10 Facts About Type 1 Diabetes

10 facts about type 1 diabetes. Image courtesy of the Nursing Times.

According to the Centers for Disease Control & Prevention (CDC), type 1 diabetes is an autoimmune disease in which the body’s own immune system destroys pancreatic beta cells that produce insulin. Without sufficient insulin, glucose levels build up in the blood and become too high, resulting in potentially life-threating symptoms. Read on to learn 10 interesting facts about type 1 diabetes.

1. T1D is less common than other forms of diabetes

Type 1 diabetes is less common than type 2 diabetes; approximately 5-10% of people living with diabetes have type 1. However, type 1 diabetes is far from a rare disease. According to Beyond Type 1, In the United States alone, 1.6 million Americans live with T1D, and an estimated 64,000 people are diagnosed with the condition each year. In fact, it is estimated that 5 million people will be diagnosed with T1D by 2050.

2. T1D is often diagnosed at a young age

Type 1 diabetes is usually diagnosed in children, teens, and young adults, but it can develop at any age. Because type 1 diabetes is caused by an autoimmune reaction, the destruction of beta cells can go on for months or even years before any symptoms appear in the patient. Type 1 diabetes can be diagnosed through a simple blood test, such as an A1C test, which measures your average blood sugar levels over the past 2-3 months. An A1C level of 6.5% or higher indicates you have diabetes.

3. There are several risk factors for T1D

Although the exact cause of type 1 diabetes is unknown, certain genes can make you more susceptible to developing T1D. Studies have shown, for example, that children with a genetic predisposition for and a family history of type 1 diabetes have more than a 1 in 5 risk for developing this autoimmune disease.

However, many people with these genes won’t go on to develop the condition even if they have a genetic predisposition. For that reason, environmental triggers, such as exposure to viruses, are also thought to play a part in the development of type 1 diabetes. Contrary to popular belief, diet and lifestyle habits do not cause type 1 diabetes.

4. Insulin is key to managing diabetes

T1D patients need to take insulin shots, or wear an insulin pump, every day to manage their blood sugar levels and get the energy their body needs. Patients with type 1 diabetes should work with their doctor to determine the most effective type of insulin and dosage that are right for them. Types of insulin range from ultra rapid-acting insulin, to rapid-acting, short-acting, intermediate-acting, long-acting, and ultra long-acting.

In addition, T1D patients also need to check their blood sugar levels regularly. By keeping their blood sugar levels close to a target determined by their physician, patients can prevent or delay further complications. Blood sugar levels can be monitored through the use of a blood glucose monitor and finger sticks, or a continuous glucose monitoring (CGM) system.

5. T1D causes a variety of symptoms

Type 1 diabetes symptoms can vary from patient to patient. According to the Mayo Clinic, some signs and symptoms of type 1 diabetes include: increased thirst, frequent urination, bed-wetting in children, extreme hunger, unintended weight loss, bacterial and fungal infections of the mouth, gum disease, irritability and mood changes, fatigue and weakness, and blurred vision.

Another common complication of type 1 diabetes is hypoglycemia, otherwise known as low blood sugar. This occurs when the patient has too much insulin, or has waited too long for a meal or snack, or simply hasn’t eaten enough food. It can also be caused by getting extra physical activity.

6. T1D can be disabling

Type 1 diabetes can result in complications affecting various bodily systems. For example, T1D can cause nerve damage, also known as neuropathy. Symptoms include tingling, numbness, burning or pain in one’s extremities. This can also cause gastrointestinal issues, like nausea, vomiting, diarrhea, or constipation. In men, erectile dysfunction can be an issue.

Foot damage may also occur, as a result of poor blood flow to or nerve damage in the feet. If not treated, cuts and blisters in the feet can turn into serious infections that may require limb amputation.

T1D may also cause kidney damage, resulting in kidney failure or irreversible end-state kidney disease, which requires dialysis or a kidney transplant.

It’s less commonly known that type 1 diabetes can also cause eye damage. The blood vessels of the retina become damaged (called diabetic retinopathy), potentially causing blindness. Diabetes also increases the risk of developing other vision conditions, like cataracts and glaucoma.

