Type 1 diabetes is a chronic (life-long) autoimmune disease that prevents your pancreas from making insulin. It requires daily management with insulin injections and blood sugar monitoring. Both children and adults can be diagnosed with Type 1 diabetes.
Type 1 diabetes is a chronic (life-long) autoimmune disease that prevents your pancreas from making insulin.
Insulin is an important hormone that regulates the amount of glucose (sugar) in your blood. Under normal circumstances, insulin functions in the following steps:
If you don’t have enough insulin, too much sugar builds up in your blood, causing hyperglycemia (high blood sugar), and your body can’t use the food you eat for energy. This can lead to serious health problems or even death if it’s not treated. People with Type 1 diabetes need synthetic insulin every day in order to live and be healthy.
Type 1 diabetes was previously known as juvenile diabetes and insulin-dependent diabetes.
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While Type 1 diabetes and Type 2 diabetes are both forms of diabetes mellitus (as opposed to diabetes insipidus) that lead to hyperglycemia (high blood sugar), they are distinct from each other.
In Type 2 diabetes (T2D), your pancreas doesn’t make enough insulin and/or your body doesn’t always use that insulin as it should — usually due to insulin resistance. Lifestyle factors, including obesity and a lack of exercise, can contribute to the development of Type 2diabetes as well as genetic factors.
In Type 1 diabetes, your pancreas doesn’t make any insulin. It’s caused by an autoimmune reaction.
Type 2 diabetes usually affects older adults, though it’s becoming more common in children. Type 1 diabetes usually develops in children or young adults, but people of any age can get it.
Type 2 diabetes is much more common than Type 1 diabetes.
Anyone at any age can develop Type 1 diabetes (T1D), though the most common age at diagnosis is between the ages of 4 to 6 and in early puberty (10 to 14 years).
In the United States, people who are non-Hispanic white are most likely to get Type 1 diabetes, and it affects people assigned female at birth and people assigned male at birth almost equally.
While you don’t have to have a family member with Type 1 diabetes to develop the condition, having a first-degree family member (parent or sibling) with Type 1 diabetes increases your risk of developing it.
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Type 1 diabetes is relatively common. In the United States, approximately 1.24 million people live with Type 1 diabetes, and that number is expected to grow to five million by 2050.
Type 1 diabetes is one of the most common chronic diseases that affect children in the United States, though adults can be diagnosed with the disease as well.
Symptoms of Type 1 diabetes typically start mild and get progressively worse or more intense, which could happen over several days, weeks or months. This is because your pancreas makes less and less insulin.
Symptoms of Type 1 diabetes include:
If you or your child has these symptoms, it’s essential to see your healthcare provider and ask to be tested for Type 1 diabetes as soon as possible. The sooner you’re diagnosed, the better.
If a diagnosis is delayed, untreated Type 1 diabetes can be life-threatening due to a complication called diabetes-related ketoacidosis (DKA). Seek emergency medical care if you or your child are experiencing any combination of the following symptoms:
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Type 1 diabetes develops when your immune system mistakenly attacks and destroys cells in your pancreas that make insulin. This destruction can happen over months or years, ultimately resulting in a total lack (deficiency) of insulin.
Although scientists don’t yet know the exact cause of Type 1 diabetes, they believe there’s a strong genetic component. The risk of developing the disease with no family history is approximately 0.4%. If your biological mother has Type 1 diabetes, your risk is 1% to 4%, and your risk is 3% to 8% if your biological father has it. If both of your biological parents have Type 1 diabetes, your risk of developing the condition is as high as 30%.
Scientists believe that certain factors, such as a virus or environmental toxins, can trigger your immune system to attack cells in your pancreas if you have a genetic predisposition for developing Type 1 diabetes.
Type 1 diabetes is relatively simple to diagnose. If you or your child has symptoms of Type 1 diabetes, your healthcare provider will order the following tests:
Your provider will also likely order the following tests to assess your overall health and to check if you have diabetes-related ketoacidosis, a serious acute complication of undiagnosed or untreated Type 1 diabetes:
An endocrinologist — a healthcare provider who specializes in treating hormone-related conditions — treats people who have Type 1 diabetes. Some endocrinologists specialize in diabetes.
If your child has Type 1 diabetes, they’ll need to see a pediatric endocrinologist.
You’ll need to see your endocrinologist regularly to ensure that your Type 1 diabetes management is working well. Your insulin needs will change throughout your life.
People with Type 1 diabetes need synthetic insulin every day, multiple times a day in order to live and be healthy. They also need to try to keep their blood sugar within a healthy range.
Since several factors affect your blood sugar level, Type 1 diabetes management is complex and highly individualized.
Three of the main components of Type 1 diabetes management include:
There are several different types of synthetic insulin. They each start to work at different speeds, and they last in your body for different lengths of time. You may need to use more than one type.
Some types of inulin are more expensive than others. Work with your endocrinologist to find the right type of insulin for your needs.
The amount of insulin you need throughout the day depends on several factors including:
Along with a background level of insulin (often called a basal rate), you’ll need to give yourself specific amounts of insulin when you eat and to correct high blood sugar levels.
You can take insulin in the following ways:
The amount of insulin you need day to day will vary across your lifespan and under specific circumstances. For example, you typically need larger doses of insulin during puberty, pregnancy and when you’re taking steroid medication.
Because of this, it’s important to see your endocrinologist regularly — usually at least three times a year —to make sure your insulin dosages and overall diabetes management are working for you.
