Type 1 diabetes | Mate huka kai rongoā taiaki

Previously known as insulin-dependent diabetes mellitus or juvenile diabetes

Type 1 diabetes (mate huka kai rongoā taiaki) is a condition that causes the level of glucose (a type of sugar) in your blood to become too high (hyperglycaemia). It happens when your body is not able to produce enough of a hormone called insulin, which controls blood glucose. Type 1 diabetes can start at any age but most often in childhood.

On this page, you can find the following information:

Key points

  1. Type 1 diabetes is mainly diagnosed in childhood and is not caused by being overweight or eating sweet foods. It is different to type 2 diabetes.
  2. Insulin is a hormone made by your pancreas. It helps control how much glucose, a type of sugar, is in your blood.
  3. Without insulin, too much glucose stays in your blood rather than passing into your body's cells, where it is used or stored for energy. 
  4. Long term, high glucose levels can cause damage to your eyes, kidneys, blood vessels, heart and feet. 
  5. If you have type 1 diabetes you need daily injections of insulin to keep your blood glucose levels under control.
  6. Managing type 1 diabetes can take some getting used to, but should not stop you from leading a full and active life.

What causes type 1 diabetes?

Type 1 diabetes is an auto-immune disease. Your body's immune system, which normally protects you from infection, attacks the insulin-making cells (beta cells) in your pancreas. This causes a decrease in insulin production. Type 1 diabetes can be genetic (run in the family). Read more about  insulin deficiency and type 1 diabetes.

Symptoms of diabetes don't occur until more than 90% of the beta cells have been destroyed. This means that it is difficult to tell that you are developing diabetes until the symptoms of diabetes occur.

Did you know?

  • Diabetes can't be caught from another person – it's not contagious.
  • Type 1 diabetes isn't caused by eating too much sugar or any other foods.
  • There's nothing you could have done differently to prevent yourself or your child from getting type 1 diabetes.
  • You can't grow out of type 1 diabetes and it doesn't change into type 2 diabetes as you get older.

What are the symptoms of type 1 diabetes? 

The symptoms of type 1 diabetes are caused by high blood glucose levels (hyperglycaemia) and can come on very quickly. People can get quite sick when they first get type 1 diabetes and often need to be in hospital for a few days. Symptoms can include:

  • feeling very thirsty and drinking lots
  • having to pee/mimi a lot more than normal
  • tiredness
  • rapid weight loss
  • sores that don't heal
  • recurring infections
  • poor concentration and performance
  • sore tummy/puku which is common in children.

If a diagnosis isn't made quickly, severe dehydration can occur.

When should I seek help for diabetes?

If you or your child have any of the above signs and symptoms, and you are concerned, please go to your healthcare provider for advice. If you can’t see a healthcare provider for whatever reason, call Healthline for advice or go to the nearest emergency department.

How is diabetes diagnosed?

A blood test is used to diagnose diabetes. 

Types of blood tests used to diagnose diabetes

  • Random blood glucose level: This blood test for the level of glucose in your blood can diagnose diabetes, but the result depends on what food you have eaten before the test.
  • HbA1c: This blood test measures the amount of glucose that has accumulated in your blood over a 3-month period. A high HbA1c result confirms the diagnosis of diabetes.
  • Fasting blood glucose: This is a measure of how much glucose is in your blood when you have not eaten anything for the past 8–10 hours.

This table shows the ranges of these measures of blood glucose for people without diabetes, with pre-diabetes or with diabetes. 

  

Normal

Pre-diabetes

Diabetes

Random glucose

    

≥ 11.1 mmol/l

HbA1c

≤ 40 mmol/mol

41–49 mmol/mol

≥ 50 mmol/mol

Fasting blood glucose

 

6.1–6.9 mmol/l

≥ 7.0 mmol/l

Sometimes your healthcare provider may do a urine test to look for sugar or ketones in your urine. This is a simple test and the results are available immediately but a urine test is not accurate enough to be used to diagnose or rule out diabetes all the time. 

What is the treatment for type 1 diabetes?

Type 1 diabetes is a lifelong condition that can be well managed and controlled with the use of artificial insulin. This insulin is used to replace the insulin that your body can't make. Insulin is taken by an injection just under the skin, not into a vein, with a short, fine needle. It's common to feel anxious at the thought of an injection, but the needle used means that insulin injections are more comfortable than a finger prick. If you need to inject insulin you will be given training and support to manage your treatment. 

 Image credit: Canva

The aim of treatment is to give the right amount of insulin to balance what you eat with how much energy you need throughout the day. You will feel better and have more energy once you're receiving the right amount of insulin.

