Type 1 Diabetes (cont.)

Doctors have identified that an environmental trigger plays a role in causing the disease. Type 1 diabetes appears to occur when something in the environment -- a toxin or a virus (but doctors aren't sure) -- triggers the immune system to mistakenly attack the pancreas and destroy the beta cells of the pancreas to the point where they can no longer produce sufficient insulin. Markers of this destruction -- called autoantibodies -- can be seen in most people with type 1 diabetes. In fact, they are present in 85% to 90% of people with the condition when the blood sugars are high.

Because it's an autoimmune disease, type 1 diabetes can occur along with other autoimmune diseases such as hyperthyroidism from Grave's disease or the patchy decrease in skin pigmentation that occurs with vitiligo.

What Are the Symptoms?

The symptoms of type 1 diabetes are often subtle, but they can become severe. They include:

  • Increased thirst
  • Increased hunger (especially after eating)
  • Dry mouth
  • Nausea and occasionally vomiting
  • Abdominal pain
  • Frequent urination
  • Unexplained weight loss (even though you are eating and feel hungry)
  • Fatigue (weak, tired feeling)
  • Blurred vision
  • Heavy, labored breathing (Kussmaul respiration)
  • Frequent infections of the skin, urinary tract or vagina

Signs of an emergency with type 1 diabetes include:

  • Shaking and confusion
  • Rapid breathing
  • Fruity smell to the breath
  • Abdominal pain
  • Loss of consciousness (rare)

How Is Type 1 Diabetes Diagnosed?

If your health care provider suspects diabetes, he will first check for abnormalities in your blood (high blood glucose level). In addition, he may look for glucose or ketone bodies in the urine.

There is currently no way to screen for or prevent the development of type 1 diabetes.

How Is Type 1 Diabetes Managed?

Many people with type 1 diabetes live long, healthy lives. The key to good health is keeping your blood sugar levels within your target range, which can be done with meal planning, exercise and intensive insulin therapy. All people with type 1 diabetes must use insulin injections to control their blood glucose.

You will also need to check your blood sugar levels regularly and make adjustment of insulin, food and activities to maintain a normal sugar level.

Consequences of Uncontrolled Diabetes

When diabetes isn't well controlled, a number of serious or life-threatening problems may develop, including:

  • Retinopathy. This eye problem occurs in 75% to 95% of adults who have had diabetes for more than 15 years. Diabetic retinopathy in type 1 diabetes is extremely rare before puberty no matter how long they have had the disease. Medical conditions such as good control of sugars, management of hypertension and regulation of blood lipids are important to prevent retinopathy. Fortunately, the vision loss isn't significant in most people with the condition.
  • Kidney damage. About 35% to 45% of people with type 1 diabetes develop kidney damage, a condition called nephropathy. The risk for kidney disease increases over time and becomes evident 15 to 25 years after the onset of the disease. This complication carries significant risk of serious illness -- such as kidney failure and heart disease.
  • Poor blood circulation. Damage to nerves and hardening of the arteries leads to decreased sensation and poor blood circulation in the feet. This can lead to increased risk of injury and decreased ability to heal open sores and wounds, which in turn significantly raises the risk of amputation. Damage to nerves may also lead to digestive problems such as nausea, vomiting and diarrhea.

Reviewed by Certified Diabetes Educators in the Department of Patient Education and Health Information and by physicians in the Department of Endocrinology at The Cleveland Clinic.
Edited by Brunilda Nazario, MD, WebMD, October 2004.

WebMD Medical Reference

Last Editorial Review: 5/24/2005

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