Type 1 diabetes

What is type 1 diabetes

Type 1 diabetes is a chronic incurable autoimmune disease. The disease often develops over a short period of time and is usually diagnosed at a young age.

Naming: diabetes or diabetes-related disease?

The full official name for diabetes is diabetes mellitus. You often hear the term diabetes. The term diabetes can lead to wrong conclusions. For example, that someone with diabetes should not eat sugar at all. That’s why we prefer to call it diabetes. Besides type 1 diabetes, type 2 diabetes also exists.

How many people have type 1 diabetes?

Over 1.1 million Dutch people have diabetes. About 9% of diabetes cases are type 1. People usually develop this form of diabetes in childhood, but adults can also get it. The majority of children with diabetes have type 1 diabetes, although type 2 diabetes also occurs in children nowadays. Most adults have type 2 diabetes.

What happens in Type 1 diabetes?

When you ingest certain carbohydrates (starches and sugars), the body converts them into glucose. Glucose enters the blood. There we call it blood glucose. Through the blood, the glucose ends up in the body cells. Thus glucose supplies energy to the body. You need this for example for breathing, moving and the beating of your heart.

Cells absorb blood glucose with the help of the hormone insulin. This hormone is made in the pancreas. Normally, the body makes sure there is enough insulin to get the glucose from the blood into the cells. Insulin actually works like a key: it opens the doors of the body’s cells so that blood glucose can enter.

Type 1 diabetes occurs when the pancreas no longer produces insulin. The cells in the pancreas which produce insulin are destroyed by the body’s own immune system. That’s called an autoimmune reaction. Type 1 diabetes is therefore also called an autoimmune disease. In people with Type 1 diabetes, glucose cannot enter the cell and remains in the blood. The blood glucose level is therefore too high.

What does blood glucose mean?

The blood glucose level is a measure of the amount of glucose dissolved in the blood. The control of blood glucose levels is regulated by the hormones insulin and glucagon. Insulin ensures the uptake of glucose by cells. Glucagon ensures the release of glucose from cells. This process keeps blood glucose levels within acceptable limits. In healthy people, under normal conditions, blood glucose levels will vary between 4 and 8.

In Type 1 diabetes, because there is no insulin to get glucose into the cells, the values rise well above 8. Cells can then take up glucose again. Thus, blood glucose levels can return to normal. But people with type 1 diabetes can rarely always keep their blood glucose values within the normal range. That’s because the amount of insulin is difficult to adjust exactly to the amount a person eats. Other factors also influence blood glucose values, such as illness, stress, exercise and alcohol.

When do you have diabetes?

A person has diabetes if the blood glucose values are determined:

• 7 or higher in sober state (nothing eaten or drunk except water in the previous 8 hours).
• 11.1 or higher is about 2 hours after a meal.

A preliminary stage of diabetes is referred to when the blood values:

• between 6.1 and 7 when sober.
• between 7.8 and 11.0 approximately 2 hours after a meal.

The blood glucose levels are normal if they:

• The fasting value is 6.0 mmol/l or lower.
• 2 hours after the meal are below 7.8 mmol/l.

What are the causes of Type 1 diabetes?

There is still much uncertainty about the cause of Type 1 diabetes. A certain hereditary disposition plays a role, but also environmental and nutritional factors. There are also indications that babies who have been breast-fed have a lower risk of developing diabetes later on.

Health effects of diabetes

Symptoms hyper (high blood glucose levels)

People with Type 1 diabetes can have excessively high blood glucose levels. This is called hyperglycaemia or ‘hyper’ for short. A hyper causes various immediate complaints, such as tiredness and listlessness, sudden moodiness, thirst, loss of appetite or hunger, frequent urination, blurred vision, nausea or vomiting. If the hyper is treated, the symptoms usually disappear quickly. Long-term high blood glucose levels damage the blood vessels. That is why people with diabetes have a higher risk of cardiovascular disease. Other complications that can arise are chronic kidney damage, a diabetic foot and impaired vision.

Symptoms hypo (low blood glucose)

If your blood glucose levels fall below 3.5, you have a hypo. The symptoms are mild irritability (dysphoria), trembling, sweating, palpitations, yawning and mood swings. If the blood glucose levels really get too low, a person faints. In the worst case, this can lead to permanent brain damage or death. This is because the brain cells are also deficient in glucose and “drop out”. It is therefore necessary to eat or drink something sweet immediately after a hypo.

How do you recognise a hypo?

You can recognise a hypo by:

• vibrate
• sweating
• palpitations
• yawn
• be moody
• unconsciousness (in an extreme case)

Do you not have diabetes, but do you think that you regularly suffer from hypoglycaemia? Then we recommend you to visit your doctor.

Long-term health effects

In the long term, hyperglycaemia (i.e. too high blood glucose levels) can lead to irreparable damage to the eyes, kidneys and nerves, with a risk of blindness, kidney failure, impotence and foot amputation (due to an out-of-control diabetic foot). Furthermore, the risk of cardiovascular disease is greatly increased in people with diabetes. These complications are due to tissue damage caused by long-term exposure to glucose.

Nutrition advice

There is no evidence that certain foods can delay or prevent the onset of type 1. However, it is possible to reduce complications such as the risk of cardiovascular disease with a healthy diet.

Medication and nutrition

People with Type 1 diabetes inject insulin via a syringe or wear an insulin pump that allows them to release insulin based on the meal eaten (boluses). With a glucose meter they can measure their blood glucose levels themselves. They adjust the amount of insulin to the amount of carbohydrates (starches and sugars) at each meal. If the insulin is taken in fixed amounts every day, the carbohydrate intake should also be roughly the same at fixed times every day. Flexible insulin schedules allow more variation in the amount of carbohydrate taken per meal.

Nutrition in Type 1 diabetes

Food has an influence on blood glucose levels. And what a person eats affects their health, for example that of their heart and blood vessels. For people with Type 1 diabetes, as for everyone, it is important to eat healthily.

The dietary advice for people with Type 1 diabetes is mainly aimed at keeping blood glucose levels under control and taking good care of the heart and blood vessels, thus reducing the risk of complications. A dietician is the right person to help with this.