Let's learn everything about Type 1 Diabetes in a simple way.

Is your child suddenly very thirsty and urinating frequently? Has he started wetting the bed at night? Or is he losing weight despite eating well? Don't dismiss these things as normal. These could be the first signs of a condition called Type 1 Diabetes. This is a lifelong condition that can affect young children, young adults, and sometimes adults. But don't worry, we'll talk about it in detail.

Simply put, what is Type 1 Diabetes?

Type 1 diabetes is a disease caused by a problem with our own immune system. To be precise, it is an autoimmune disease . Normally, our immune system fights off germs that cause disease. But in this case, our immune system goes wrong and starts destroying the cells in our own pancreas that make the hormone insulin.

Think of insulin as a key that opens the doors to the cells in our body. In order for the sugar (glucose) in the food we eat to enter the cells as energy, this insulin key is absolutely necessary. So when those cells are destroyed, the production of insulin stops completely. What happens is that the sugar in the blood cannot enter the cells and accumulates in the blood. We call this high blood sugar level (hyperglycemia). If this is not controlled, it can cause serious damage to the body.

What are the symptoms of type 1 diabetes? How do you recognize it?

These symptoms usually start gradually and can become severe over a few days or weeks. If you or someone in your family has these symptoms, it is very important to see a doctor as soon as possible for advice.

These emergency symptoms indicate a life-threatening condition called Diabetic Ketoacidosis (DKA). If you see something like this, go to a hospital's Emergency Department (ETU) without delay.

Why is this happening? What is the reason?

Scientists still don't know the exact cause of type 1 diabetes, but they believe it's caused by a combination of genetics and environmental factors .

Simply put, a person may have a genetic predisposition to develop this disease. Then, a virus or something in the environment may trigger the body's defense system to launch that wrong attack.

If someone in the family has this disease, the risk of others developing it is slightly higher.

• If no one in the family has it, the risk is about 1 in 250.
• If the mother has it, the risk is between 1 in 25 and 1 in 100.
• If the father has it, the risk is 1 in 17.
• If both parents have it, the risk can be between 1 in 10 and 1 in 4.

What are the possible complications of type 1 diabetes?

Uncontrolled high blood sugar levels over a long period of time can damage various parts of the body. Therefore, it is very important to keep blood sugar levels within the appropriate range.

Possible complications:

• Eye problems: things like vision loss (retinopathy), cataracts.
• Foot problems: Numbness in the legs, wounds that do not heal and become serious.
• Heart disease and high blood pressure.
• Kidney disease: Damage to the kidneys over time.
• Nerve damage (Neuropathy): Things like numbness and tingling in the limbs.
• Skin diseases: Dry skin, frequent infections.
• Increased risk of stroke .

Rather than being afraid of these things, remember that you can protect yourself from almost all these complications by controlling your blood sugar levels well. Also, living with this disease can cause stress and depression. Therefore, it is essential to take care of your mental health as well as your physical health . Seek medical advice if necessary.

How do doctors accurately diagnose this disease?

Diagnosing type 1 diabetes is usually easy. Your doctor will do these tests:

• Blood glucose test: When the disease is diagnosed, the sugar level is usually very high.
• A1c test (Glycosylated hemoglobin test): This measures your average blood sugar level over the past three months.
• Antibody test: This is used to confirm whether you have type 1 or type 2 diabetes. If autoantibodies related to type 1 diabetes are present in the blood, it is confirmed as type 1.

In addition, you can also do things like a urine test to check for ketones in the urine.

How is it treated and managed?

Living with type 1 diabetes means you have to take insulin every day to survive. This cannot be done with a pill. Insulin is life-saving for these patients. The main goal of treatment is to keep blood sugar levels within a healthy range.

This is not something you have to do alone. An endocrinologist and diabetes team can help you. But you have to make the decisions every day. There are three main parts to management:

1. Insulin therapy

2. Glucose monitoring

3. Required Education and Awareness (Education)

Methods of taking insulin

There are several types of insulin. They vary in how quickly they work and how long they last in the body. You may need to use more than one type. There are several main ways to get insulin:

• Multiple daily injections (MDI): Injecting insulin into the fatty layer under the skin several times a day using a syringe.
• Insulin Pen: This is a pen-like device that comes pre-filled with insulin. It is easier to use than injections.
• Insulin pump: This is a small device that delivers insulin to the body in the amount needed throughout the day through a small tube placed under the skin.
• Inhaled insulin: There is also a type of insulin that is inhaled through the mouth, similar to an inhaler used by asthma patients.

The amount of insulin you need can change from day to day, with age, when you develop an illness, or during pregnancy.

Monitoring sugar levels

You need to be careful about your blood sugar levels throughout the day.

• Blood glucose meter: A device that measures blood sugar levels by taking a small drop of blood from the fingertip.
• CGM (Continuous Glucose Monitoring - CGM): A method that continuously measures blood sugar levels every few minutes using a small sensor implanted under the skin and sends the data to your phone or other device. This is now available in Sri Lanka.

Your doctor will give you a target blood sugar level. The most important thing is to try to stay at that level.

Can this disease be completely cured?

Unfortunately, there is currently no cure for type 1 diabetes, but scientists are continuing to research ways to prevent the disease or control its progression.

In some developed countries, there are two types of transplant treatments, but they are more risky.

• Islet cell transplant: Transplantation of only the insulin-producing cells.
• Pancreas transplant: This is usually done at the same time for patients who need a kidney transplant.

These are risky treatments that are still in the research stage and not available to everyone.

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