Type 1 diabetes: symptoms and treatment

What is type 1 diabetes?

Type 1 diabetes develops when the insulin-producing beta cells of the pancreas are damaged by an autoimmune process. As a result, insulin is either not secreted at all or only in negligible amounts.

The disease usually begins before the age of 30 and occurs mainly in children, teenagers and young adults, although it can also appear in middle-aged people with autoimmune diseases. Because the body lacks insulin, patients have to receive insulin from outside for life – which is why type 1 diabetes is also called “insulin-dependent diabetes”.

Type 1 diabetes is not caused by mistakes in the lifestyle of the child or the parents, and it cannot be prevented by diet. So there is no need to blame yourself or your child – what matters is detecting the disease in time and starting the right treatment.

The difference from type 2 diabetes is that in type 2 insulin is produced but does not work well enough. Type 2 is treated with lifestyle changes, oral medicines or insulin, whereas in type 1 diabetes the main treatment is insulin.

Which symptoms should raise concern?

In type 1 diabetes the symptoms of high blood sugar often appear suddenly. How quickly they develop depends on the extent and speed of the damage to the beta cells.

• dry mouth and constant thirst, drinking a lot of water;
• frequent and abundant urination;
• frequent hunger;
• unexplained weight loss;
• fatigue and weakness;
• blurred vision;
• reduced sensation or numbness in the hands and feet.

What should parents watch for?

In children, diabetes is most often seen during puberty – at 10–14 years of age – but it can also develop at a younger age.

A change in a child’s urination can be the first signal. For example, if a child who used to stay dry at night starts wetting the bed again or gets up to use the toilet often at night, pay attention. Together with drinking a lot, losing weight despite a bigger appetite, weakness and blurred vision, these signs call for a blood sugar test.

Without insulin, which regulates energy in the body, fat reserves are used up first and then muscle tissue. That is why a child can lose noticeable weight in a short time and become weak and tired.

Why is ketoacidosis dangerous?

Without insulin, the body is forced to use its own fat and protein reserves to meet its energy needs. The presence of ketones in the urine is a condition that requires insulin treatment to be started immediately.

When fats are broken down, ketone bodies build up in the blood and the blood becomes acidic – this is called diabetic ketoacidosis. It can be the first sign of type 1 diabetes and, if left untreated, can lead to coma.

If the following symptoms appear, do not wait – seek emergency medical help:

• nausea, vomiting and abdominal pain;
• a smell of acetone (fruity smell) on the breath;
• rapid, deep breathing;
• severe weakness, drowsiness, confusion.

How is it treated?

Before insulin was discovered, type 1 diabetes was a severe disease with no treatment. Insulin was discovered in 1921 at the University of Toronto in Canada by Frederick Banting, who was awarded the Nobel Prize for this discovery in 1923.

Insulin treatment is lifelong. Alongside it, healthy eating, physical activity and diabetes education for the patient – and for the parents in the case of children – are also important. Children’s meals should be planned in amounts and proportions that suit their age and stage of development.

Measuring blood sugar regularly, recognising the signs of low blood sugar and changing the insulin dose only on your doctor’s advice are key conditions for successful treatment.

If your child has diabetes, inform the kindergarten or school staff: they should recognise the signs of low blood sugar and know what to do in that situation.