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People with type 1 diabetes have certain genes that make them more likely to develop diabetes. In people with these genes it is thought that some sort of trigger is needed for the immune system to start damaging the pancreas. These triggers are believed to be factors in the environment, which are still not fully understood.
Once diabetes is triggered, the body’s immune system, which normally protects us from infection, begins to attack the insulin producing cells (beta cells) of the pancreas. The immune system thinks that the beta cells are foreign to the body and starts to destroy them, causing a decrease in insulin production. It can take from a few weeks to many years for all of the beta cells to be destroyed. The pancreas has many beta cells to spare, so symptoms of diabetes do not occur until more than 90% of the cells have been destroyed.
When type 1 diabetes develops, blood glucose levels (BGL) may rise up to five to ten times the normal level. Excess glucose spills over into the urine, drawing water with it and causing frequent trips to the toilet to pass urine, and dehydration. You get very thirsty, you feel really tired and have changes in your mood.
The body is unable to use glucose from food for energy and starts to break down fat and muscle leading to weight loss over weeks or months. The breakdown of fat causes chemicals, known as ketones, to stay in the blood, causing stomach pain, nausea and vomiting. If undetected, glucose and ketone levels become very high in the blood stream with severe dehydration and loss of salts from the body. This is called diabetic ketoacidosis (DKA) and needs urgent medical attention. Common signs and symptoms are going to the toilet frequently to pass urine, excessive thirst and drinking lots, weight loss, tiredness and mood changes.
To see if someone has type 1 diabetes, a doctor will do a test for blood glucose levels and a urine test for glucose and ketones. High levels of glucose and ketones (in the blood and urine) suggest that it is type 1 diabetes. It is important not to delay the diagnosis of type 1 diabetes, as it can be life threatening if left untreated.