Needed to read PDF's

Type 1 Diabetes

Key points

With type 1 diabetes, your pancreas doesn't make insulin or makes very little insulin.

People with type 1 diabetes need to take insulin every day.

Currently, type 1 diabetes can't be prevented, but it can be treated effectively.

Overview

Type 1 diabetes is a chronic, progressive autoimmune condition

That means it needs to be managed for life and it gets worse over time in stages. You can think of an autoimmune disease like a programming error in the immune system. The immune system is programmed to protect people from harmful threats. But with autoimmune type 1 diabetes, the immune system mistakenly thinks healthy cells, called beta cells, are a harmful threat and attacks them.

Beta cells make insulin—and people need insulin to convert blood sugar into energy. In short, people need insulin to live. Without enough insulin, your blood sugar level stays higher than normal, and serious, potentially life-threatening complications like diabetic ketoacidosis (DKA) can happen.

This is also the point when lifelong lifestyle changes and insulin injections are needed.

If you have type 1 diabetes, your pancreas doesn't make insulin or makes very little insulin. Insulin helps blood sugar enter the cells in your body for use as energy. Without insulin, blood sugar can't get into cells and builds up in the bloodstream. High blood sugar is damaging to the body and causes many of the symptoms and complications of diabetes.

Type 1 diabetes was once called insulin-dependent or juvenile diabetes. It often develops in children, teens, and young adults, but it can happen at any age. Type 1 diabetes is less common than type 2—about 5-10% of people with diabetes have type 1. Currently, no one knows how to prevent type 1 diabetes, but it can be managed successfully by:

Following your doctor's recommendations for living a healthy lifestyle.

Managing your blood sugar.

Getting regular health checkups.

Getting diabetes self-management education and support.

Type 1 diabetes progresses in 3 stages

Early-stage (or pre-insulin-dependent) type 1 diabetes is when the attack on beta cells has begun but the body can still make enough insulin to keep blood sugars in a relatively healthy range.


Stage 1	Stage 2	Stage 3^*
Early-stage type 1 diabetes Beta cell attack begins Blood sugars are within a normal range No visible signs or symptoms	Early-stage type 1 diabetes Beta cell attack continues Blood sugars are higher or lower than a normal range No visible signs or symptoms	Insulin-dependent type 1 diabetes Body no longer able to make enough or any insulin Blood sugars are much higher than normal range Visible signs and symptoms appear, and insulin dependence begins *This stage is when type 1 diabetes is typically diagnosed

You don't have to be caught off guard!

A diagnosis of autoimmune type 1 diabetes often comes without warning and in a traumatic way like an emergency room visit. Early screening could help.

Signs and symptoms

It can take months or years before symptoms of type 1 diabetes are noticed. Type 1 diabetes symptoms can develop in just a few weeks or months. Once symptoms appear, they can be severe.

Some type 1 diabetes symptoms are similar to symptoms of other health conditions. Don't guess! If you think you could have type 1 diabetes, see your doctor to get your blood sugar tested. Untreated diabetes can lead to very serious—even fatal—health problems.

Risk factors

You can get type 1 diabetes at any age, but it usually develops in children, teens, or young adults.

Risk factors for type 1 diabetes are not as clear as for prediabetes and type 2 diabetes. Known risk factors include:

Family history: Having a parent, brother, or sister with type 1 diabetes.

Age: You can get type 1 diabetes at any age, but it usually develops in children, teens, or young adults.

In the United States, White people are more likely to develop type 1 diabetes than African American and Hispanic or Latino people.

Causes

Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake). This reaction destroys the cells in the pancreas that make insulin, called beta cells. This process can go on for months or years before any symptoms appear.

Some people have certain genes (traits passed on from parent to child) that increase their chance of developing type 1 diabetes. However, many of them won't go on to have type 1 diabetes even if they have the genes. A trigger in the environment, such as a virus, may also play a part in developing type 1 diabetes. Diet and lifestyle habits don't cause type 1 diabetes.

Testing and screening

A simple blood test is used to screen for diabetes. If you were tested at a health fair or pharmacy, follow up at a clinic or doctor's office. That way you'll be sure the results are accurate.

If your doctor thinks you have type 1 diabetes, your blood may also be tested for autoantibodies. These substances indicate your body is attacking itself and are often found with type 1 diabetes but not with type 2. You may have your urine tested for ketones. Ketones are produced when your body burns fat for energy. Having ketones in your urine indicates you have type 1 diabetes instead of type 2.

For parents‎

If your young child has type 1 diabetes, you'll handle daily diabetes care, such as giving insulin injections and watching for and treating hypoglycemia (low blood sugar). You'll also need to stay in close contact with your child's health care team. They will help you understand the treatment plan and how to help your child stay healthy.

Treatment

Unlike many health conditions, diabetes is managed mostly by you, with support from your health care team:

Primary care doctor

Foot doctor

Dentist

Eye doctor

Registered dietitian nutritionist

Diabetes educator

Pharmacist

Also ask your family, teachers, and other important people in your life for help and support. Managing diabetes can be challenging, but everything you do to improve your health is worth it!

