Type 1 diabetes
develops because the body destroys the beta cells in the islet tissue of the
pancreas that produce
insulin. The rate at which the beta cells are
destroyed varies. Infants and children usually develop the disease suddenly
because the beta cells are destroyed rapidly. Adults tend to develop the
disease slowly because the beta cells are destroyed gradually.
Sometimes people notice diabetes symptoms after an illness, such as the
flu. If they do not seek medical care quickly, the lack of insulin can cause
the blood sugar level to rise much higher than normal. The body then uses fat
and muscle for energy, which causes the release of
ketones, or fatty acids. Ketones can lead to a
chemical imbalance called
diabetic ketoacidosis. It is a medical emergency.
Symptoms of diabetic ketoacidosis include confusion; strong, fruity breath; and
drowsiness, or even coma.
Sometimes after receiving initial
treatment for type 1 diabetes, people have a period of time-from a few weeks to
a few months-when the pancreas is again able to produce insulin. This is often
called the "honeymoon period." At this time, a person may need to take little
or no insulin, depending on how much insulin the pancreas produces. When the
honeymoon period is over, the person needs to take insulin for the rest of his
or her life.
Every person who has type 1 diabetes requires
treatment designed for his or her needs. Treatment involves:
People with type 1 diabetes often have blood sugar levels
outside of their
target range. These out-of-range levels happen because
injections of insulin cannot control blood sugar as smoothly as natural insulin
made by your body. Blood sugar below a normal range (hypoglycemia) can develop
quickly and lead to an emergency in only a few minutes. On the other hand, high
blood sugar levels (hyperglycemia) usually develop slowly over hours or days.
If blood sugar levels continue to rise, diabetic ketoacidosis can
Over time, diabetes can damage the body's tissues.
Persistent high blood sugar can damage the eyes (diabetic retinopathy), kidneys
(diabetic nephropathy), nerves (diabetic neuropathy), and heart (leading to
heart attacks). It also can damage blood vessels,
strokes and blockage of other arteries, especially in
the legs. People who keep their blood sugar levels within a target range often can prevent-or at least delay-these complications. But some
people still develop complications even with good blood sugar control.
People who work closely with their doctors and follow their prescribed
treatment usually feel better and more in control of their lives.
Planning pregnancy when you have type 1 diabetes
Women who want to
plan a pregnancy need to talk to their doctors about
making sure they have good control of their blood sugar. Blood sugar levels that are higher than the target range during the first trimester of pregnancy raise the risk of
birth defects. Good care of diabetes before conception appears to reduce the
risk of birth defects.
Women with diabetes who do not want to be
become pregnant should use birth control. This reduces the risk of birth
defects in unplanned pregnancies.