Type 1 Diabetes Demystified

Type 1 diabetes is a complex and often misunderstood condition that affects millions worldwide. In this article, I hope to demystify some of the hidden intricacies of living and caring for a person with type 1 diabetes and maybe even bust a few myths about this invisible condition!


pin for type 1 diabetes demystified showing an insulin bottle and syringes

Imagine a world where your body waged a silent, relentless war against itself. Where your own immune system blindly attacks the very cells that keep you alive. This is the reality for those living with type 1 diabetes, a complex and often misunderstood disease that affects millions worldwide.

By demystifying this silent disease, I hope to empower you with the knowledge to be more aware and provide the support that will make a difference in the lives of those affected by type 1 diabetes.

In this article, I will explain some of the intricacies of type 1 diabetes. Delving into some of the daily challenges faced and the significance of managing blood sugar levels. I am not medically trained, but I am a parent that has cared for a child living with type 1 diabetes for a few years. So this is my perspective from all that I have learnt and experienced as a type 1 mum.


The Basics of Type 1 Diabetes

To truly understand the complexities of type 1 diabetes, it is crucial to grasp the fundamental aspects of this invisible condition.

Type 1 diabetes is an autoimmune disease that occurs when the body’s immune system mistakenly attacks and destroys the beta cells in the pancreas. These beta cells are responsible for producing insulin, a hormone that plays a vital role in regulating blood sugar levels.

Without insulin, our bodies are unable to move the energy from carbohydrates (glucose) and release the glucose from our blood cells. So why is this a problem? If our body stores glucose in our blood cells, our glucose levels rise. If this continues over a considerable period of time it will damage nerves, blood vessels and vital organs.

Survival and day to day management have improved considerably due to the continued progress in medical research and technology. However, a cure for type 1 diabetes is yet to be found. Nevertheless, I should point out that there are still many in the UK and around the globe who can not access advanced diabetes treatments and management tools due to lack of availability and high costs.

cell under a microscope

How do you get Type 1 Diabetes?

This is all still a bit of a mystery, which is amazing, considering it’s believed that the history of the condition goes as far back as the Egyptians around 1550 BC! Unsurprisingly significant medical progress has been made since then and despite known genetic associations, most people who are diagnosed with type 1 diabetes do not have other cases in the family.

However, we do know that you DO NOT get any form of diabetes from eating too much sugar! and an important difference when understanding type 1 is:

There are no lifestyle changes you can make to lower your risk of type 1 diabetes” (NHS. UK).

Unlike type 2 diabetes, which is often associated with lifestyle factors, type 1 diabetes is not preventable or caused by lifestyle choices. Whilst the exact cause of type 1 diabetes remains unknown, researchers believe that a combination of genetic and environmental factors may trigger its onset.


Recognising the signs of Type 1 Diabetes

Recognising and getting to the point of diagnosis is not always clear cut with type 1 diabetes. In our case, we kept wondering why our daughter was losing weight and was more lethargic than normal. I still kick myself today as to why I waited so long to call the doctors when she was so poorly. But we just didn’t connect the dots and simply put it down to a growth spurt as she was entering her teens.

Symptoms can present themselves quickly in children but there are some key signs to look out for.

Type 1 diabetes symptoms:

  • Going to the toilet a lot, especially at night
  • Being really thirsty
  • Feeling more tired than usual
  • Losing weight without trying to
  • Genital itching or thrush
  • Cuts and wounds take longer to heal
  • Blurred eyesight
  • Increased hunger

If you are unsure always seek a professional like your GP, as a simple blood sugar and urine test can clearly identify high blood glucose levels.


The Different Types of Diabetes

There are 11 different types of diabetes listed on Diabetes UK. Most people are more aware of type 2 diabetes, which, in 2021, accounted for 90% of all diabetes prevalence. (Lancet 2023).

The 11 types of Diabetes are:

  • Type 1 Diabetes
  • Type 2 Diabetes
  • Gestational Diabetes
  • Diabetes LADA
  • Diabetes MODY
  • Type 3c Diabetes
  • Steroid Induced Diabetes
  • Neonatal diabetes
  • Wolfram Syndrome
  • Alström Syndrome
  • Cystic fibrosis diabetes

By better understanding, the many types and the different ways people learn to live with diabetes, helps us to stop the generalisation and common misinformation around this condition.


Day to day management of Type 1 Diabetes

Living with type 1 diabetes presents a unique set of challenges on a daily basis. The most notable among these challenges is the need for constant blood sugar management. Since their bodies no longer produce insulin, people with type 1 diabetes must rely on external sources of insulin, such as injections or an insulin pump, to maintain stable blood sugar levels.