You'll need to take insulin shots (or wear an insulin pump) every day. Insulin is needed to manage your blood sugar levels and give your body energy. You can't take insulin as a pill. That's because the acid in your stomach would destroy it before it could get into your bloodstream. Your doctor will work with you to figure out the most effective type and dosage of insulin for you.

You'll also need to do regular blood sugar checks. Ask your doctor how often you should check it and what your target blood sugar levels should be. Keeping your blood sugar levels as close to target as possible will help you prevent or delay diabetes-related complications.

Hypoglycemia and diabetic ketoacidosis are common complications of diabetes, and you'll need to know how to handle them. Meet with your doctor for step-by-step instructions.

Stress is a part of life, but it can make managing diabetes harder. Regular physical activity, getting enough sleep, and exercises to relax can help. Talk to your doctor and diabetes educator about these and other ways you can manage stress.

Healthy lifestyle habits are really important too:

Making healthy food choices

Being physically active

Managing your blood pressure

Managing your cholesterol

Regular appointments with your health care team can help you stay on track with your treatment plan and offer new ideas and strategies if needed.

Medications for Diabetes, Type 1

The medications listed below are related to or used in the treatment of this condition.

Drug name	Rating	Rx/OTC	Preg	CSA	Alcohol
Humalog	7.6	Rx	B	N	X
Lantus	7.5	Rx	C	N	X
Novolog	6.6	Rx	B	N	X
Lantus SoloStar	3.0	Rx	C	N	X
Levemir	5.4	Rx	B	N	X
NovoLog FlexPen	1.5	Rx	B	N	X
insulin glargine	3.1	Rx	C	N	X
Apidra		Rx	C	N	X
Tresiba	4.1	Rx	C	N	X
insulin lispro	3.9	Rx	B	N	X
Basaglar	2.0	Rx	C	N	X
insulin aspart	6.2	Rx	B	N	X
Toujeo SoloStar	2.7	Rx	C	N	X
Humulin N	10	OTC	B	N	X
Afrezza	68	Rx	C	N	X
Fiasp	7.6	Rx	B	N	X
Humulin R		OTC	B	N	X
insulin regular	7.5	Rx/OTC	B	N	X
Novolin R	7.0	OTC	B	N	X
Symlin	10	Rx	C	N	X
Novolin N	2.0	OTC	B	N	X
Admelog	2.6	Rx	B	N	X
Humulin 70/30		OTC	B	N	X
Novolin 70/30	10	OTC	B	N	X
Semglee	1.0	Rx	C	N	X
Toujeo Max SoloStar		Rx	C	N	X
Humalog Mix 75/25	9.0	Rx	B	N	X
Lyumjev	9.0	Rx	B	N	X
Rezvoglar		Rx	C	N	X
insulin glulisine	8.5	Rx	C	N	X
NovoLog Mix 70/30	10	Rx	B	N	X
octreotide Off-label	9.0	Rx	B	N
Humulin R U-500 (Concentrated)	10	Rx	B	N	X
insulin degludec	4.1	Rx	C	N	X
insulin detemir	5.4	Rx	B	N	X
insulin isophane	8.4	OTC	B	N	X
NovoLog Mix 70/30 FlexPen		Rx	B	N	X
NovoLog PenFill		Rx	B	N	X
pramlintide	10	Rx	C	N	X
Humalog Mix 75/25 KwikPen		Rx	B	N	X
Humulin R U-500 KwikPen		Rx	B	N	X
insulin aspart/insulin aspart protamine	10	Rx	B	N	X
insulin inhalation, rapid acting	6.8	Rx	C	N	X
insulin isophane / insulin regular	95	OTC	B	N	X
Merilog		Rx	B	N	X
Myxredlin		Rx	B	N	X
Humalog Mix 50/50 KwikPen		Rx	B	N	X
Humulin N Pen		OTC	B	N	X
insulin lispro/insulin lispro protamine	9.0	Rx	B	N	X
Symlin Pen		Rx	C	N	X
SymlinPen 60	10	Rx	C	N	X
teplizumab		Rx		N
Tzield		Rx		N
donislecel		Rx		U
Humulin 50/50		OTC	B	N	X
Humulin 70/30 Pen		OTC	B	N	X
Lantidra		Rx		U
ReliOn/Novolin 70/30	9.0	OTC	B	N	X
SymlinPen 120	10	Rx	C	N	X

Legend
Rating	For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Rx	Prescription only.
OTC	Over-the-counter.
Rx/OTC	Prescription or Over-the-counter.

Pregnancy Category		Controlled Substances Act (CSA) Schedule		Alcohol
B	Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.	U	CSA Schedule is unknown.	X	Interacts with Alcohol.
C	Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.	N	Is not subject to the Controlled Substances Act.