Type One Diabetes affects over 400,000 people in the United Kingdom and over 1,600,000 in the USA alone. 

What is type 1 diabetes?

Type 1 Diabetes Mellitus (T1D) is an autoimmune condition that results in an inability to produce insulin. Your immune system mistakenly recognizes your beta cells as foreign and attacks them. Beta cells are a part of the Islet of Langerhans family of cells and are responsible for insulin production in the pancreas.

While our immune system protects us from harmful bacteria, viruses, and more, it can malfunction and produce an autoimmune condition. Science has not yet discovered why our immune system can target our beta cells, but a tremendous amount of research is underway to understand this.

It is essential that you understand that type one diabetes is not your fault. We can't prevent it in any way, and there is nothing you can do to increase your likelihood of getting it or reduce your chance of getting it. You are not responsible for your Diabetes.

Ultimately, type one diabetes means you can no longer produce enough insulin.

Why is insulin so important?

When we digest food, we absorb nutrients into our bloodstream. Insulin is like a chaperone, guiding energy toward one of our cells, like a muscle cell. Insulin will then activate the GLUT4 receptor on the surface of one of our cells. Once activated, the GLUT4 receptor tells the cell to ingest the energy delivered to it from the bloodstream.

Without insulin, there isn't a chaperone. That means nothing is activating GLUT4 and other glucose receptors, so glucose can't leave your bloodstream, and so you become hyperglycaemic. When we inject insulin, like through an Omnipod or Novopen, we give ourselves the ability to shuttle glucose out of our bloodstream.

The impact of hyperglycemia

So without insulin, your sugars continue to rise. When your sugars are high for long periods, a process called glycosylation starts. This is the permanent binding of glucose molecules to structures in your eye, peripheral nerves (like feet), and more. Fundamentally, the accrual of glycosylation events over your life produces most of the long-term complications of Diabetes.

Signs and Symptoms of T1D

Our body likes to preserve homeostasis, ensuring our temperature, blood glucose, blood pressure, hydration, and more are kept relatively constant and in a safe range. Maintenance of blood glucose levels (i.e., homeostasis) is the foundation of the blood glucose target ranges in continuous glucose monitoring, like with Dexcom, Freestyle Libre, and other systems.

When our internal environment changes suddenly, like in hyperglycemia, the body initiates various symptoms as part of its emergency response to bring your blood glucose levels back down to the normal range. Hyperglycaemia is also when the "high blood glucose" alarms can go off on continuous glucose monitors, like Dexcom G6.

The main symptoms include:

• Constantly needing to use the bathroom. Our body will speed up our kidneys to remove excess glucose via urination. 
• Extreme thirst. Our brain will send out a hormone called Angiotensin 2 to initiate the feeling of thirst. More fluids mean we can go to the toilet more and excrete more glucose.
• Tiredness. Without adequate glucose, and energy uptake, your body will struggle to maintain its normal functions, and you will feel tired.
• Sudden weight loss. If you aren't getting energy from glucose, your body will go into a starvation response. Lipolysis rates will, and you'll start breaking down fat stores to get energy.
• Smelly breath. After some time, the consistent breakdown of fat will cause a build-up of ketones in your bloodstream. The ketones produce a pear-like smell on your breath. They can also cause abdominal pains. Critically, this can lead to diabetic ketoacidosis, a potentially fatal condition. Read more about it here.

If you notice any of these signs over recent days, weeks, or months, you need to see your doctor immediately. If you are experiencing symptoms of diabetic ketoacidosis, go to the emergency room now!

Below is a list of references, sources, and further reading used for this article. If you have any questions, please write to us - we will do our best to help you, and if we can't we will find somebody who can.

Sources & References:

Diabetes.org. 2022. Diabetes & DKA (Ketoacidosis) | ADA. [online] Available at: <https://www.diabetes.org/diabetes/dka-ketoacidosis-ketones#:~:text=When%20ketones%20build%20up%20in,high%2C%20you%20can%20develop%20DKA.> [Accessed 23 February 2022].

Edwards, M. and Mohiuddin, S., 2022. Biochemistry, Lipolysis. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK560564/> [Accessed 23 February 2022].

Encyclopedia Britannica. 2022. immune system - Antigens. [online] Available at: <https://www.britannica.com/science/immune-system/Antigens> [Accessed 23 February 2022].

Encyclopedia Britannica. 2022. islets of Langerhans | Definition, Function, Location, & Facts. [online] Available at: <https://www.britannica.com/science/islets-of-Langerhans> [Accessed 23 February 2022].

Gerich, J., 2010. Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: therapeutic implications. Diabetic Medicine, 27(2), pp.136-142.

JDRF. 2022. Type 1 diabetes research - JDRF, the type 1 diabetes charity. [online] Available at: <https://jdrf.org.uk/our-research/> [Accessed 23 February 2022].

Meyts, P., 2022. The Insulin Receptor and Its Signal Transduction Network. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK378978/> [Accessed 23 February 2022].

Modell, H., Cliff, W., Michael, J., McFarland, J., Wenderoth, M. and Wright, A., 2015. A physiologist's view of homeostasis. Advances in Physiology Education, 39(4), pp.259-266.

Morabito, G., Miglio, C., Peluso, I. and Serafini, M., 2014. Fruit Polyphenols and Postprandial Inflammatory Stress. Polyphenols in Human Health and Disease, pp.1107-1126.

nhs.uk. 2022. Hyperglycaemia (high blood sugar). [online] Available at: <https://www.nhs.uk/conditions/high-blood-sugar-hyperglycaemia/#:~:text=Hyperglycaemia%20is%20the%20medical%20term,pregnant%20women%20with%20gestational%20diabetes.> [Accessed 23 February 2022].

Singh, V., Bali, A., Singh, N. and Jaggi, A., 2014. Advanced Glycation End Products and Diabetic Complications. The Korean Journal of Physiology & Pharmacology, 18(1), p.1.

Skyler, J., 2021. New insights into halting type 1 diabetes. The Lancet Diabetes & Endocrinology, 9(8), pp.475-476.

Stöckli, J., Fazakerley, D. and James, D., 2011. GLUT4 exocytosis. Journal of Cell Science, 124(24), pp.4147-4159.

UK, D., diabetes, C., confidence, M., diabetes?, D. and possible, Y., 2022. Complications of diabetes. [online] Diabetes UK. Available at: <https://www.diabetes.org.uk/guide-to-diabetes/complications?gclid=Cj0KCQiA09eQBhCxARIsAAYRiynGrKCe0jhHY1HQrfz_YWesOM4QcEkagSpyohcaML295PgLOXJii4caAvl7EALw_wcB> [Accessed 23 February 2022].

UK, D., diabetes, T. and possible, Y., 2022. Type 1 diabetes. [online] Diabetes UK. Available at: <https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-1?gclid=Cj0KCQiA09eQBhCxARIsAAYRiylHCYdmCbsTT2NxKyYREHTK_oqeezbE5ZjS5Vx3e7ssjqwrLW4pV9saAh6aEALw_wcB> [Accessed 23 February 2022].