Type 1 diabetes is an autoimmune condition where the body’s immune system attacks and destroys the cells in the pancreas that make insulin. This means the body can’t control blood sugar on its own. Without insulin, glucose stays in the blood and makes blood sugar levels too high.

Approximately 1.45 million individuals in the U.S. have type 1 diabetes, and by 2040 is expected to increase to 2.1 million individuals.

Type 1 diabetes is not the same as type 2 diabetes, which is influenced by a range of genetic and lifestyle factors that impact the body’s ability to use insulin.

Type 2 diabetes can be managed with lifestyle interventions and medications, but people with type 1 diabetes need insulin to survive. Today, there is no known cure for either type of diabetes.

Type 1 diabetes often starts in children and young adults, but it can happen to anyone at any age. Without management of high blood glucose levels, over time it can lead to serious health conditions, such as:

  • Heart disease and stroke
  • Kidney, eye, and dental disease
  • Nerve damage and poor blood flow
  • Foot sores and infections
  • Depression
  • Sleep apnea
Symptoms

Symptoms of type 1 diabetes are serious and usually happen quickly, over a few days to weeks, and can include:

  • Increased thirst or hunger
  • Increased urination or bedwetting
  • Fatigue
  • Unexplained weight loss
  • Irritability or behavioral changes
  • Blurred vision
  • Fruity-smelling breath

Diabetic Ketoacidosis

When the body can’t make enough insulin, a serious condition called diabetic ketoacidosis may occur. Without insulin, the body starts using fat for energy. This causes acids called ketones to build up in the blood. If not treated, this can lead to diabetic ketoacidosis.

Diabetic ketoacidosis is a life-threatening complication associated with long-term health impacts. Ketones can build up to high levels and lead to coma or death. Symptoms of diabetic ketoacidosis include:

  • Dry or flushed skin
  • Nausea or vomiting
  • Stomach pain
  • Severe high blood sugar
  • Trouble breathing/rapid breathing
  • Trouble paying attention or feeling confused

Symptoms of diabetic ketoacidosis can become immediately life-threatening, so it is critical to seek emergency care right away.

Today, more than 40% of individuals are diagnosed with type 1 diabetes once they are in diabetic ketoacidosis.

Stages

Type 1 diabetes is detectable as soon as autoantibodies are found in the blood. Autoantibodies are proteins produced by the immune system that mistakenly attack the beta cells (cells that produce insulin) in the pancreas.

If a person has two or more autoantibodies, they are very likely to develop type 1 diabetes.

Stages of Type 1 Diabetes

Type 1 diabetes develops in three stages, which can start months to year before a diagnosis.

  • Stage 1: Presence of two or more autoantibodies with normal blood sugar and no symptoms 
  • Stage 2: Presence of two or more autoantibodies. Blood sugar begins to rise, but there are still no symptoms. 
  • Stage 3: High blood sugar and insulin dependence. Symptoms are present.

As type 1 diabetes progresses, the body loses cells that produce insulin and cannot replace them. When fewer cells are available to make insulin, the body needs insulin treatment to help do the job those cells once did.

Preserving Beta Cells

Many people still have some working beta cells when they are diagnosed with type 1 diabetes. Preserving even a small number of working beta cells can:

  • Help your body continue making some of its own insulin
  • Keep blood sugar levels closer to a healthy range
  • Lower the chance of diabetic ketoacidosis, a life-threatening complication
  • Help protect the health of your eyes, kidneys, and nerves
  • Make diabetes easier to manage 
Early Screening

Early screening is available. Studies indicate that measuring autoantibodies through a blood test can effectively identify those who will develop type 1 diabetes, potentially before the need for insulin. This is different than measuring blood sugar levels, which are only elevated in later stages of the disease.

With the presence or history of two or more autoantibodies, measurement of glucose levels can be used to identify the individual’s stage of type 1 diabetes.

Screening Test

The blood test can identify proteins that appear when type 1 diabetes begins, even in early stages before there are any symptoms. Two or more autoantibodies are a strong sign that the earliest stages of type 1 diabetes may have begun.

  • Cell cytoplasmic (ICA)
  • Glutamic acid decarboxylase (GAD)
  • Insulin (IAA)
  • Islet antigen-2 (IA-2)
  • Zinc transporter 8 (ZnT8)

Understanding the early phase of type 1 diabetes allows individuals to work with their health care provider to monitor progress, and develop management, or treatment strategies.

Early Screening Options

Talk to your child’s health care provider about your concerns. They can refer you for testing resources. Other free screening resources include:

Risk Factors
  • Type 1 diabetes often starts in children and young adults, but it can happen at any age. It is most common in children ages 4-6 and 10-14.
  • Having a family member with type 1 diabetes increases the risk of developing the condition. Individuals with a parent, sibling, or child with the disease are more likely to be diagnosed, however many people with type 1 diabetes do not have a family history of the disease.
  • Having an autoimmune condition, such as Hashimoto’s, Graves’, or celiac disease.
  • Environmental factors, including viruses, are another factor behind onset. Some researchers believe that certain viruses may specifically target beta cells, and as the body’s immune response tries to combat these viruses, it may mistakenly attack and damage the beta cells.
  • Having a high glycated hemoglobin (A1C) level, which shows your average blood sugar level over the past 2–3 months. A normal A1C level for a person without diabetes is below 5.7%. An A1C level of 6.5% or higher indicates a diagnosis of diabetes.
Treatment

People with type 1 diabetes need to take insulin every day to stay healthy. Insulin can’t be taken orally (stomach enzymes will break down the insulin), so injections or an insulin pump will be used.

In addition to insulin, making healthy lifestyle choices is important to managing the condition. Eating healthy food, monitoring blood sugar levels, exercising regularly, and maintaining a healthy weight help in managing the impacts of type 1 diabetes. The goal is to keep the blood sugar level as close to normal as possible to delay or prevent complications.

Whether you are at higher risk of developing type 1 diabetes or in the early stages of the disease, getting the right care quickly can make a meaningful difference in your health journey.

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Prevention

Type 1 diabetes is not caused by diet or lifestyle choices. There are no known ways to prevent type 1 diabetes.

Eating healthy food, monitoring blood sugar levels, exercising regularly, and maintaining a healthy weight help in managing the impacts of type 1 diabetes.

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