Type 1 diabetes is an autoimmune condition
Type 1 diabetes is not preventable, and there is no cure. Type 1 diabetes occurs when the body’s immune system makes a mistake and attacks the cells of the pancreas that produce insulin. These are known as beta cells. Insulin helps our body to use glucose as energy. Glucose is our body's preferred energy source, like the petrol you put in the car. Insulin's role is to unlock the body's cells to allow the glucose to move from the blood stream into the cell so it can be used as an energy source. Without insulin the glucose cannot get into our cells, and instead builds up in the bloodstream.
We do not know what causes this autoimmune attack, but a combination of genetic and environmental factors appears to play a part. The attack on the beta-cells can happen gradually over several months or years. By the time symptoms of type 1 diabetes occur, approximately 70-80% of beta-cell function is already lost. Therefore, early diagnosis by a GP is critical because once all beta-cell function is destroyed, the body no longer produces insulin and insulin injections are essential to survive.
People diagnosed with type 1 diabetes are prescribed insulin either via multiple insulin injections each day, or with an insulin pump.
Diet and lifestyle factors do not contribute to type 1 diabetes development, but a healthy diet is important to manage the condition.
Type 1 diabetes symptoms develop quickly over a few days or weeks and can be life-threatening if left untreated
The four T's describe the common symptoms of type 1 diabetes, Tiredness, Thirsty, Toilet, Thinner. Without insulin, the body cannot use glucose as an energy source from our food, so an individual with undiagnosed type 1 diabetes often feels very tired. As the body tries to get rid of glucose from the bloodstream by flushing it out in the urine, an individual may need to go to the toilet more often and becomes thirstier. Rapid weight loss can also occur over a short period of time because the body starts to break down fats to use as an alternative energy source. Temporary blurred vision may also be experienced as elevated glucose levels in the blood change the shape of the lens in the eye.
The most serious symptoms of undiagnosed type 1 diabetes include fruity-smelling breath, stomach pain, nausea and vomiting, deep, rapid breathing, drowsiness, or loss of consciousness which occur due to Diabetic Ketoacidosis (DKA). In the absence of insulin, ketones are produced due to the breakdown of fat and they build up in the blood stream becoming toxic. DKA is life-threatening if left untreated.
If you or a loved one are experiencing any of these symptoms, seek medical attention immediately.
Ten people are diagnosed with type 1 diabetes each day across Australia
Over 127,000 people live with type 1 diabetes across Australia (9.1% of the national population). While most (60%) new type 1 diabetes cases occur in children and young people aged under 25 years, they can occur at any age. Type 1 diabetes does not discriminate, and incidence rates are similar regardless of socio-economic status, remoteness, ethnicity, and Aboriginal or Torres Strait Islander status.
The diagnosis of type 1 diabetes is usually made after investigation by a GP, when an individual presents with symptoms of the 4T's – i.e., Tiredness, Thirsty, Toilet, Thinner. A GP may request an individual have an initial random fasting blood glucose test, followed-up with a glycated-haemoglobin (HbA1c) blood test (an indicator of average blood glucose management over the past three months) to confirm the diagnosis. The GP may also order blood tests to check for specific antibodies (commonly IA-2A, GADA, and Zinc Transporter 8) indicating an immune attack on the beta cells.
Latent autoimmune diabetes (LADA) is a slow-progressing form of type 1 diabetes often misdiagnosed as type 2 diabetes. LADA is diagnosed during adulthood and usually has a slower onset, in some cases not requiring insulin in the early stages. LADA can be differentiated from type 2 diabetes through antibody testing to identify the autoimmune origin of the diabetes.
The long-term complications of living with type 1 diabetes can be delayed or prevented with optimal diabetes management
Over time, elevated blood glucose levels can lead to a range of complications, including increased risk of heart attack or stroke, kidney disease, vision loss, poor circulation, nerve damage, and limb amputation. Living with type 1 diabetes can also affect mental health, leading to diabetes distress or burn-out, depression, and anxiety. Twenty-eight percent of people living with diabetes worry about the future and the possibility of diabetes-related complications.
The good news is the long-term effects can be delayed or prevented with optimal diabetes management, and achieving or maintaining blood glucose levels as close to target as possible. Diabetes management takes a team. Whether it be your GP, diabetes specialist (endocrinologist), diabetes educator, dietitian, exercise physiologist, podiatrist, optometrist or psychologist, there are a range of health professionals to support you and your diabetes management.
If complications do develop, early detection, diagnosis, and treatment is essential to reduce further complications and maintain quality of life. Your diabetes annual cycle of care outlines the range of checks recommended each year to monitor all areas of your health and wellbeing. If you're not sure where to start, speak with your diabetes educator for information and support.
A person living with type 1 diabetes will face up to 180 diabetes-related decisions every day: that's 65,000 extra decisions each year
What is my blood glucose level? Do I need to take insulin? How much carbohydrate is in my lunch? Do I need to have something to eat before I go for a run? Did I give my insulin already? Am I feeling shaky because I'm hungry, or are my glucose levels low? Did I pack my hypo treatment?
Living with type 1 diabetes requires a lot of day-to-day self-management and engagement to achieve and maintain optimal glucose levels and prevent long-term complications. Whether it be blood glucose monitoring, carbohydrate counting, insulin dosing, adjusting for exercise, illness, or stress, there are many decisions and thoughts related to diabetes every day. Making so many decisions can be taxing and challenging to sustain over a long time. Twenty-three percent of people living with type 1 diabetes report feeling burnt-out by the constant effort required to manage diabetes.
Diabetes distress or burn-out is the term used to describe the emotional stress associated with living with diabetes. It can lead to less engagement with day-to-day diabetes management activities and elevated glucose levels, which may increase risk of diabetes complications. If this sounds like you or a loved one, remember there is support available. Talk to your family or friends, others living with type 1 diabetes, or seek professional support from any member of your healthcare team.