Diabetes is a lifelong condition when your blood glucose level is too high.  The most common types of diabetes are Type 1 and Type 2 Diabetes. Type 2 Diabetes is the accounts for around 90% of cases while Type 1 accounts for just under 10% of cases.

Causes Type 1 Diabetes

Type 1 diabetes mellitus (T1DM) is the most common type of diabetes mellitus in children and adolescents.  T1DM is primarily due to pancreatic islet β-cell destruction resulting to severe insulin deficiency.  More than 90% of patients with newly diagnosed T1DM have low or undetectable levels of C-peptide and/or diabetes associated auto-antibodies in their blood.

Click to view DiabetesUK video on Type 1 Diabetes

Symptoms of Type 1 Diabetes

Typically T1DM have 2 types of presentations;

1. Gradual onset of symptoms over 2-6 weeks of;

• feeling very thirsty
• passing urine more often than usual especially at night (which may result in bed wetting)
• fungal vaginal infection in girls
• unexplained weight loss (over 2-6 weeks)
• recurrent skin infections

2. Emergency presentations (up to 40% of cases may present like this)

• Dehydration
• Vomiting
• Abdominal pain
• Hyperventilation
• Acetone smelling breath due to Diabetic Keto-Acidosis (DKA)
• Decreased level of consciousness
• Low blood pressure

Diagnosis of Type 1 Diabetes

There are a few ways to diagnose diabetes and tests should be carried out in your doctor’s clinic or a health lab prior to initiating therapy.

1. Fasting & Random Blood Glucose Test

The Fasting Plasma Glucose (FPG) Test is a blood test to diagnose diabetes or pre-diabetes and requires you to fast for 8 hours before performing the test.

The Random Plasma Glucose (RPG) Test measures your blood glucose at any time.

Results interpretation

• For individual with symptoms, 1 abnormal blood glucose reading is sufficient for diagnosis
• For individual without symptoms, 2 abnormal blood glucose readings are needed

	Fasting	Random
Venous Blood (mmol / l)	> 7.0	> 11.1

2. HbA1c Blood Test

The HbA1C Test measures your average blood glucose over the past 2-3 months. It shows how well your blood sugar has been controlled over the last 2-3 months period.  High values mean you are at risk of vascular complications of diabetes. 

Results interpretation

• For individual with symptoms, 1 abnormal reading is sufficient for diagnosis
• For individual without symptoms, HbA1c should be repeated within 4 weeks after first abnormal test

Normal	Pre-Diabetes	Diabetes
< 5.6%	5.7-6.2%	> 6.3%

Click T1DM Explained video on How to Manage T1DM

Treatment Targets of Type 1 Diabetes

Evidence has shown that intensive management and good control of the diabetes is associated with fewer microvascular complications such as kidney dysfunction, heart disease, eye retinopathy, peripheral vascular disease and foot ulcers.  Ideal treatment targets include;

• achieving near normal ideal blood glucose levels
• no significant hypoglycaemia or DKA through self monitoring
• normal growth and development
• normal psychological development and adjustment to daily school life
• prevention of long term complications

‘Each patient should have their targets individually determined by their Diabetic Care Team with the goal of achieving a value as close to normal as possible while avoiding severe hypoglycaemia and minimising frequent episodes of hypoglycaemia’

Insulin is usually the first line of treatment for T1DM.  The general rule is to try to achieve at least > 50% of the self monitoring readings within Target Range (see below) and as little as possible in the hypoglycaemia (extreme low values) range;

Take time to discuss your condition with your doctor, dietician/nutritionist or pharmacist to improve your diabetic control and AVOID diabetic related health complications.

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