Type 1 diabetes

At a Glance

Type 1 diabetes is a chronic disease characterized by elevated blood glucose levels due to an almost total or complete lack of insulin production by the pancreas, and it is also known as immune-mediated diabetes.

Typical manifestations include severe thirst, frequent urination, hunger, fatigue, weight loss, and blurred vision, which may be accompanied by numbness in the hands and feet or wounds that heal poorly.

How the disease works

It involves an autoimmune response in which the immune system mistakenly attacks the pancreatic cells that produce insulin, and both genetic and environmental factors can influence its onset.

When insulin is insufficient, glucose cannot move sufficiently into the cells, leading to its accumulation in the blood, while fat breakdown and ketone production may increase instead.

Variations in presentation among individuals

It commonly begins in children and young adults but can occur at any age, and a family history in parents or siblings can increase the risk.

The broad framework of diagnosis and management

Symptoms can appear particularly rapidly in children and may progress more slowly in adults, and uncontrolled hyperglycemia can lead to long-term complications.

Diagnosis centers on blood tests to evaluate blood glucose, and depending on the clinical situation, glycated hemoglobin (HbA1c) and autoantibody/ketone tests are also considered.

Current status of treatment

Rather than determining type and severity based solely on a single test value, symptoms, timing of the test, presence of ketones, and the possibility of other diabetes types must be interpreted together.

Management encompasses insulin replacement, blood glucose monitoring, regulation of diet and physical activity, prevention of hypoglycemia and hyperglycemia, and screening for complications.

The core of current treatment is daily insulin injection or administration via an insulin pump, and some patients may use additional diabetes medications.

How to read clinical trials

On ClinicalTrials.gov, the interventional study NCT04035993 is recorded as completed, but this does not mean that results have been posted; registration alone cannot demonstrate efficacy, approval, or standard of care.

Points to verify during clinical consultations

In clinical care, it is important to confirm symptom onset and changes, methods for measuring blood glucose and ketones, experiences of hypoglycemia, insulin use and living conditions, and plans for complication screening.