diabetes are:
- Passing urine frequently (bedwetting is common)
- Very thirsty and drinking lots
- Weight loss
- Tummy pain
- Excessive hunger
- Decreased concentration at school
- Mood changes
- Poor healing (chronic infections such as thrush)
When the body does not make insulin the glucose in the blood rises and the extra glucose spills over into the urine. When glucose passes through the kidneys it draws water with it leading to increased amounts of urine (going to the toilet lots). This can cause dehydration resulting in excessive thirst.
Because there is no insulin available to allow the glucose to be used as energy, the body starts to break down fat as an alternate energy source. This results in weight loss.
When fat is broken down a waste product called "ketones" is produced. Ketones can build up in the blood and cause stomach pain, nausea and vomiting.
If left untreated the combination of high glucose levels and ketones continue to rise in the blood causing severe dehydration which results in a loss of salts from the body. This is called "ketoacidosis" and is life threatening.
Treatment of type 1 diabetes
The underlying cause of type 1 diabetes is a lack of insulin due to the destruction of the beta cells in the pancreas.
The focus of treatment is to replace the insulin that is no longer produced in the body.
Insulin is not able to be given in tablet form as it is broken down in the stomach. People with type 1 diabetes require regular insulin injections to stay alive.
There are lots of different types and ways of administering insulin and the treatment plan is individualised to best suit each child's needs in partnership with the diabetes team.
How is type 1 diabetes diagnosed?
If symptoms of type 1 diabetes are present, a blood test can check the level of glucose and also check if ketones are present. A test called HbA1c (also called Haemoglobin A1c or Glycated Haemoglobin) may also be measured. This test measures the amount of glucose which sticks to the protein in red blood cells. This helps to give a picture of average blood glucose levels over the preceding 3 month period. Treatment with insulin will usually be started if the glucose levels are high and symptoms of type 1 diabetes are present. A blood test to check for diabetes auto-antibodies will also be requested in most cases. This test generally takes 1-2 weeks to be processed. Antibodies are proteins produced in response to the immune system attacking the beta cells. High levels of these antibodies in the blood confirm the diagnosis of type 1 diabetes.
Think you've got it sorted now?
If you have read through the information above and watched the video, and you feel confident that you understand this module, print off and fill in the evaluation form below (you might need to ask someone to print this off for you) and return to the nurse on your ward. If you have any questions, note them down on this form and your diabetes nurse specialist will discuss them with you.
What is type 1 diabetes: Evaluation
Click on the image below to view or download a pdf version of the evaluation form
More From Starship
The Starship Diabetes team have put together some resources for young people and their families around transitioning to adult care
Visit the Kidshealth website for a wide range of resources written for families on dealing with diabetes.