For a normal, healthy person, every carbohydrate they eat is broken down into glucose molecules. These glucose molecules are then absorbed into the bloodstream. When the body detects glucose in the blood, it releases insulin, a hormone made by the islet cells of the pancreas. Insulin allows for the glucose to be taken into the cells of the body, which is used for energy. If ever the blood glucose gets too low, the body releases glucagon, which is a form of glucose that is stored in the liver. The body regulates the glucose and insulin balance so carefully that healthy individuals maintain a steady blood glucose level throughout the day.

Type one diabetes is an autoimmune disorder. There is still no known cause and no cure. The immune system of a type one diabetic sees the islet cells in the pancreas, the ones that make insulin, as harmful and threatening, and slowly destroys these cells. As the cells are slowly destroyed, the remaining islet cells have to work harder to keep the blood sugar regulated. Once the majority of islet cells are gone, the remaining few are unable to control the blood sugar and the symptoms of diabetes begin. Initial symptoms include excessive thirst and urination, fatigue, and weight loss. As the symptoms progress, vomiting and nausea are common.

The treatment for type one diabetes includes frequent blood sugar checks and insulin shots. Synthetic insulin must be given through subcutaneous shots because the acid in the stomach would destroy it if it were taken orally. Type one diabetics have to carefully balance how many carbohydrates they eat with the amount of insulin they give. Other factors, such as exercise, time of day, types of food, emotions and weather can affect blood sugar as well. The goal for a type one diabetic is to keep the blood sugar as balanced as possible, though that is not always a reality and most diabetics have frequent periods of hypoglycemia and hyperglycemia.

Hypoglycemia literally means low blood sugar. As mentioned above, for a healthy individual, the body self-regulates blood sugar and prevents lows from happening. A type one diabetic cannot do this. If too much insulin is given or too much exercise is done, a type one diabetic may experience low blood sugar. Low blood sugar is treated by giving sugar or simple carbohydrates to the individual to rapidly bring blood sugar up. If low blood sugar is left untreated, the individual can go into insulin shock, fall into a coma, and even die.

Hyperglycemia means high blood sugar. If too much is eaten, too little insulin is given, or the individual is too excited or scared, they may experience high blood sugar. High blood sugar is treated by giving additional insulin, though insulin typically takes 30-90 minutes to get into the bloodstream from a subcutaneous shot. High blood sugar damages nerves and other various cells in the body. While the danger isn’t as immediate, high blood sugar can slowly deteriorate the systems in the body, causing organ failure, and resulting in amputations or death. High blood sugar for a type one diabetic can also lead to diabetic ketoacidosis (DKA), which can be fatal if not immediately treated.

Unfortunately, type one diabetes is not something that goes away with age. The body has killed the cells that make insulin. This cannot be reversed. Transplanting islet cells has been tried with only limited success. Because the disease is autoimmune, the immune system is still programmed to kill islet cells. The transplanted cells have often been killed off like the original cells.

New areas of research include the development of an artificial pancreas, which will automatically check blood sugar levels and respond by dosing insulin from an external pump. Research is also being done on ways to destroy the immune cells that are fighting islet cells, thus allowing for transplants in current diabetics and prevention of future diabetics.

A common misunderstanding is the relation between type one diabetes and type two diabetes. While they both are diseases affected by the insulin regulation in the body, they are actually very different diseases. While type one is autoimmune and typically occurs in children and adolescents, type two diabetes is considered lifestyle-related and occurs in older adults. With type two diabetes, the body still makes insulin, but the cells no longer respond to it very well. Type two diabetics are initially told to eat healthy, low-carbohydrate diets and exercise regularly. As the disease progresses, they often need oral medication and can eventually need insulin shots. The reason for insulin shots for a type two diabetic is to increase the amount of insulin in their system. If their body is only responding to 25% of the insulin it is making, by injecting additional insulin, it makes the amount that is used higher.

Type two diabetes is considered lifestyle because it tends to occur in individuals who have had unhealthy diets, have not consistently exercised, and who are overweight or obese. Type two diabetes does appear to have genetic components and individuals may not have unhealthy lifestyles and still have type two diabetes.