Type 1 Diabetes (T1D) Basics
T1D occurs when your immune system attacks and destroys the insulin-producing beta cells of the pancreas. As the body becomes incapable of creating insulin, T1D symptoms start to appear, such as extreme thirst, frequent urination, weight loss, and fatigue.
- Type 1 diabetes doesn’t discriminate. It affects people of all races, ethnicities, ages, and socioeconomic backgrounds.
Although the exact causes of T1D are unknown, researchers have discovered possible genetic, environmental, and immune factors that may lead to a higher risk of developing the condition.
A type 1 diabetes diagnosis can happen suddenly and unexpectedly. T1D often initially presents itself as the flu or malaise, but physicians must be quick to spot the telltale signs and symptoms of a possible T1D diagnosis. Tools used to determine a positive T1D diagnosis include blood glucose tests, an HbA1C test, and a ketone test
Insulin is a hormone the human body makes to helps regulate blood-sugar levels throughout the day and night. Because their bodies produce too little or no insulin, people with T1D rely on insulin therapy to help manage their blood-glucose levels. The food you eat, stress, illness, excitement, and several other factors can all affect glucose levels, requiring insulin for stabilization.
Hypoglycemia is the medical term for low blood sugar (low blood glucose). Your body, especially your brain, depends on glucose to work. Too little sugar in your blood causes problems that can sometimes be serious.
Symptoms of low blood sugar include:
- Feeling sweaty, shaky, or hungry
- Having trouble seeing clearly
- Getting disoriented
To treat mild to moderate hypoglycemia, you must ingest glucose in the form of fast-acting carbohydrates. When hypoglycemia is severe, a form of glucagon may be needed.
Learn more about hypoglycemia (low blood sugar).
Download JDRF’s printable guide on hypoglycemia (low blood sugar).
Hyperglycemia is the medical term for high blood sugar (high blood glucose). It happens when your body has too little insulin to use the sugar in your blood.
To treat hyperglycemia, you must administer insulin.
Symptoms of high blood sugar include:
- Being extremely thirsty
- Urinating (peeing) a lot
- Feeling very tired
- Having trouble seeing or concentrating
- Experiencing stomach pain, nausea, or vomiting
- Having sweet-smelling or “fruity” breath
Prolonged hyperglycemia can lead to a life-threatening condition called diabetic ketoacidosis, or DKA.
Learn more about hyperglycemia (high blood sugar).
Download JDRF’s printable guide on hyperglycemia (high blood sugar).
Diabetic ketoacidosis (DKA) is a serious condition in which an insulin-deprived body seeks energy from stored fat. Ketones are caused by the breakdown of fat when there isn’t enough insulin to allow the glucose (sugar) into your cells for energy. When ketones build up, the result is acidosis (too much acid in the blood). If not treated, this can lead to death.
Learn more about DKA, what signs to look for, and how to prevent it.
Time-in-range (TIR) is a measurement that tells you what percentage of the day your blood sugars are in your goal range.
Today, the measure of TIR has become a potentially more valuable method of assessing blood sugar management thanks to the development of continuous glucose monitors (CGM). While using a CGM, you’ll work with your healthcare team to determine the appropriate goal range for your blood sugar levels. TIR tells you how often you’re actually within that goal range.
Learn more about time-in-range and how it can help you in daily type 1 diabetes management.
Type 1 diabetes is a disease that requires 24-7 management. But thanks to advancements in medication types and delivery methods, people with T1D can live long, happy lives with proper care and disease management.
Get more information on staying healthy while living with type 1 diabetes.
Type 1 diabetes is managed through use of insulin. People with T1D must work closely with their medical team to find the right insulin type and treatment for their condition.
Treatment for T1D also includes monitoring and lifestyle choices in addition to insulin. Blood-sugar monitoring, carbohydrate counting, exercise and diet, and regular medical checkups are all essential to mitigate the effects of T1D.
There are many types of insulin. These include rapid-acting, regular, intermediate-acting, long-acting, ultra-long acting, and inhaled.
Insulin is administered via injection, insulin pump, inhaler, or artificial pancreas system/automated insulin delivery system.
Insulin pumps are small, wearable devices individually programmed to deliver insulin into the body at numerous intervals throughout the day and night. They are used in place of multiple daily injections (MDI) of insulin.
Insulin pumps release a low, steady flow of insulin 24 hours a day (basal insulin), as well as extra doses of insulin (boluses) to accommodate rises in blood sugar as needed (e.g., when one eats).
Learn more about insulin pumps, including a comparison of insulin pumps available in the U.S.
Continuous Glucose Monitors (CGMs) are small, wearable devices that continuously measure a person’s blood-glucose levels. They are used in place of traditional glucose meters and regular finger sticks.
A sensor just under the skin measures the tissue-glucose levels in real time; CGMs are mostly worn on the upper arm or abdomen. The levels are then relayed to a receiver, smartphone or watch, or insulin pump which displays the readings.
Learn more about CGMs, including a comparison of CGMs approved in the U.S.
An artificial pancreas system has three main components: an insulin pump, a continuous glucose monitor (CGM), and an algorithm (the “brain” that determines the best insulin dose to help keep you in range”). It measures glucose and adjusts insulin automatically–it gives less insulin when blood sugar is low and more insulin when blood sugar is high.
Learn more about automated insulin delivery systems, including a comparison of systems available in the U.S.
T1D Healthcare Coverage and Costs
It can be frustrating and sometimes scary if you’re not able to fill a prescription, continue a treatment, or face paying the full cost of your treatment. The good news is you have the right to appeal the decision. And, while it can be time-consuming to deal with, many health insurance denials may be resolved through the insurance appeals process.
Learn more about filing an appeal with your health insurance company.