Successful management of type 1 diabetes involves:

  • regularly testing your blood glucose level throughout the day
  • taking regular injections of insulin 2 or more times per day
  • eating regular meals and choosing healthy food
  • keeping physically active to keep your heart and blood vessels healthy
  • learning how to fine-tune your insulin doses with different meal sizes and activity levels.

Learn more about insulin.

How can I look after myself with type 1 diabetes?

Diabetes is a lifelong condition. If it's poorly managed and blood glucose levels aren't controlled, diabetes increases the risk of serious complications such as problems with vision or blindness, heart attack or stroke, kidney failure, circulatory problems and impotence in men.

With good control of your diabetes, many of these complications can be prevented or slowed down.

Long-term risks and complications can be minimised by:

  • learning as much as you can about diabetes
  • having good medical care – make sure to have your regular check-ups with your doctor or nurse so that potential problems can be found and treated early
  • having a healthy food plan and a regular intake of carbohydrates both for growth and development and to balance insulin and activity levels
  • getting regular exercise and understanding how physical activity affects blood glucose levels
  • watching your cholesterol and blood pressure
  • generally having a healthy lifestyle.

Managing low blood glucose (hypoglycaemia)

Although people with type 1 diabetes are trying to keep their blood glucose level from going too high, it's also important to stop it going too low (hypoglycaemia). This can happen when too much insulin is injected or not enough of the right food is eaten at the right time. 

Symptoms of hypoglycaemia include sweating, shakiness and light-headedness, and can lead to unconsciousness if not treated. Low blood glucose must be raised urgently, with quick-acting carbohydrate such as glucose tablets (or glucagon injections if the person is unconscious).

Blood glucose testing

To test your blood glucose level throughout the day, you use a small finger prick test to get a drop of blood to put onto a testing strip. The testing strip is inserted into a blood glucose meter and gives a result within seconds. Read more about blood glucose testing for type 1 diabetes. 

  • A normal reading is between 4–7 mmol/L (glucose is measured in millimoles per litre of blood).
  • Check with your doctor, nurse or pharmacist what your target level should be.
  • If the level is below 4 mmol/L, you will usually need to eat something.
  • If the level is above 7 mmol/L, you may need to alter your insulin dose or do something active.
  • Learning how to balance these levels with what you eat, how much insulin you give yourself and your activity levels are the key to managing your diabetes.
  • For some people, blood glucose monitoring with a continuous glucose monitoring device may be an option. However this is not currently funded in Aotearoa New Zealand. Read more about continuous glucose monitoring.

Healthy eating and exercise

What you eat and how much exercise you do affects your blood glucose levels. The more you eat and the less you exercise, the higher your blood-glucose levels will be and the more insulin you will need. Learning how to fine-tune your insulin doses with different meal sizes and activity levels is part of managing type 1 diabetes.

To help give you more even blood glucose levels:

  • Eat breakfast, lunch and dinner at regular times of the day, with snacks in between as advised by your dietitian or nurse.
  • Eat healthy, balanced meals with a range of carbohydrates, fats and protein. Read more about healthy eating.
  • Choose high fibre carbohydrates, eg, wholegrain breads (breads with lots of grainy bits), high-fibre breakfast cereals, legumes, fruit and vegetables and those with a low glycaemic index (GI). Carbohydrate foods with a low GI are digested (broken down to glucose) more slowly.
  • Exercise regularly. 

Stress management and illness with diabetes

Managing stress is especially important. Blood glucose levels are more difficult to control if you are under stress, so you may need to monitor them more frequently.

  • Make sure you know what to do when unwell and have a ‘sick day’ plan.
  • If you are vomiting or have diarrhoea, see a doctor as you are at higher risk of becoming dehydrated.

Read more about diabetes and sick day planning.

Support for type 1 diabetes

It can take time to get used to managing diabetes, but you can still do all the things you enjoy and live a fulfilling life. Working with healthcare providers, diabetes support groups and diabetes educators will help you get a clear understanding of diabetes so you know how to manage best day-today. 

Diabetes NZ is a national organisation with regional branches and youth support groups.

Some of the main centre links are provided below: 

Learn more

There is a wealth of information now about living well with diabetes. Be aware that websites from other countries may have information that differs from New Zealand recommendations.  

Kiwis living well with diabetes Diabetes NZ
Diabetes in children KidsHealth NZ
Living well with diabetes Diabetes NZ
Type 1 diabetes NHS, UK
Diabetes Foundation Aotearoa 

References

  1. Insulin and type 1 diabetes Diabetes NZ

 

Credits: Health Navigator Editorial Team.