Type 1 Diabetes Basics Type 1 diabetes (T1D) is an autoimmune condition where the body attacks insulin-producing cells. Insulin is an essential hormone that regulates blood glucose, your body’s fuel source. It can take months, and often, years for the condition to develop. Knowing the signs of and risk for T1D are essential for overall health and wellbeing, as well as mission readiness. The earlier you catch T1D, the lower your risk for negative health outcomes. How Does T1D Develop? Autoimmune conditions occur when your immune system mistakenly attacks your body’s tissues. In T1D, your immune system attacks the cells that produce insulin in your pancreas. Over time, the body learns to no longer produce these cells due to constant attack. Currently, there is no determined cause for this. However, there are factors that may increase your likelihood of developing T1D, such as family history, genetics and environmental factors (e.g., viruses). Symptoms Extreme or consistent thirst Urinating often Strong feelings of hunger and fatigue Unexplained weight loss Slow healing wounds Dry, itchy skin Tingling or numbness in hands and/or feet Worsening eyesight (e.g., blurry vision) There are three defined developmental stages of T1D which are determined via autoantibody testing. Autoantibodies show there is an immune response to insulin-producing cells. Stage1 Stage2 Stage3 This is the earliest stage of T1D development where 2+ autoantibodies are present. Blood glucose is often in normal range (70-180 mg/dL). Few to no symptoms of the condition are present. This stage shows the condition is advancing. The pancreas still produces insulin, but inconsistently. Blood glucose varies more, especially after eating, and symptoms begin to show more prominently. Delaying onset of Stage 3 is possible with early screening and medication. This stage is when most people receive a diagnosis of T1D. Blood glucose levels are typically >180 mg/dL and require insulin to return to normal range. Symptoms are present and risk of diabetic ketoacidosis (DKA) is high. Diabetic Ketoacidosis DKA occurs when your body can’t effectively use glucose for energy because there isn’t enough insulin. As a result, your body turns to stored fats as an energy source. These fats are rapidly broken down, which leads to increased ketones. These chemicals make your blood acidic and are toxic in large amounts. Untreated DKA can lead to a diabetic coma. Both conditions are emergent and require immediate treatment from a health care provider. Many people think only children can get T1D, but that’s not the case. Though it was previously referred to as ‘juvenile diabetes,’ the term was phased out because nearly half of all diagnoses occur in adults. Many adults with T1D are misdiagnosed with type 2 diabetes, which increases their risk of experiencing DKA. Who Is Impacted? Even though there is no known cause of T1D, there are certain factors that may increase your risk of developing the condition. The overall risk is 0.4%. Family history, viral infections and gut health all play a role in potential T1D development. Family History If your family members live with T1D, your risk increases. Mother: 3-4% Father: 5-6% Sibling: 8-10% Identical twin: 30-50% Viral Infections Enteroviruses (e.g., hand, foot and mouth disease, meningitis, severe pink eye) can trigger an autoimmune response to insulin-producing cells. Gut Health Your gut is the largest organ in your immune system. It’s essential to mounting an immune response, so any imbalance in gut bacteria may lead to immune dysfunction. T1D and the Military Though living with T1D is an automatic disqualification for joining military service, it is not an automatic medical separation if diagnosis occurs during service. With technological advancements and increased education, some Warfighters are able to continue their military service on a case-by-case basis. To stay active duty, Warfighters are referred to a Medical Evaluation Board (MEB), must pass their branch’s physical requirements and successfully complete other unit-related activities. Warfighters that are retained may not be fit for deployment, though a T1D diagnosis does not automatically make someone non-deployable. Type 1 diabetes is a complex condition that requires consistent care. Though there’s no way to prevent the condition, assessing your risk and seeking testing with your health care provider can catch the condition in its early stages. If you are experiencing any symptoms, contact your care team immediately. Additional ResourcesBreakthrough T1D Beyond Type 1 Diabetes Education & Camping Association Ohio State University - “The mental health effects of type 1 diabetes”ReferencesBeyond Type 1 - “What Are the Different Stages of Type 1 Diabetes?”Castaneda, C. et al - “A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes”Choi, Y. S. & Cucura, J. - “US Army Soldiers With Type 1 Diabetes Mellitus”Duca, L. M. et al - “Diabetic Ketoacidosis at Diagnosis of Type 1 Diabetes Predicts Poor Long-term Glycemic Control”Krischer, J. P. - “The use of intermediate endpoints in the design of type 1 diabetes prevention trials”MedlinePlus - “Diabetic ketoacidosis”MedlinePlus - “Diabetes Type 1”Tokmakidis, S. P. et al - “The effects of combined strength and aerobic exercise program on glucose control and insulin action in women with type 2 diabetes”Ziegler, A. G., Rewers, M., & Simell, O. - “Seroconversion to Multiple Islet Autoantibodies and Risk of Progression to Diabetes in Children”