There are so many factors to consider when managing type 1 on a daily basis. In fact, there are over 40 things that can affect blood glucose levels from; food consumed, to activity, illness, hormones, stress and even the weather outside! Unsurprisingly this makes management tricky and sometimes we can get it wrong because we just don’t know what on earth is going on. But that’s OK!

However, in order to simplify this, the key measures that have to be monitored regularly throughout the day are:

  • Blood Glucose Levels
  • Insulin Levels
  • Carbohydrate Counting

We will now look at each of these in a little more detail.


Blood Glucose Levels

A person checking thier blood glucose levels via a CGM on thier phone.

It is essential that a person with diabetes measures and keeps track of their blood glucose levels. This can be done through a finger prick test or using a Continuous Glucose monitor (CGM) which is worn on the body.

This regular monitoring of blood sugar levels allows individuals to make informed decisions about their insulin dosage, diet, and physical activity to help maintain control. And thankfully diabetes technology just keeps getting better. In the UK this is now available to all people living with type 1 diabetes. This has made monitoring easier and less painful for my daughter’s fingers, however, it can be a double-edged sword in that it does become all-consuming.

Keeping in range is really hard work and can be mentally exhausting.

Keeping blood sugar levels within a target range is crucial for individuals with type 1 diabetes to maintain their health and well-being. The NHS recommendation is between 4-8 mmol/L. As a reference, a non-diabetic person’s range is between 3.5 and 5.5 mmol/L. When blood sugar levels are consistently too high or too low, it can lead to a range of complications and impact daily life in significant ways.

2 common terms used to describe these extremes in blood glucose levels are, hyperglycaemia and hypoglycaemia

Hyperglycaemia

This is when blood glucose levels are too high and above the recommended thresholds. Left untreated it can make you feel very unwell, impact concentration and you will start to have symptoms as listed above.

Hypoglycaemia

This is when blood glucose levels fall below 3.9 and will need to be treated with a fast-acting carbohydrate like sugary sweets, glucose tablets or a sugary drink. The risk, as with hyperglycaemia, if left untreated is a diabetic coma. Again there are many signs you may feel when you are experiencing a “hypo” from shaking, blurred vision, sweating, and dizziness to name but a few.

Managing blood sugar levels requires a delicate balance and constant attention. Individuals with type 1 diabetes must be vigilant about monitoring their levels and making adjustments as necessary throughout the day. It can be challenging, as factors such as stress, illness, and hormonal changes can impact blood sugar levels unpredictably. Nevertheless, by closely managing their blood sugar, individuals can help prevent immediate complications and reduce the risk of long-term health issues.


Insulin Levels

A person with type 1 diabetes has to physically provide their body with insulin. Insulin is essential as it helps regulate the amount of glucose in the bloodstream, allowing cells to absorb and use it for energy. For many individuals, this involves multiple daily injections or using an insulin pump.

How this is managed, the quantities of insulin needed and delivered are totally unique to every type 1 individual.

In our case, my daughter moved from daily injections (which were easily 10 plus a day) to an insulin pump. This then delivers the insulin requirements through a tube that is connected via a small cannula in her stomach. with more delivery mechanisms available for a person with type 1, it’s about figuring out what suits that individual best.

Individuals with type 1 diabetes must be vigilant about monitoring their insulin levels, considering any movement/exercise after insulin has been delivered and making adjustments as necessary throughout the day.


Carbohydrate Counting

“Knowing how many carbs you’re eating and drinking helps you manage your blood glucose levels by matching your insulin dose to the amount of carbs in your meals and snacks.” (NHS.UK)

In order to manage blood glucose levels and know how much insulin is required it’s important to carb count as accurately as possible. Understanding how different carbohydrates impact your blood sugar levels allows people living with diabetes to make informed choices about their diet and maintain glucose control.

However not all carbs are the same, we all respond differently to different types of carbohydrates which can make this task particularly challenging.

carbohydrates are found in the following foods:

  • Grains (bread, pasta, cereals)
  • Fruits
  • Vegetables
  • Root crops (potatoes, sweet potatoes, and yams)
  • Most alcoholic drinks ( Beer, cider, lager, most cocktails)
  • Desserts and sweets
  • Most dairy products, except cheese,
  • Sugars including sucrose, fructose, dextrose, maltose

What is Diabetic Carb Counting and why is it important?