7. T1D can be life-threatening

Type 1 diabetes can in fact be life-threatening. For instance, T1D can cause cardiovascular problems like high blood pressure, coronary artery disease, chest pain (angina), atherosclerosis (narrowing of the arteries), heart attack, and stroke.

Another life-threatening complication of type 1 diabetes is diabetic ketoacidosis (DKA), a state in which your body cannot use the sugar in its bloodstream to produce energy, so it starts to break down fat as fuel. This causes ketones to be released into the body. If the level of ketones in your body becomes excessively high, this can result in a coma or even death. Some warning signs of DKA include dehydration, extreme thirst, flushed skin, nausea, stomach pain, vomiting, shortness of breath, fruity-smelling breath, and disorientation.

8. Lifestyle changes can make a difference

Although type 1 diabetes isn’t caused by poor diet or lifestyle habits, maintaining healthy lifestyle habits can go a long way to improving your overall health and wellbeing. Such habits include stress reduction, getting sufficient sleep, making healthy food choices, being physically active, and controlling your blood pressure and cholesterol levels.

Maintaining a close working relationship with your medical care team, and regularly attending your appointments, are also important in managing your type 1 diabetes. Your care team may include your primary care physician, endocrinologist, podiatrist (foot doctor), ophthalmologist and optometrist (eye doctors), dentist, pharmacist, registered dietician, and more.

9. Type 1 diabetes can develop during pregnancy

Type 1 diabetes may develop in women who are pregnant, a condition referred to as gestational diabetes. This occurs when blood sugar levels become high during pregnancy. Gestational diabetes affects up to 10% of women who are pregnant in the US each year. While gestational diabetes does go away after giving birth, it can impact your baby’s health, and raises your risk of developing type 2 diabetes later in life.

10. There is hope

If you are a type 1 diabetes patient, it’s important to get the support and resources you need to manage daily life with the condition. Here are a few resources that may help:

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Experimental Immunotherapy Puts Lupus into Remission for Young Patient

20-year-old lupus patient Thu-Thao received an experimental treatment which put her symptoms into remission. Story via Autoimmune Warrior.
Thu-Thao (center) received an experimental treatment called CAR-T which put her lupus symptoms into remission.

Thu-Thao was 16 years old when she was diagnosed with systemic lupus erythematosus, a debilitating autoimmune disease that causes a myriad of symptoms, including organ damage, joint pain, fatigue, brain fog, and more. Thu-Thao’s main lupus symptoms were severe joint pain, heart palpitations, kidney issues, hair loss, and skin rashes. She faced life-threatening complications, and as a result, had to drop out of playing sports.

After being diagnosed with lupus, Thu-Thao received a number of conventional treatments over the course of four years, including the anti-malarial drug hydroxychloroquine (the generic for Plaquenil), steroids, biologics, and immunosuppressants. However, none of these treatments were effective and her joint pain and skin problems continued to worsen.

In March 2021, at 20 years of age, Thu-Thao received an experimental immunotherapy called chimeric antigen receptor T-cell, or CAR-T for short. This immunotherapy is typically used on cancer patients, specifically those experiencing aggressive forms of leukemia or lymphoma. This therapy reprograms destructive immune cells in the patient’s body, allowing them to recognize and destroy tumors. 

However, B-cells (the target of the therapy) are also heavily implicated in lupus, in which they create antibodies that directly target double-stranded DNA. The researchers theorized that they could use CAR-T therapy to decrease B-cell numbers in the body, resulting in fewer circulating autoantibodies that cause lupus symptoms. 

Following the therapy, Thu-Thao’s CAR-T cell numbers rapidly increased and remained circulating in her system. The B-cells and autoantibodies in her body—thought to be the cause of the autoimmune symptoms—then began to rapidly deplete as well. Just six months after the treatment, Thu-Thao is in remission from her lupus symptoms, and has returned to playing sports.

20-year-old Thu-Thao is finally experiencing relief from her debilitating lupus symptoms, four years after being diagnosed.

