Sugar Matters
February 19, 2010
The Basics on Type 1 Diabetes

BY NOW you all are starting to realize that Type 1 and Type 2 diabetes are a lot like second cousins: they are related but can look VERY different. Up until now we have been largely focusing on discussing Type 2 diabetes because that disease is far more prevalent and affects more people around the world. But interestingly many of the ideas people have about diabetes come mainly from what they have heard about Type 1.{{more}} So let’s go through some basics to introduce you to Type 1 diabetes.

Type 1 diabetes is classified as an autoimmune condition, meaning that the immune system of the body essentially turned on itself and other cells of its native body (instead of only fighting “outsiders” like germs). The actual genetic background and biological process where this happens is complicated and truly not 100% sorted out. What we see clinically and by lab results is usually clear. Someone with Type 1 Diabetes has a pancreas that makes little to no insulin; this person almost always has lab tests that show evidence of this autoimmune reaction (we can test for that); the person with Type 1 diabetes will not respond to oral diabetes medications and needs insulin instead. There are some exceptions to these rules, but for the most part the diagnosis of Type 1 diabetes is based on someone needing insulin absolutely, having evidence of not making any on his/her own, and tests positive for that autoimmune process I mentioned.

Some of the other ideas about Type 1 are also true for the most part, but there are many more exceptions to those rules:

MOST people with Type 1 diabetes are diagnosed as children, but many are well into adulthood even at the first time of diagnosis. I have a colleague who has a father and brother with Type 1 diabetes-her brother was diagnosed at age 11 and her father at age 51.

MOST people with Type 1 diabetes are on the slender side, especially when they are first diagnosed, but I also have many patients who were or are overweight with Type 1 diabetes.

People who have Type 1 diabetes need insulin, but there is often a time called the “honeymoon period” where some people with Type 1 diabetes actually can take diabetes pills and be okay. Unfortunately, this tricks some patients and doctors into thinking the patient may have Type 2 instead, until he/she gets very sick and has a blood sugar of 600mg/dL. It can be tough to figure out at times.

These days if they follow guidelines for staying healthy and taking medications, many people with Type 1 diabetes can lead essentially normal lives and live as long as people without Type 1 diabetes. Having Type 1 diabetes does not make you disabled, weak or “sick.” I personally know people from all walks of life with this disease: doctors, nurses, teachers, mechanics, truck drivers, computer programmers, tri-athletes, police officers, soldiers…you name it.

We’ll continue on next week, same time and place.

Until next week, stay safe and healthy, Vincies!

Anita Ramsetty, MD
Medical Director Endocrine Care Group
Tel: 843-798-4227