Type 1 diabetes mellitus (T1DM)

Type 1 Diabetes Mellitus (T1DM) - What it is

Diabetes is a condition characterized by high glucose levels. Our body produces a hormone called insulin which enables glucose to enter our cells. If our bodies do not produce enough insulin, or if our cells are not able to respond well enough to insulin, glucose cannot enter our cells and instead accumulates in the bloodstream.

In type 1 diabetes, the body is unable to produce insulin. The cells are therefore not able to absorb glucose from the bloodstream.

The exact cause of type 1 diabetes is unknown. However, it is recognized as an autoimmune disease. The body’s immune system mistakenly attacks the insulin-producing cells in the pancreas (the beta cells). The damaged beta cells are then unable to produce insulin.

Type 1 diabetes affects just 5% of all people with diabetes. It is usually diagnosed in children and young adults. However, even older adults may be diagnosed with type 1 diabetes.

Type 1 Diabetes Mellitus (T1DM) - Symptoms

Some symptoms of high blood glucose levels that may occur in type 1 diabetes are listed below:

Excessive thirst and urination
Fatigue
Weight loss
Blurred vision
Slow-healing sores or frequent infections

Diabetic ketoacidosis is a complication of type 1 diabetes. In addition to the above, symptoms may include:

Rapid breathing
Nausea or vomiting
Abdominal pain

Diabetes can also give rise to complications if it is not well controlled. These may include blindness, kidney failure, nerve damage, ulcers and amputations, heart attacks or strokes. With good control of diabetes, these complications can be prevented.

Type 1 Diabetes Mellitus (T1DM) - Causes and Risk Factors

Different factors may contribute to type 1 diabetes, including genetics and some viruses or other environmental factors. However, the exact cause of type 1 diabetes is still unknown.

Anyone with a parent or sibling with type 1 diabetes has a slightly higher risk of developing type 1 diabetes.

Type 1 Diabetes Mellitus (T1DM) - Diagnosis

Blood tests can be done to diagnose diabetes. These include:

Random blood glucose

This is a blood glucose sample that is taken without fasting
A random blood glucose 11.1mmol/L or greater is suggestive of diabetes

Fasting blood glucose

This is a blood glucose sample taken after an overnight fast
Diabetes is diagnosed with the fasting blood glucose is 7.0mmol/L or greater

Oral glucose tolerance test (OGTT)

A fasting blood glucose level will be taken, after which you will drink a standard amount of sugary drink (75g)
Diabetes is diagnosed when the fasting blood glucose is 7.0mmol/L or greater, or a glucose reading 2 hours after the sugary drink is 11.1mmol/L or greater

People with symptoms of high blood glucose will only need one test to diagnose diabetes. People who do not have symptoms of high blood glucose will need to be tested on 2 separate occasions to diagnose diabetes.

Additional blood tests may be helpful to tell the difference between type 1 and type 2 diabetes.

Type 1 Diabetes Mellitus (T1DM) - Treatments

People with type 1 diabetes need insulin to manage their condition.

People with type 1 diabetes receiving insulin injections should be on a basal-bolus regimen. This consists of 2 components:

Basal (or background) insulin: this type of insulin is gradually released, providing a constant supply of insulin throughout the day
Bolus (or mealtime) insulin: this is quick-acting insulin delivered in multiple doses throughout the day, before meals or certain snacks

Another mode of insulin delivery is through continuous subcutaneous insulin infusion via an insulin pump.