“I can finally breathe properly and sleep through the night, and I no longer have any water retention, and the redness in my face has disappeared. My hair is also growing much more densely,” said Thu-Thao. She is also no longer experiencing heart palpitations: her heart rate dropped from an average of 115 to 130 beats per minute to 80 beats per minute.

The scientists at Universitätsklinikum Erlangen, the German university where the CAR-T treatment was administered, are pleased to see positive preliminary results in a patient with lupus.

“We see this as a milestone in the therapy of autoimmune diseases,” the scientists commented. They are now planning a clinical study with CAR-T cells in more patients with autoimmune diseases.

To read more about this new immunotherapy and the research being done at the Universitätsklinikum Erlangen, read the full article.

FDA Approves Drug to Treat Rare Autoimmune Disease

The U.S. Federal Drug Administration (FDA) has approved a drug manufactured by ChemoCentryx to treat a rare group of autoimmune diseases, called anti-neutrophil cytoplasmic autoantibody-associated vasculitis, or ANCA-AAV for short. According to ANCA Vasculitis News, ANCA-AAV causes inflammation and damage to the body’s small blood vessels. This inflammation is the result of antibodies that bind to certain cells of the immune system, called neutrophils, and overly activate them.

Since small blood vessels are found throughout the body, ANCA-AAV causes a variety of symptoms, including:

  • Poor kidney function, leading to kidney failure
  • Severe respiratory problems, including shortness of breath, hoarse voice, cough with blood or mucus, and chest pain
  • Neurological symptoms, including tingling, burning, numbness, and weakness
  • Central nervous system (CNS) involvement, such as headaches, cognitive impairment, and memory deficits. In severe cases, seizures, paralysis or loss of consciousness may also result.
  • Ear, nose, and throat (ENT) symptoms, like sinusitis, nasal discharge, rhinitis, and tinnitus (ringing in the ears)
  • Eye symptoms, including eye pain, vision impairment, and vision loss
  • Joint pain, muscle pain, and muscle loss
  • Skin lesions, including rashes, sores, ulcers, bumps, and bleeding underneath the skin
  • Digestive problems, like vomiting, diarrhea, nausea, abdominal pain, and blood in one’s stool
  • And more…

Due to the numerous symptoms ANCA-AAV causes, it can often be fatal for patients; in fact, ChemoCentryx states that the first year mortality rate for patients living with the disease is between 11 and 18 percent. Current ANCA-AAV treatments on the market include steroids and immunosuppressant medications which compromise the body’s ability to fight off infections. That’s why having a new treatment on the market that works via a different mechanism may be a saving grace for many ANCA-AAV patients.

The new drug, called avacopan, will be sold by ChemoCentryx under the brand name Tavneos. It works by blocking a protein called C5a receptor that is responsible for causing numerous inflammatory diseases. The drug’s wholesale price will be an astronomical $150,000-$200,000 per patient per year. However, it could be the life-saving treatment that the 40,000 ANCA-AAV patients in the US need.

The drug is currently being tested for use on other conditions as well, including the autoimmune skin disease Hidradenitis Suppurativa (HS). The drug has already received approval for commercialization in Japan, and is expected to be approved in Europe by the end of 2021.

Martina, a 29-year-old mother-of-two from Stuttgart, Germany, describes what it was like being diagnosed with this challenging autoimmune condition:

“It began rather unspectacularly, with flu-like symptoms, fever, headaches, and joint pain. So anyone would think, ‘It’s just a normal flu.’ Then it got worse over the course of a week and I went to the hospital.”

She was eventually diagnosed with ANCA-AAV after undergoing a series of blood tests. Unfortunately, she had to give up her career as an educator in the process, since she didn’t have a strong enough immune system to be interacting with children while taking steroids and immunosuppressants to control the disease. Patients like Martina are the ones that could potentially stand to benefit from new drug therapies like avacopan.

Martina, 29, appears in an ad to raise awareness for vasculitis conditions.

To find resources for those living with ANCA-AAV and their caretakers, visit: https://www.myancavasculitis.com/living-with-aav/