What is Type 1 Diabetes?

Dear Reader,

I will be blogging about my daughter’s diabetes a lot so it seems wise to get some basic facts out of the way up front. I am sure others have done a more thorough, better job of explaining all this but here is my take.

Diabetes is the name used for a few similar diseases all of which affect the body’s insulin production. Insulin is a hormone which the body needs to get glucose (sugar) into cells. If the cells can’t get the sugar, they don’t have energy. They can’t do anything. So insulin is very necessary. It is like a key that unlocks the cells so the glucose can get in. Your body converts all carbohydrates into glucose to use as energy.

For centuries, doctors lumped all diabetes together. They saw differences in cases but didn’t distinguish different diseases. More recently, as the causes of various types have become better known, they have made distinctions. The two main types are called type 1 and type 2. (There are other even rarer types too.) Type 2 accounts for about 90% of cases. It has a genetic component but also can be related a lot to lifestyle. In type 2, the body gets worn out from making too much insulin and can’t keep up. It stops making enough and also can’t use what it has effectively enough. This is the type that gets a lot of media coverage. It can often be controlled, at least for a time, by lifestyle changes or oral medication. If you live long enough with type 2, there is a good chance you will need to start using insulin too.

Type 1 accounts for 10% of diabetes. It is also known as juvenile (versus adult-onset which is type 2) or insulin-dependent diabetes. Many of us with kids with type 1 think it should have a completely new name like “acute pancreatic failure” because we are tired of people thinking what our kids have is the same as what their grandpa had. Type 1 usually appears by age 35 (hence the juvenile bit). It is an autoimmune disease. The body’s immune system kills off the beta cells in the pancreas that produce insulin. Those cells are dead. They cannot come back to life. The body now makes no insulin. If it does not get insulin from outside (ie shots or an insulin pump), it will waste away and die. This is what happened to everyone with type 1 before the 1920s when insulin was discovered. This is why type 1 is called “insulin-dependent.” People with it cannot live for long without supplemental insulin. Though it is called juvenile, it is not something just kids have. It cannot be outgrown. Unless a cure is discovered, our kids will have it all their lives. Though the discovery of insulin allows our kids to live relatively normal lives, they are not cured. Our healthy bodies do an amazing job of giving us the insulin we need when we need it. The best control we can achieve with shots of artificial insulin are a poor imitation of this. Managing type 1 diabetes is a constant balancing act. Too little insulin leads to long term complications like damage to the eyes, nerves, and kidneys. Too much insulin causes the blood sugar to go too low and can lead to confusion, seizures, and even death. The variables that affect how much insulin one needs are many and (at least in growing children) constantly changing.

That’s my brief intro to what type 1 diabetes is. Coming soon: what I wish family and friends understood about my dd’s diabetes.



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