When 80% of the insulin-producing cells in the pancreas are destroyed, the remaining insulin is not enough to break down sugar.
Within days or weeks, typical symptoms of type 1 diabetes then appear:
- Unquenchable thirst
- Excessive urination
- Weight loss
- Exhaustion
- Frequent infections
As metabolic imbalance worsens, it can lead to a coma. A ketone-like odor on the breath may also indicate type 1 diabetes.
Image source: Mikael Häggström, CC0, via Wikimedia Commons
Many possible causes have been discussed to date regarding the development of the disease (genetic, environmental, and dietary factors). However, there are no definitive findings as of yet.
How does a lack of insulin lead to elevated blood sugar levels?
Insulin is a hormone produced by the beta cells in the pancreas and released into the bloodstream. Insulin plays a crucial role in regulating blood sugar. It is the only hormone in the body that lowers blood sugar levels.
Insulin controls carbohydrate metabolism and ensures that the liver or muscles take up, utilize, or store blood sugar. Therefore, insulin inhibits the liver’s production of glucose. When energy demand is high (due to stress, exercise, or fever), the body can ensure that the organs are supplied with glucose as fuel. If this delicate interplay of hormones becomes unbalanced, blood sugar levels rise. In this case, the condition is referred to as diabetes mellitus—sugar disease.
Specialists in the treatment of diabetes are physicians in the field of diabetology. To diagnose diabetes mellitus, doctors perform a blood sugar test.
The fasting blood sugar level (when measured repeatedly) and the HbA1c level are key indicators. The HbA1c level reflects the long-term blood sugar level. Doctors also use an oral glucose tolerance test for diagnosis. In this test, the doctor measures changes in blood glucose levels after the patient has drunk a glucose solution.
Because the disease manifests relatively quickly, people with type 1 diabetes are usually identified by significantly elevated blood glucose levels. Often, patients also already have pronounced symptoms that indicate the disease. In addition to elevated blood sugar levels, specific autoimmune markers are frequently found in the blood of people with type 1 diabetes. This allows the condition to be distinguished from other forms of diabetes, which is important for treatment.
The short-term treatment goal for type 1 diabetes is to prevent metabolic complications and alleviate the associated symptoms. This means avoiding severe spikes in blood sugar levels or episodes of hypoglycemia.
Since type 1 diabetes is characterized by a lack of insulin, patients receive insulin as treatment. This is typically administered via injections or an insulin pump. In addition, doctors may use procedures such as natural islet cell transplantation in individual cases.
Researchers are also working on experimental treatment methods (“artificial islet organ”). The long-term goal of insulin therapy is to prevent complications.
Possible complications include damage to:
Diet plays a major role for patients with type 1 diabetes. How much insulin they inject and when depends on their meals. A proper and mindful diet is therefore a lifelong part of diabetes management.
Islet Cell Transplantation
Islet transplantation is a form of treatment that involves transferring insulin-producing cells (“islets”) from a donor organ.
Who is eligible?
Patients (primarily those with type 1 diabetes) for whom insulin injections or insulin pumps are insufficient and who continue to suffer from severe hypoglycemic episodes.
How are the islets isolated and transplanted?
Experts isolate the islets from a donor organ through a complex digestion process. The islets are tested according to strict criteria such as purity, sterility, and function. Doctors then infuse the islets into the patient’s liver via the hepatic vein. There, they settle and begin producing insulin.
What happens after the transplant?
The recipient’s immune system recognizes the transplanted cells as “foreign.” This would normally result in rejection of the transplant. To prevent this, islet recipients must take immunosuppressive medications.
The primary therapeutic goal of islet cell transplantation is to restore the body’s own insulin production and stabilize glucose metabolism. In some cases, insulin independence for several years is even possible.
Type 1 diabetes is a complex condition characterized by low insulin levels and the inability to properly regulate blood sugar. The disease develops because the insulin-producing beta cells in the pancreas are destroyed and can no longer produce sufficient insulin. The first signs often develop during childhood and adolescence, which is why many children are affected by diabetes and the term “juvenile diabetes” is used. When type 1 diabetes is diagnosed, immediate treatment is necessary to prevent complications such as diabetic ketoacidosis.
The diagnosis of diabetes is based on typical symptoms and laboratory test results, with symptoms often appearing suddenly and providing clear indications of the condition. People with type 1 diabetes must learn to actively manage their daily lives, as proper management of the condition is crucial. In contrast to type 2 diabetes, this is a different form of the disease, while variants such as “latent autoimmune diabetes” or “autoimmune diabetes in adults” represent specific subtypes.
In this condition, type 1 diabetes results from an abnormal immune system response that attacks cells in the pancreas. This damages the pancreatic cells, preventing insulin production. Type 1 diabetes is therefore characterized by an absolute insulin deficiency, as the pancreas no longer produces sufficient insulin. People with type 1 diabetes—and people with diabetes in general—are therefore permanently dependent on insulin. This is particularly relevant for the approximately 3,700 children and adolescents who are newly diagnosed each year.
The causes of type 1 diabetes are not yet fully understood, but genetic and environmental factors play a role. Studies such as those published in *Diabetes Care* show that the disease is on the rise worldwide, particularly among children and adolescents. Type 1 diabetes usually develops rapidly and can be diagnosed within a short period of time.
For those affected, living with diabetes means continuously monitoring blood sugar levels and adjusting treatment, as more insulin is needed when more sugar is consumed from food. Early detection of potential symptoms indicates diabetes and enables prompt treatment. Although the condition is incurable, type 1 diabetes can be managed so that those affected can live well and understand that type 1 is a chronic but manageable condition.
What is Type 1 diabetes?
Type 1 diabetes is an autoimmune disease in which the insulin-producing beta cells in the pancreas are destroyed. This results in an absolute insulin deficiency, which is why people with type 1 diabetes require insulin for the rest of their lives.
What are the symptoms of Type 1 diabetes?
Typical symptoms include extreme thirst, frequent urination, weight loss, fatigue, and elevated blood sugar levels. These symptoms often appear suddenly in Type 1 diabetes.
How is type 1 diabetes mellitus diagnosed?
Diabetes is diagnosed based on blood glucose levels, HbA1c levels, and the detection of antibodies. Once type 1 diabetes is diagnosed, treatment usually begins immediately.
How is type 1 diabetes treated?
Type 1 diabetes is treated with insulin therapy. Insulin is administered via injection or an insulin pump to keep blood sugar levels stable.
Is type 1 diabetes curable?
Type 1 diabetes is currently incurable. However, with effective treatment, regular monitoring, and appropriate medical care, people with diabetes can lead largely normal lives.
