Type 1 diabetes

What is type 1 diabetes?

Diabetes is a chronic disease marked by high levels of sugar in the blood. There are several types of diabetes. Type 1 diabetes (also known as insulin-dependent diabetes mellitus and juvenile diabetes) accounts for about five percent of all diagnosed cases of diabetes in the U.S. Type 1 diabetes usually develops in children or young adults, but can start at any age.

There are two forms of type 1 diabetes. Idiopathic type 1 diabetes is a rare form of the disease with no known cause. Immune-mediated diabetes is the most common form of type 1 diabetes; it’s an autoimmune disorder in which the body's immune system destroys, or attempts to destroy, the cells in the pancreas that produce insulin. The information on this page refers to this form of type 1 diabetes.

Our approach

Northwell Health has an experienced team with specific training in diabetes that provides a range of care and services. From comprehensive inpatient care to specialized foot and wound services, patients can feel confident that they are receiving world-class care for all aspects of the condition.

Symptoms

Type 1 diabetes often appears suddenly. The following are the most common symptoms of type 1 diabetes:

Unusual thirst
Frequent urination
Unexplained weight loss despite extreme hunger
Blurred vision
Nausea and vomiting
Extreme weakness and fatigue
Irritability and mood changes

In children, symptoms may be similar to those of having the flu. Some very young children may start bedwetting again.

Causes

The cause of type 1 diabetes is unknown, but it is believed to result from the immune system being triggered. The body's immune system attacks and destroys the insulin producing cells in the pancreas. Insulin allows glucose to enter the cells of the body to provide energy. When glucose cannot enter the cells, it builds up in the blood, depriving the cells of nutrition. People with type 1 diabetes must take daily insulin injections and regularly monitor their blood sugar levels.

Complications

Type 1 diabetes can cause many different problems. However, the three key complications of diabetes include the following:

Kidney failure
Blindness
Ketoacidosis (high blood sugar and a buildup of acids in the blood due to untreated or undertreated diabetes)
Heart attack
Stroke
Foot ulcers
Amputations

Types of treatment

People with type 1 diabetes must have daily injections of insulin to keep their blood sugar level within normal ranges. Other parts of the treatment protocol may include:

Appropriate diet (to manage blood sugar levels)
Exercise (to lower and help the body use blood sugar)
Careful self-monitoring of blood sugar levels several times a day and keeping a log, as directed by a doctor
Careful self-monitoring of ketone levels in the urine several times a day, as directed by a doctor
Regular monitoring of the hemoglobin A1c levels

The hemoglobin A1c test (also called HbA1c test) shows the average amount of sugar in the blood over the last three months. The result will indicate if the blood sugar level is under control. The frequency of HbA1c testing will be determined by a doctor. The American Diabetes Association (ADA) recommends that testing occur at least twice a year if the blood sugar level is in the target range and stable, and more frequently if the blood sugar level is unstable. Most people with type 1 diabetes require three monthly HbA1c tests.

Prognosis

Advances in diabetes research have led to improved methods of managing diabetes and treating its complications. Scientists continue to explore the causes of diabetes and ways to prevent and treat the disorder.

Coping and support

Inpatient care for diabetes at Northwell

When people need inpatient care to manage their diabetes, physicians at North Shore University Hospital and Long Island Jewish Medical Center are ready. Dedicated diabetes physicians consult with other Northwell medical staff to provide comprehensive inpatient care. The multidisciplinary team includes:

Endocrinologists (physicians who specializes in disorders of the glands and hormones)
Certified nurse practitioners
Certified diabetes educators who are nurses, registered dietitians, physical therapists and pharmacists
Certified wound care nurses
Vascular surgeons
Weight management consultants

The diabetes team at Northwell is well known for excellence in diabetes care. The Joint Commission has certified both North Shore University Hospital and Long Island Jewish Medical Center for their superior inpatient diabetes programs.

Diabetic foot care at Northwell

Diabetes can lead to neuropathy (nerve damage) and blood vessel problems, especially in the legs and feet. People who have nerve damage and poor circulation in their legs may not notice injuries or sores until they worsen. If these injuries are left untreated, they can result in serious ulcerations, infections and even amputation. Proper foot care is critical to help prevent serious infections and amputations.

At Northwell, the podiatry services provide specialized care for people with diabetes. Podiatrists are physicians who specialize in treating conditions that affect the foot, ankle and related structures of the leg. They can check patients’ feet regularly for any problems and show them and their caregivers proper foot care.

Diabetic wound care at Northwell

Wound care specialists treat acute and chronic, hard-to-heal wounds that many people with diabetes experience. With highly specialized care designed specifically for wounds resulting from diabetes, the goals are to heal wounds, preserve limbs, and prevent wounds from recurring. The experienced staff at Northwell has advanced, specialized training in the latest wound care therapies, including technology, techniques and medication. The dedicated nursing staff manages all aspects of patient care, including:

Coordinating wound care among disciplines
Referring patients to home care services
Monitoring the healing progress

The multidisciplinary team for wound care includes: