3 minute 35 second read

What is Type 1 Diabetes?

Type 1 Diabetes (T1D) is a condition where the body creates antibodies that attack insulin-producing beta cells in the pancreas. This results in the body losing its ability to produce insulin.

Insulin is a key hormone that regulates glucose in the bloodstream, which acts as the body’s major energy source.
Without insulin, blood glucose levels will rise to a potentially dangerous level.

What are the symptoms of Type 1 Diabetes?

The classic symptoms of T1D consist of weight loss, passing urine frequently (polyuria), and feeling thirsty all the time (polydipsia). These symptoms tend to come on within weeks, and require immediate medical attention if noted.

What complications can result from Type 1 diabetes?

Without adequate control of diabetes, one will be at risk of microvascular complications, such as diabetic retinopathy (damage to blood vessels in back of eye), neuropathy (nerve damage), and kidney disease; or macrovascular complications, such as ischaemic heart disease (heart attack), and cerebrovascular disease (stroke).

How do you treat Type 1 Diabetes?

The short answer, is to replace insulin by the way of regular injections.

There are two components to this: background or basal insulin, which replicates the body’s base insulin production to ‘keep us alive’; and quick-acting or bolus insulin, which replaces the body’s insulin surge after food intake to bring glucose levels back down to normal.

Treatment may sound simple, yet it is anything but. T1D is one of the hardest diseases to manage, as one needs to maintain constant awareness of one’s dietary intake, activity levels, and even emotional state. Exercise, alcohol, and things like stress, can lead to major fluctuations in glucose levels.

If treating T1D is so complicated, how am I going to manage?

Thanks to technological advancements and knowledge expansion through research, we can now offer various options to help reduce the burden of T1D management.

The first, and most vital component, is education. Information on how to best manage T1D, should not just lie within the healthcare profession. After all, your doctor or nurse cannot be with you round-the-clock! This information should be provided to those living with T1D, to empower them to look after themselves.

Technological advancement has also greatly simplified the management of T1D. For one, the advent of glucose sensors has reduced the need for constant finger pricking to check capillary blood glucose levels. In the past, it was necessary to take 6 – 8 finger pricks per day, in order to achieve good diabetes control. As one can imagine, this was inconvenient and burdensome, translating to poor compliance, poor self-management, and poor outcomes for patients.

In contrast, glucose sensors, once inserted under the skin, provide accurate and ‘real time’ readings for the life of the sensor (usually 7-14 days depending on the brand of sensors). Glucose sensors are widely viewed as one of the most important tools in reducing the burden of living with, and managing T1D.

There is also the insulin pump, a small ‘on body’ device that continuously delivers insulin into the blood stream. The pump holds a ‘reservoir’ of insulin, known as an ‘infusion set’, which is changed every 2 – 3 days. This is in contrast to the traditional method of insulin delivery, requiring 4 – 5 injections per day. Pumps also allow the user to set different rates of background or basal insulin delivery. For example, one could temporarily decrease the basal delivery rate by 20% prior to vigorous physical activity, in order to reduce the risk of hypoglycaemia (low blood sugar).

The invention of the closed-loop system or artificial pancreas, has further reduced the burden of diabetes care. This system works by pairing the glucose sensor and the insulin pump, which talk to each other, and help regulate glucose levels. It should be noted that current systems on the market still require the user to manually input mealtime insulin delivery.

What can we offer for individuals living with T1D?

Dr Tan is the Type 1 Diabetes Lead at Royal United Hospital Bath. His research interests lie in the usage of insulin pumps and glucose sensors to treat patients experiencing recurrent severe hypoglycaemia (low blood sugar). In addition to undertaking and publishing research in this area, Dr Tan has more than 10 years of clinical experience in managing T1D using technological devices.

Dr Tan combines specialised knowledge and clinical experience, with an understanding of the day-to-day challenges experienced by individuals living with T1D. This allows him to provide tailored solutions that are clinically appropriate, whilst sensitive to each patient’s unique circumstances.