From womenshealthmag.com
Type 1 diabetes is an autoimmune disease, which means that the body’s immune response attacks its own tissues—specifically, the beta cells in the pancreas that produce insulin. As this cell destruction progresses, the body can no longer produce insulin on its own. But post-diagnosis, a combination of insulin therapy, proper education, and lifestyle adjustments ensures that people living with type 1 diabetes can live healthy lives with well-managed blood-glucose levels.
While type 1 diabetes has often been referred to as “juvenile-onset diabetes,” due to its predominantly being diagnosed in childhood, the autoimmune condition can also develop in adulthood. In fact, says Rita R. Kalyani, MD, MHS, an associate professor of medicine at Johns Hopkins University School of Medicine, “type 1 diabetes can occur at any age. Adult-onset type 1 has also been referred to as ‘latent autoimmune diabetes of adulthood,’ or LADA.” Joel Zonzsein, MD, director of the Diabetes Centre at the University Hospital of the Albert Einstein College of Medicine, adds that about 10 percent of people with type 1 diabetes are diagnosed after the age of 18.
Does The Age Of Diagnosis Make A Difference?
There are a few differences between adult- and childhood-onset type 1 diabetes, Dr. Zonzsein notes. While the typical symptoms of type 1 diabetes vary, they tend to first appear in a more abrupt and intense fashion in childhood. In juvenile-onset diabetes, you might notice extreme thirst, frequent urination, and prolonged elevated blood sugars (common symptoms of which include frequent urination, feeling unusually thirsty, and a dry mouth). Left untreated or unnoticed, high blood sugar can result in hospitalization for diabetic ketoacidosis (DKA).
But the symptoms of adult-onset type 1, or LADA, can often resemble those of type 2 diabetes. “In general, adults with type 1 experience less severe symptoms than children,” Dr. Zonszein says, “because adults may have some remaining beta cells in their pancreas that are still producing some amount of insulin.”
And that does mean there’s sometimes a difference in the way adult-onset diabetes is treated. “Most children will have complete insulin deficiency when diagnosed and need insulin treatment from the start,” says Dr. Kalyani. “In adults, there may still be some residual insulin production, which wanes over time until complete insulin deficiency occurs, and insulin injections may not be needed until a few months to sometimes years after diagnosis.”
Living With A Type 1 Diabetes Diagnosis
Once the body is insulin-dependent or completely insulin-deficient, however, the treatment for type 1 diabetes—regardless of the age of diagnosis or development of the condition—is the same. Managing type 1 requires “a healthy lifestyle, proper education, and insulin therapy,” Dr. Zonszein says. In addition to regular insulin injections or a pump, people living with type 1 diabetes should be mindful of a few lifestyle changes, including:
- Regular blood-glucose monitoring
- Counting carbohydrates and adjusting insulin dosage accordingly
- Regular exercise, which can help to regulate blood sugar and prevent long-term complications
- Regular check-ups with a team of medical specialists, including an endocrinologist, optometrist, and in some cases a dietitian
Avoiding Long-Term Complications Of Type 1 Diabetes
While there are several acute and chronic complications associated with type 1 diabetes, most can be prevented by well-managed blood-sugar levels. The acute complications are directly related to blood glucose, including hypoglycaemia (low blood sugar) and diabetic ketoacidosis. The latter, which results from prolonged high blood sugar and presents with symptoms including nausea and vomiting, confusion, and severe stomach pain, requires emergency care.
“There are several potential chronic or long-term complications of type 1 diabetes that can affect many organs, like the eyes, kidneys, heart, and nerves,” adds Dr. Zonszein. These include:
- Eye issues: High blood sugars can damage the blood vessels in the retina and result in diabetic retinopathy, which can cause blindness.
- Kidney disease: Type 1 diabetes can lead to kidney disease. Left untreated, this can lead to failure of the organ.
- Heart disease and stroke: People with type 1 diabetes are at an increased risk for both conditions.
- Nerve damage: High blood sugars can damage the nerves and lead to diabetic neuropathy, which can cause numbness, tingling, and pain in the hands and feet.
Most of these complications are a direct result of poorly managed blood-glucose levels, so regular check-ups with a team of medical professionals and a good diabetes-management plan are crucial to prevent and detect health issues down the line. “Monitoring blood-sugar levels regularly—before meals, after meals, and whenever there’s suspicion of low blood sugar—is essential for managing diabetes,” Dr. Zonszein says. The good news: With well-managed blood glucose, people with type 1 diabetes can live healthy lives and avoid serious complications later in life.
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