Out of the nearly 37 million Americans affected by diabetes, only 5–10% have type 1 diabetes (T1DM). Unlike type 2 diabetes — which most often occurs in older adults and is preventable –– type 1 diabetes is a chronic (life-long) autoimmune condition seen mostly in children, teenagers and young adults that causes people’s bodies to stop making insulin entirely. Although it has been referred to as “juvenile diabetes,” T1DM can present at any age.

Insulin, a hormone made by the pancreas, is important because it allows the body’s cells to use and store sugar from carbohydrates as energy. In someone with T1DM, the body’s immune system begins attacking itself and destroying the insulin-producing beta cells. When that happens, insulin is prevented from entering the cells. With nowhere else to go, insulin backs up into the bloodstream — creating what is known as high blood sugar. Left untreated, this could seriously damage the body’s organs.

Unfortunately, no one knows how to prevent T1DM, but some scientists think it’s caused by genes and environmental factors, such as viruses, that might trigger the disease. Scientists don’t believe that diet and lifestyle habits cause T1DM.

What are the symptoms?

According to the Centers for Disease Control and Prevention (CDC), it can take months or years before symptoms of T1DM are noticed, but once they do, they can develop quickly and be severe. If you are experiencing any of the following symptoms, the CDC recommends seeing your doctor to get your blood sugar tested:

• Urinate (pee) a lot, often at night.
• Are very thirsty.
• Lose weight without trying.
• Are very hungry.
• Have blurry vision.
• Have numb or tingling hands or feet.
• Feel very tired.
• Have very dry skin.
• Have sores that heal slowly.
• Have more infections than usual.

Other symptoms may include nausea, vomiting or stomach pains. 

Testing for type 1 diabetes

The CDC lists the following tests for T1DM.

Fasting blood-glucose test ⁠
⁠This blood test is typically conducted in the morning after fasting overnight. The fasting allows doctors to see how the body manages blood sugar levels without the impact of food intake.

Oral glucose tolerance test ⁠
⁠Following a fasting blood-glucose test, a doctor may order an oral glucose test. For this test,  you drink a sugary drink and then your blood sugar is monitored for the next couple of hours. This test shows your baseline sugar level and then measures how the body responds to carbohydrate (sugar) intake.

Random blood-glucose test ⁠
⁠This test measures your current blood sugar regardless of when you ate, so no fasting is required. Sometimes, this may be the first test you do.

Glycated hemoglobin (HbA1c) test ⁠
⁠The hemoglobin A1c test is a blood test that shows your average blood-sugar level for the past two to three months and is the most comprehensive. 

Your doctor may also test your blood for autoantibodies, which would indicate if your body is attacking itself — an indicator of type 1 diabetes but not type 2. You may also have your urine tested for ketones. If you have T1DM, your body may produce high amounts of ketones because it is burning fat for energy instead of sugar.

Managing type 1 diabetes

Although there is no cure, T1DM is very treatable. When you receive a diagnosis, you and your primary care physician (PCP) will put a treatment plan in place and meet regularly. That plan could include help from others doctors, such as: 

• Foot doctor.
• Dentist.
• Eye doctor.
• Registered dietitian nutritionist.
• Diabetes educator.
• Pharmacist.

Although you will have a care team, diabetes is managed mostly by you. 

To keep your blood sugar stable, you’ll need to take insulin shots (or wear an insulin pump) every day. You’ll also need to check your blood sugar regularly. Your doctor will tell you what your target blood sugar level is and how often to check it. According to the CDC, type 1 diabetics typically check their blood sugar anywhere between four to 10 times a day. Keeping your blood sugar levels as close to normal as possible will help you prevent or delay diabetes-related complications, such as damage to organs including the heart, blood vessels, nerves, eyes and kidneys.

Your doctor will continue to monitor your blood sugar levels and will check your A1C levels two to three times per year. Your target A1C goal may vary depending on your age and other factors. The American Diabetes Association generally recommends that A1C levels be below 7%, or an average glucose level of about 154 mg/dL (8.5 mmol/L). A high A1C level may mean you need to change your insulin amount, diet or both. Your doctor will also put in orders for blood and urine samples to check cholesterol levels, as well as thyroid, liver and kidney function. 

Stress can make it hard to manage diabetes, so it’s important to get support from people who care about you, such as family, friends, teachers, neighbors and others in your life. Though managing diabetes can be challenging, your health is worth it.

Healthy lifestyle habits are also important. In addition to insulin shots and blood sugar checks, you’ll also be encouraged to:

• Make healthy food choices.
• Be physically active.
• Monitor your blood pressure.
• Monitor your cholesterol.

Though T1DM is treatable, it’s a chronic condition that needs to be taken seriously. Left untreated, it can be life-threatening. It’s important to make regular appointments with your healthcare team and to stay on track with your treatment plan.

Number of people with type 1 diabetes expected to increase

HealthTap’s Chief Medical Officer and Co-founder Dr. Geoffrey Rutledge recently wrote an article reporting on a new T1DM modeling study published in The Lancet. 

According to The Lancet, 8.4 million people across the world live with type 1 diabetes, and that number is expected to double to 17.4 million by 2040.

Dr. Rutledge wrote: “The burden of T1DM is significant and is expected to increase rapidly, especially in resource-limited countries. In the United States, insulin remains overpriced, adding to the growing crisis. The type 1 Diabetes Index model will be made publicly available, and we expect it will be an important tool to support health delivery, advocacy, and funding decisions for T1DM.”

The increasing prevalence of T1DM is of particular concern for low- and lower-income countries where delivery of care is suboptimal. 

Because little is known about how to prevent T1DM, early diagnosis and intervention are key. In light of steady increases in the number of people diagnosed with diabetes (both type 1 and type 2), The World Health Organization created several initiatives, including the Global Diabetes Compact, which aims for “sustained improvements in diabetes prevention and care, with a particular focus on supporting low- and middle-income countries.”

HealthTap can help

Regardless of whether you’re concerned about symptoms, or if you’ve already been diagnosed with type 1 diabetes, HealthTap doctors can help. We can:

• Order labs and tests to determine if you have type 1 diabetes.
• Recommend a prevention or management plan that’s right for you.
• Prescribe insulin and send it to your nearest pharmacy.
• Check in with you regularly — including free, post-visit follow-up text messages — to make sure your plan is on track.

Talk to your doctor or sign up for HealthTap today to get started.