Diabetic carb counting involves determining the amount of carbohydrates consumed in meals and snacks throughout the day. Since carbohydrates have a direct impact on blood sugar levels, monitoring and adjusting their intake becomes an essential part of daily life for those living with diabetes.


Carb counting empowers you to tailor and accurately dose insulin. However, there are quite a few factors to consider when deciding on how much insulin to give with meals and snacks. This ranges from knowing your unique carb-to-insulin ratios, which can be different throughout the day, to differentiating between types of carbohydrates, what you are eating with the carbohydrate and if you are planning any activities after that meal.

By understanding the relationship between carbs and blood sugar fluctuations, you can achieve better glycemic control while enjoying a varied and balanced diet. For some this could be, choosing a low carb diet, making some changes that will reduce the carb content of a meal or just eating carbs as and when you want. Again it’s about learning what works best for each individual which I discuss in more detail in the article below.

picture of a muffin and fruit to represent the diabetic diet

The Diabetic Diet – Does it exist?

Navigate through the confusing landscape of the ‘diabetic diet’ by separating fact from fiction. This article delves into the concept of the “diabetic diet”, our food journey and considers finding balance in the food we eat.

The Mental toll of managing type 1 Diabetes

The complexities of type 1 diabetes extend way beyond just the physical aspects it takes on those living or caring for a person with diabetes. While the constant monitoring and management of blood sugar levels are the main focus, the emotional and mental well-being of this can not be overlooked.

The continuous fear of hypoglycemic or hyperglycemic episodes can lead to a heightened sense of anxiety and stress. All of which makes it harder to navigate daily life. Moreover, the need for constant vigilance over health can sometimes result in a sense of isolation and an inability to fully engage in various activities. This can be particularly hard for children as they don’t have the emotional development to fully grasp this.


Impacts on Daily Life

To maintain stable blood sugar levels, individuals with type 1 diabetes must carefully consider every aspect of their daily routine. They need to track the carbohydrates consumed in each meal and the corresponding insulin dosage required to maintain glucose range.

Lifestyle adjustments play a crucial role in managing blood sugar levels as well. Diet is really important and finding that balance of consuming a good mix of carbohydrates, proteins, and fats in appropriate portions. This helps regulate how quickly glucose enters the bloodstream. you can read more about this in the article below

picture of friends supporting each other

Our Diabetes Management Toolkit

Living with and/or caring for a person with type 1 diabetes is demanding, which is why it’s so important to create a diabetes management toolkit that can help you every day.

Physical activity also plays a role, as exercise can both lower blood sugar levels in the short term and increase insulin sensitivity in the long term. Therefore, again it’s about finding that balance between fueling your body appropriately for physical activity and avoiding dangerous drops in blood sugar levels.

The meticulous management of type 1 diabetes is demanding and time-consuming. It requires constant attention and a commitment to self-care. How a person living with type 1 diabetes chooses to manage their condition is totally individual. It is not a one size fits all.

However, by closely managing their blood sugar, individuals can help prevent immediate complications and reduce the risk of long-term health issues.


In conclusion

Understanding the basics of type 1 diabetes is the first step in demystifying this complex condition. Appreciating the constant effort required allows us the opportunity to further empathise with the daily challenges faced.

As with many invisible conditions and illnesses, a person caring for or living with type 1 and can feel frustration, guilt, exhaustion and embarrassment to name but a few of the emotions. So next time someone tells you that they are living with type 1 diabetes, maybe show them some compassion and share what you have learnt in this article. But most importantly listen to them, as they are by far the experts in their own condition.

Sources

DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018). Type 1 diabetes. The Lancet, 391(10138), 2449–2462. doi:10.1016/s0140-6736(18)31320-5

www.diabetes.co.uk/diabetes-history

www.nhs.uk/conditions/diabetes

www.diabetes.org.uk/diabetes-the-basics/diabetes-symptoms

www.diabetes.co.uk/diet/carbohydrate-counting.html

Type 1 Diabetes in children, adolescents and young adults, 7th edition by Dr Ragnar Hanas

www.nwpc.com/supporting-people-with-invisible-illness/

Diabetes: a defining disease of the 21st Century

Michelle Rorke avatar

AUTHOR

2 responses to “Type 1 Diabetes Demystified”

  1. Kadi avatar

    Wow! Thanks Michelle
    This is such an eye opener. I never knew much about the different types of diabetes and how they work and attack the body. Thanks for sharing.

    1. Michelle avatar

      Thanks Kadi I am glad that you took something from it.

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