People with Type 1 diabetes need to monitor their blood sugar closely throughout the day. Maintaining a healthy blood sugar range is the best way to avoid health complications. You can monitor your blood sugar in the following ways:
Your healthcare provider will tell you what your target blood glucose level range should be. It depends on a variety of factors, including your:
A large part of Type 1 diabetes management is counting carbohydrates (carbs) in the food and drinks you consume in order to give yourself proper doses of insulin.
Carbohydrates are a type of macronutrient found in certain foods and drinks, such as grains, sweets, legumes and milk. When your body digests foods and drinks that contain carbs, it turns them into glucose, which is your body’s preferred form of energy. This raises your blood sugar level.
Because of this, people with Type 1 diabetes need to give themselves insulin doses when they consume carbohydrates.
Carb counting at its basic level involves counting the number of grams of carbohydrate in a meal (through reading nutrition labels) and matching that to your dose of insulin.
You’ll use what's known as an insulin-to-carb ratio to calculate how much insulin you should take in order to manage your blood sugars when eating. Insulin-to-carb rations vary from person to person and may even be different at different times of the day. Your endocrinologist will help you determine your insulin-to-carb ratio.
The main side effect of diabetes treatment through insulin is low blood sugar (hypoglycemia). Low blood sugar can occur if you take too much insulin based on your food intake and/or activity level. Hypoglycemia is usually considered to be below 70 mg/dL (milligrams per decilitre).
Symptoms of low blood sugar can start quickly, with people experiencing them in different ways. The signs of hypoglycemia are unpleasant, but they provide good warnings that you should take action before your blood sugar drops more.
The symptoms of low blood sugar include:
Hypoglycemia can be dangerous and needs to be treated right away.
The American Diabetes Association recommends the “15-15 rule” for an episode of low blood sugar, which involves:
If you have symptoms of hypoglycemia but can’t test your blood sugar, use the 15-15 rule until you feel better.
Children typically need fewer grams of carbs to treat lows. Check with their healthcare provider.
There is currently no cure for Type 1 diabetes, but scientists are working on ways to prevent or slow down the progression of the condition through studies such as TrialNet.
Scientists are also working on research into pancreatic islet transplantation — an experimental treatment for people who have brittle diabetes.
Pancreatic islets are clusters of cells in the pancreas that make insulin. Your immune system attacks these cells in Type 1 diabetes. A pancreatic islet transplant replaces destroyed islets with new ones that make and release insulin. This procedure takes islets from the pancreas of an organ donor and transfers them to a person with Type 1 diabetes. Because researchers are still studying pancreatic islet transplantation, the procedure is only available to people enrolled in a study.
Unfortunately, there’s nothing you can do to prevent developing Type 1 diabetes.
Since Type 1 diabetes can run in families, your healthcare provider can test your family members for the autoantibodies that cause the disease. Type 1 Diabetes TrialNet, an international research network, also offers autoantibody testing to family members of people with Type 1 diabetes.
The presence of autoantibodies, even without diabetes symptoms, means you’re more likely to develop Type 1 diabetes. If you have a sibling, child or parent with Type 1 diabetes, you may want to get an autoantibody test. These tests can help catch Type 1 diabetes in its earliest phases.
Type 1 diabetes is a challenging condition to manage properly, especially consistently throughout your lifetime. Because of this, T1D is associated with several complications. Close to 50% of people with Type 1 diabetes will develop a serious complication over their lifetime. Some may lose eyesight while others may develop end-stage kidney disease.
For those who reach the first 20 years after diagnosis without any complications, the prognosis (outlook) is good.
Since your blood touches virtually every part of your body, having poorly managed Type 1 diabetes that results in continuous high blood sugar (hyperglycemia) can damage several different areas of your body.
Potential complications of Type 1 diabetes include:
Type 1 diabetes is a complex condition that requires daily management, effort and planning. Some tips that can help you manage your Type 1 diabetes include:
When your child is first diagnosed with Type 1 diabetes, it can be overwhelming. There’s a lot to learn, and you’ll need to get up to speed quickly on how to manage Type 1 diabetes and incorporate lifestyle changes at home. Caregivers often manage Type 1 diabetes for their children, especially if they’re young.
Some things you’ll need to do include:
If you or your child are experiencing symptoms of Type 1 diabetes, such as extreme thirst and frequent urination, see your healthcare provider as soon as possible.
If you or your child have been diagnosed with diabetes, you’ll need to see your endocrinologist multiple times a year throughout your life to make sure your diabetes management is working well for you.
If you’re experiencing symptoms of diabetes-related ketoacidosis (DKA), such as high blood sugar, nausea and vomiting and rapid breathing, get to the nearest emergency room (ER) as soon as possible. DKA is life-threatening and requires immediate medical care.
A note from Cleveland Clinic
Being diagnosed with Type 1 diabetes is a life-changing event, but it doesn’t mean that you can’t live a happy and healthy life. Type 1 diabetes involves constant day-to-day care and management. While it’ll likely be very overwhelming at first, over time you’ll get a better grasp on how to manage the condition and how to be in tune with your body.
Be sure to see your endocrinologist and other healthcare providers regularly. Managing Type 1 diabetes involves a team effort — you’ll want both medical professionals and friends and family on your side. Don’t be afraid to reach out to them if you need help.
Last reviewed on 03/09/2022.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy