Type 1 diabetes factsheet
Introduction
Type 1 diabetes is an autoimmune condition that can develop during childhood. Autoimmune conditions are when the immune system attacks healthy cells instead of fighting off illness or infection.
Type 1 diabetes affects the pancreas, a gland that produces a hormone called insulin. Insulin helps move sugar, or glucose, from the blood into the cells for energy.
In type 1 diabetes, the immune system destroys the cells that make insulin. Without insulin, glucose stays in the blood. High levels of glucose in the blood over time can cause:
- severe illness
- damage or shut down of important organs, like the eyes and kidneys
- death.
Type 1 diabetes is different to:
- type 2 diabetes
- gestational diabetes 鈥� a condition that can develop during pregnancy.
Type 1 diabetes cannot be prevented or cured, and it is not caused by things like lifestyle.
Children are more at risk of having type 1 diabetes if they have a parent with type 1 diabetes.
聽Signs and symptoms
Type 1 diabetes can develop months or years before symptoms show up. In children, symptoms can appear suddenly.
They can include:
- unexpected weight loss
- feeling tired during the day
- extreme thirst
- needing to do a wee more than usual
- wetting the bed, even if toilet trained.
Unmanaged or undiagnosed type 1 diabetes can also cause more severe and life-threatening symptoms.
Diabetic ketoacidosis
Diabetic ketoacidosis (DKA) is a severe and life-threatening condition that can happen when type 1 diabetes is undiagnosed or not well managed.
When your child's body doesn't have enough insulin, it starts breaking down fat for energy, producing chemicals called ketones.
Your child鈥檚 body will try to get rid of ketones through urine or wee, but they can continue to build up over time. When ketones build up, they can make the blood acidic. This is toxic and can lead to severe illness and death if not treated.
Signs of DKA include Type 1 diabetes symptoms, along with:
- belly pain
- vomiting
- deep or fast breathing
- fruity-smelling breath
- confusion.
Call triple zero (000) for an ambulance or go to your nearest emergency department if your child is showing symptoms of DKA.
Hyperglycemia
Hyperglycemia means high blood glucose. It can happen when there is not enough insulin, or your child鈥檚 body cannot use insulin properly. It can happen in both Type 1 and Type 2 diabetes.
Hypoglycemia
Hypoglycemia means low blood glucose. It can happen when there is not enough glucose in the blood. This can happen in both
Type 1 and Type 2 diabetes when your child:
- has too much insulin
- skips meals
- does physical activity.
Diagnosis
If you notice your child has signs of type 1 diabetes, see your local doctor as soon as possible. Early diagnosis and treatment can reduce the risk of serious illness.
Your local doctor may send you to the nearest emergency department for assessment, depending on signs and symptoms.
Type 1 diabetes can be diagnosed using results from blood tests, including:
- fasting glucose 鈥� measures blood glucose after not eating or drinking for several hours
- random glucose 鈥� measures blood glucose at any time in the day
- glucose tolerance test 鈥� measures how well your child鈥檚 body manages a special sugary drink after a period of not eating or drinking
- HbA1c 鈥� measures average blood glucose levels over the last 10-12 weeks.
Your child鈥檚 doctor will tell you about the tests needed and what you need to do to prepare.
Treatment
After diagnosis, children will see a specialist, such as a:
- paediatrician 鈥� a child health specialist
- endocrinologist 鈥� a hormone specialist.
Your child may need to stay in hospital for a short period after they are diagnosed to:
- treat any symptoms
- start insulin therapy
- see a diabetes educator - a health professional who will teach you and your child how to manage the condition
- see a dietician 鈥� a health professional who provides support around nutrition.
Insulin therapy
In insulin therapy, your child is given replacement insulin every day through:
- multiple injections with a very fine needle
- a pump with a tube under the skin that is replaced every few days.
Children often start with injections and later, with the support of their diabetes team, may switch to a pump.
Your child鈥檚 diabetes team will teach you about:
- different types of insulin and the ones that are best for your child
- how to give injections
- how to adjust the doses depending on blood glucose levels, food, illness and exercise.
Glucose monitoring
Glucose monitoring is a way to check that your child is getting the right amount of insulin throughout the day.
This can be done using:
- A blood glucose monitor - a small device used to check blood glucose levels. Your child will use a small needle or lancet to prick their finger and get a drop of blood. They will then place the drop on a test strip in the monitor, which shows their blood glucose level.
- Continuous glucose monitoring (CGM) is a small device that continuously measures your child's blood glucose levels. The CGM sensor is placed under the skin of your child's arm or belly. It measures the glucose in the fluid between the cells and sends the information to a device like a smartphone. The sensor needs to be replaced every few days.
Lifestyle changes
Children with Type 1 diabetes should not need a special diet. Like all other children, they should eat well-balanced, nutritious foods and enjoy daily physical activity.
Your child鈥檚 diabetes team will teach you about adjusting insulin based on what your child eats and physical activity.
Healthcare team
A team approach helps manage type 1 diabetes. Along with your local doctor and diabetes team, your child may need support from other health professionals like a:
- dietitian 鈥� for nutrition and diet support
- exercise physiologist 鈥� for exercise and physical activity support
- podiatrist 鈥� to treat foot problems related to diabetes
- optometrist 鈥� to treat eye and vision problems related to diabetes
- pharmacist - for support with insulin and medication
- counsellor, social worker or psychologist 鈥� to support behaviour, mental health and managing long-term illness.
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Stages of type 1 diabetes
Type 1 diabetes may start months or years before your child has symptoms.
It will usually develop in three stages:
Stage 1: The immune system starts attacking cells in the pancreas. Blood glucose levels are normal, and there are usually no symptoms.
Stage 2: More cells are destroyed, and blood glucose levels rise. There are usually still no symptoms.
Stage 3: About 80% of the insulin-producing cells are destroyed, leading to high blood glucose levels and noticeable symptoms.
Type 1 diabetes is usually diagnosed and treated at stage 3.