A prior authorization is a requirement from your health insurance company that your doctor obtain approval from your plan before it will cover the costs of a specific medicine, medical device, or procedure. Many times, this involves your doctor completing a form to illustrate to your insurance company why the insulin, insulin pump, or continuous glucose monitor (CGM) you are prescribed is medically necessary.
Prescription costs for drugs to treat type 1 diabetes (T1D) can make up a large percentage of what you pay each year for healthcare. There are a few ways you can lower your prescription and insulin costs: through state and nonprofit programs; diabetes patient assistance programs offered by pharmaceutical companies; medication discount cards; and prescription alternatives such as biosimilar insulin.
Learn more about getting help with your diabetes prescription and insulin costs.
T1D and Lifestyle
No! That is a common misconception about T1D. T1D is an autoimmune disease. Nothing can currently be done to prevent type 1 diabetes.
Yes. But having type 1 diabetes means that in addition to consuming responsibly, you will also need to understand the effect of alcohol on blood sugar and keep an eye on it while drinking.
Moderate amounts of alcohol may cause blood sugar to rise, but excess alcohol can actually decrease your blood sugar level, which can be dangerous for people with T1D. People with T1D should only drink while eating food.
Learn more about drinking alcohol safely with type 1 diabetes.
Editor’s note: How you manage your type 1 diabetes is a personal decision that should be made by you and your healthcare team. JDRF content is for informational purposes only and is not a substitute for professional medical advice. Please contact your doctor or other qualified health provider with any questions you may have regarding type 1 diabetes or any medical condition.
A healthy, balanced diet is key to managing T1D. Thanks to modern insulin, CGMs, insulin pumps, and automated insulin delivery systems, people with T1D have little to no restriction on what types of foods they can eat.
People living with type 1 diabetes (T1D) can and should experience the benefits of sports and exercise. Physical activity is great for your body and has positive effects on your mind—and T1D should not prevent anyone from reaping the benefits. Exercising with T1D does require extra preparation, but by following some guidelines, everyone can incorporate sports and exercise into their life.
The most important advice for a traveler with type 1 diabetes is be
- Pack roughly twice as many supplies as you think you will need.
- Be sure to have cooling packs for insulin storage.
- Check with your health insurance to ensure you have coverage at your destination.
- Wear a medical ID bracelet and always keep your emergency contact information with you.
- If flying, keep your diabetes-related supplies, equipment, and medication with you in a carry-on bag. Insulin in a checked bag can freeze or get damaged. Consult the TSA guidelines for travelers with medical conditions.
Pregnancy with type 1 diabetes can directly impact the health of the child and the mother. Having T1D well-managed at conception is key to a safe and healthy pregnancy.
You should also create a pregnancy plan. Many women choose to work with a team that includes an endocrinologist, primary care doctor, and an OB-GYN, preferably one who has experience with T1D pregnancies.
Most experts recommend having an HbA1c at or below 6 percent before you conceive and maintaining that range throughout your pregnancy. It’s also important early in the planning stages to consider wearing a continuous glucose monitor (CGM) to help you maintain healthy blood-glucose levels.
T1D at School
A 504 Plan is a legal, written document specifying what “reasonable” modifications and accommodations the school must provide for a student with a disability. 504 Plans are a way for you to hold the school accountable for meeting your child’s needs while in the school’s care.
School can be overwhelming for students living with type 1 diabetes (T1D), as well as their parents and caregivers. It is important for teachers and educators to be aware of T1D so they can ensure the safety and well-being of the student.
Learn more about helping your child with T1D success at school.
The transition from high school to living independently with type 1 diabetes will bring a lot of new learning experiences, challenges to overcome, and adventures. Creating a diabetes management plan allows your child to have a system in place to aid in managing their T1D no matter what new or stressful situations they encounter.
Download the JDRF guide Living Independently with Type 1 Diabetes.
Not yet, but thanks to decades of JDRF-funded research, we know what is necessary for finding cures for T1D:
- Turn off the autoimmune attack that destroys the insulin-producing beta cells
- Restore insulin production inside or replace them with cells from outside the body
To accomplish that, JDRF has three priority areas of research:
- Global Universal Screening
There’s a simple blood test that can detect T1D autoantibodies, an established marker of risk of developing T1D—and ensuring more people have access to it can have a transformative effect on the landscape of T1D research and save lives at the same time.
Learn more about the important role screening plays in achieving a world without T1D.
- Disease-Modifying Therapies
T1D is a progression. There are people whose own immune system has begun attacking the insulin producing beta cells, but they are not symptomatic yet. There are also people who have had T1D for decades and have lost nearly all insulin production. Disease-modifying therapies are aimed at helping everyone with T1D—regardless of where they are on the disease continuum.
In 2022, the first-ever disease-modifying therapy for individuals at risk of developing T1D was approved by the FDA. This was a watershed moment for the T1D community and puts us on the critical pathway to finding cures and, one day, preventing T1D entirely.
Learn more about JDRF’s exciting research in disease-modifying therapies.
- Cell Therapies
Thanks to recent advances, people with T1D could one day be freed from their blood-glucose monitors and insulin injections for years, or even decades. JDRF’s Cell Therapies Program invests in research and clinical trials to develop and deliver life-changing therapies that place healthy, insulin-producing beta or islet cells back into the bodies of people with T1D.
Learn more about JDRF’s promising research in cell therapies, which is now being tested in several human clinical trials.
Having T1D can increase your risk for additional health problems, particularly if blood glucose levels aren’t well-managed. The longer you have T1D, the higher your risk becomes for developing complications like kidney disease, eye disease, and cardiovascular disease.
Learn more about T1D complications and how to treat and prevent them.