What is Type 1 Diabetes and Why You Should Care

Even if you haven’t read anything about this disease, you’ve probably heard about diabetes. Something about sugar, right?  

It’s more common in fat people. Someone’s friend’s grandma had it and needed a foot amputated, maybe. Another person probably went blind from it.  

These things can happen, but those stories tell you nothing about what diabetes really is.  What often surprises people is that there are two established types of diabetes. Both of them are almost completely different. 

While both are devastating to be diagnosed with, Type 1 is often called the “worse one.”  

There is a huge disconnect in doctors’ offices, on the internet, and even on TV that there is a major, major difference between Type 1 and Type 2 Diabetes. So major, in fact, that they really need to be considered two separate diseases.

Type 1 Diabetes is not caused by eating too much sugar, or by being fat/overweight/obese, or any other preventable thing.  

T1D is most likely genetic and often triggered by environmental and unrelated medical effects.

What is Type 1 Diabetes?

Diabetes is when the pancreas essentially attacks itself.  

The immune system suddenly flags insulin-producing beta cells as invaders and quickly destroys them. The onset of symptoms can be very abrupt, which is just one of many reasons going untreated and undiagnosed can be a death sentence.  

Since insulin regulates the level of sugar in the bloodstream, a lack of it results in enormously high blood sugars, which can be fatal. Mine, at diagnosis, was 544 mg/dL (milligrams of glucose per deciliter of blood.  

Metric countries use mmol/L, which is millimols of glucose per liter of blood. A conversion chart can be found here).

For perspective, the non-D range is between 70 and 140 mg/dL, and organs start failing at 1000 mg/dL.

Symptoms

Doctors often confuse Type 1 for the flu, as they share many symptoms.  

Common T1D symptoms:

• frequent urination
• rapid weight loss
• increased appetite
• insatiable thirst
• fatigue
• nausea
• dizziness
• a fruity smell on both the breath and urine.

It’s very important to be observant for these symptoms, even if you don’t have a family history of diabetes. I was the first in my family to get it, and the incidence of T1D is rising.  

Because of this uptick in diagnoses, it’s becoming increasingly essential to have children tested for it, starting as young as possible. I received my diagnosis at two and a half, and I have a friend who got hers at just eighteen months old.

Education

The first line of defense is education. Despite the explosion of new diagnoses, many general practitioners are unfamiliar with the symptoms being indicative of type 1. This is most likely because type 2 is far more common, and many children have been diagnosed with sicknesses that share symptoms.

Apparently, doctors still consider type 1 diabetes a relatively rare disease.

When it comes to education, I’m a huge advocate.

Just listen to my podcast! LOL!

I enjoy it when people ask me about my insulin pump or my CGM because it gives me an opportunity to educate.

I post T1D info on Facebook and Instagram, and for 20 years of my life I went to diabetes camp. In 2019, Jessie and I started This is Type 1.  

When I was in elementary school, my mom would do education assemblies to teach my classmates about my disease, and what to watch out for if I started behaving strangely. Throughout elementary, junior high, high school, and even college, I informed my teachers and professors that I had type 1 diabetes. Sometimes I even supplied them with an emergency pack of glucose tablets and juice to keep in their desks in case my blood sugar crashed during class and I didn’t have anything with me.  

This saved my butt a lot in school, and I became nicely acquainted with several teachers’ bottom desk drawers.

Treatment

A pretty significant difference is that while both types are serious, T1D is the deadlier of the two.  

A lot of ignorant people claim that there are “natural cures.”

Things like cinnamon and okra water are nothing more than snake oil.

But type 1 cannot be cured.  

It can only be treated, whereas type 2 can be “reversed” with diet and exercise (most notably the ketogenic diet), and treated with medications like Metformin, which artificially lowers the amount of sugar in the bloodstream via the liver.

T1D requires constant insulin.

Insulin is the gatekeeper that allows cells to absorb sugar from the bloodstream. Not enough insulin and the blood sugar rises. Too much insulin, on the flip side, and blood sugar drops, often to dangerous and lethal levels.

Being too high for long periods of time is damaging—that’s where the amputated feet and blindness come in.  

Being too low is deadly, as it can send diabetics into a coma. Unfortunately, some will never wake.  

The lowest I can remember my blood sugar being (while conscious) is about 23 mg/dL. For some people, that’s far below their threshold for consciousness, but I was in first or second grade and apparently have a good tolerance for lows. In any case, with a number that low, fast-acting juice or glucagon is essential.

Injections & Pumps

For T1Ds, there are several options for the method of treatment.  

Like all type 1 diabetics, I started on insulin injections, with a long-acting insulin (e.g. Lantus, Levemir, Basalgar) to keep my numbers mostly steady over 12 to 24 hours, and fast-acting insulin (e.g. Humalog, Novolog, Apidra, Fiasp) for meals and blood sugar corrections.

After seven years on injections, I transitioned onto a Medtronic insulin pump. This made my life a LOT easier in terms of controlling my blood sugars. After fifteen years with Medtronic, I switched to Tandem.

Insulin pumps (e.g. Medtronic, Omnipod, Tandem) look like pagers from the 1990’s but allow a customizable basal rate that takes the place of long-acting insulin, and the ability to finely correct for food and unhook or “suspend” if the situation requires it.

Continuous Glucose Monitors

Since 2007, CGMs, or continuous glucose monitors (e.g. Dexcom, Medtronic, Libre, Eversense) have risen in popularity.  

These devices are able to read blood sugars in real-time, at 5-minute intervals to reflect trends in numbers.  

This is especially useful to parents with T1D children who often can’t feel highs or lows because the device alerts by beeping or vibrating. Dexcom’s sensors are capable of Bluetooth connections to cell phones. This means parents or loved ones can keep an eye on blood sugars while their kid is at school.

What’s Next for T1Ds

We all hope for a cure.

We only discovered insulin, our regulator, our lifesaver, in 1921.  It’s amazing the progress made in less than a hundred years. Researchers have recently managed to engineer a substance that can act as manufactured insulin for up to six months—one of many steps towards a cure for humans.

In the meantime, we just have to take it one day at a time.