Type 1 diabetes living patient overview

Overview

Type 1 diabetes is a lifelong condition where your body’s immune system mistakenly attacks the cells in the pancreas that make insulin. Insulin is a hormone that helps sugar from food enter your cells to be used for energy. Without insulin, sugar builds up in your blood, which can cause serious health problems. People with type 1 diabetes need to take insulin every day to manage their blood sugar levels.

Type 1 diabetes is less common than type 2 diabetes. About 5–10% of all diabetes cases are type 1. In the UK, around 400,000 people have type 1 diabetes.

Type 1 diabetes can develop at any age, but it is most often diagnosed in children, teenagers, and young adults. It affects people of all ethnic backgrounds, and slightly more males than females.

Symptoms

Common symptoms

• Feeling very thirsty and drinking more than usual
• Urinating (peeing) much more often, especially at night
• Losing weight without trying
• Feeling very tired and weak
• Blurred vision

Symptoms in children

• Bedwetting after being dry at night
• Irritability or mood changes
• Slow healing of cuts or infections
• Fruity-smelling breath (a sign of high ketones)

Symptoms in older adults

• Symptoms can be less obvious and may be mistaken for other conditions
• Recurrent infections, such as skin, urinary tract, or yeast infections
• Slow healing of wounds
• Unexplained weight loss

Causes

Main causes

• Type 1 diabetes is caused by an autoimmune reaction where the body’s immune system destroys the insulin-producing beta cells in the pancreas.
• The exact trigger is unknown, but it likely involves a combination of genetic factors and an environmental trigger, such as a viral infection.

Risk factors

• Family history: having a parent or sibling with type 1 diabetes increases the risk.
• Genes: certain gene variants (HLA types) are linked to a higher risk.
• Geographical location: type 1 diabetes is more common in countries farther from the equator.

When to see a doctor

See a doctor urgently if:

• If you or your child have symptoms of very high blood sugar (see emergency symptoms) and cannot contact your diabetes team.

Book a routine appointment if:

• If you notice any of the common symptoms listed above, especially in a child.
• If you have been diagnosed and need a check-up or adjustment to your insulin plan.

Diagnosis

A doctor diagnoses type 1 diabetes based on your symptoms and blood tests that measure your blood sugar levels.

Tests that may be done

• Fasting blood sugar test – after not eating for at least 8 hours, a level of 126 mg/dL (7.0 mmol/L) or higher suggests diabetes.
• HbA1c test – shows your average blood sugar over the past 2–3 months.
• Random blood sugar test – a level of 200 mg/dL (11.1 mmol/L) or higher with symptoms.
• Autoantibody tests – to check for the immune markers that are present in type 1 diabetes.

What to expect at your appointment

Your doctor will explain your test results and refer you to a diabetes specialist team. You will learn how to check your blood sugar, give insulin injections, and plan meals. Support from a diabetes nurse and dietitian is usually provided.

Treatment

Treatment for type 1 diabetes focuses on replacing the insulin your body no longer makes. This is done with daily insulin injections or an insulin pump. You also need to check your blood sugar regularly and balance insulin with food and physical activity. The goal is to keep blood sugar levels in a target range to prevent short- and long-term problems.

Self-care at home

• Check your blood sugar as recommended by your healthcare team (typically several times a day).
• Count carbohydrates in meals to match your insulin dose.
• Stay active with regular exercise, but adjust insulin and food to avoid lows.
• Learn to recognize and treat low blood sugar (hypoglycemia) – symptoms include shakiness, sweating, confusion, and dizziness. Treat quickly with a sugary drink or glucose tablets.

Medical treatments

The main treatment is insulin therapy. Different types of insulin work at different speeds – some work quickly to cover meals, others work slowly to provide background insulin. Insulin can be given by multiple daily injections using a pen or syringe, or through an insulin pump that delivers a steady flow. Your healthcare team will help you choose the best regimen for your lifestyle. Regular blood sugar monitoring and sometimes continuous glucose monitors (CGMs) are also used.

When is surgery considered?

Surgery is not used to treat type 1 diabetes. However, if you need surgery for another reason, your diabetes team will adjust your insulin and monitoring plan to keep you safe during and after the procedure.

Living with this condition

Living with type 1 diabetes means making daily decisions about insulin, food, and activity. Most people get into a routine that feels natural over time. You'll need to carry supplies (insulin, glucose monitor, snacks) with you. With proper management, you can do almost everything people without diabetes do – go to school, work, travel, and play sports.

Lifestyle tips

• Keep a consistent daily routine for meals and insulin doses.
• Wear a medical ID (bracelet or necklace) that says you have diabetes.
• Plan ahead for exercise: check blood sugar before, during, and after.
• Avoid smoking and limit alcohol – alcohol can cause low blood sugar hours later.

Diet and exercise

A healthy diet for type 1 diabetes is similar to what everyone should eat: plenty of vegetables, whole grains, lean protein, and healthy fats. You'll learn to count carbohydrates to match your insulin dose. Regular physical activity helps control blood sugar and improves overall health. Always check your blood sugar before exercise and have a fast-acting carbohydrate snack available.

Mental health and emotional wellbeing

Managing a chronic condition like type 1 diabetes can be stressful. It is common to feel overwhelmed, anxious, or burned out at times. This is sometimes called 'diabetes distress.' Talk to your healthcare team if you are feeling down or struggling with self-care. They can connect you with a counselor or support group. Remember, you are not alone.

Prevention

Currently, there is no known way to prevent type 1 diabetes. Research is ongoing, but lifestyle changes do not stop the autoimmune process that causes it.

Screening programmes

If you have a close relative with type 1 diabetes, you may be able to participate in research studies or screening programs. Talk to your doctor about any available options. However, routine screening for the general population is not recommended.

Complications

If left untreated

• Diabetic ketoacidosis (DKA) – a dangerous buildup of acid in the blood that can be life-threatening if not treated quickly.
• Long-term high blood sugar can damage small blood vessels, leading to eye problems (retinopathy), kidney damage (nephropathy), and nerve damage (neuropathy).
• Increased risk of heart attack, stroke, and poor circulation in the feet, which may lead to foot ulcers and infections.

Long-term outlook

With modern insulin therapy and careful blood sugar management, people with type 1 diabetes can live long, full, and active lives. The key is to keep blood sugar levels as stable as possible and attend regular check-ups to catch any early changes. Many people with type 1 diabetes go on to have successful careers, families, and hobbies. Your healthcare team is there to help you every step of the way.

Find support

International organisations

• International Diabetes Federation ↗

Local organisations

• Diabetes UK ↗ · United Kingdom

Helplines

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