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Understanding Type 1 Diabetes

To get energy, the body breaks down food into sugar. When you have diabetes, your body has trouble using this sugar for energy.

Outline of body and inset of blood vessel and cells showing how insulin and glucose work together.

Cross section of blood vessel and cells showing glucose building up in bloodstream.
Without insulin, glucose cannot enter the cells.

How the body normally gets energy

The digestive system breaks down food. This creates a sugar (glucose). Some of this sugar is stored in the liver. But most of it enters your blood. It travels to your cells to be used as fuel. Glucose needs a hormone called insulin to enter the cells. Insulin is made in the pancreas. This is an organ in your belly. The insulin is released into the blood when there's glucose in the blood. Think of insulin as a key. When insulin reaches a cell, it attaches to the cell wall. This tells the cell to make an opening to let glucose enter the cell.

When you have type 1 diabetes

Special cells (beta cells) in the pancreas make insulin. In most people, type 1 diabetes is an autoimmune disease. This means the body's immune system harms the beta cells. This lowers the amount of insulin made by the pancreas. In children, this often happens quickly. In adults, it isn't as fast. Without insulin, your cells can't get glucose to burn for energy. This is why you may feel weak or tired.

Glucose builds up

Without insulin, glucose can’t enter the cells. It stays in your blood instead. Your liver puts out even more glucose into the blood. This may lead to higher and higher blood sugar levels. This is called hyperglycemia. Over time, high blood sugar levels can cause serious health problems.

Ketones form

When your cells can’t get glucose to burn for energy, they burn fat instead. This leaves behind acids called ketones in your blood and urine (ketosis). High blood sugar, high ketones, and other chemical changes in the blood (metabolic acidosis) can cause a dangerous condition called diabetic ketoacidosis (DKA). For some people, DKA is the first sign of type 1 diabetes.

Insulin can be replaced

The insulin you’re missing can be replaced. Insulin can't be taken by mouth. That's because it is broken down during digestion just like protein. But the insulin you’re missing can be replaced with shots (injections) of insulin. Some people also use insulin pumps. Then your body can burn glucose for energy. This helps keep your blood sugar in a healthy range.

Long-term complications

Over time, high blood sugar levels can harm blood vessels. This can lead to health problems (complications). Keeping your blood sugar in a healthy range can help prevent or delay complications. Balancing insulin, diet, and activity is important. This can help keep blood sugar levels in your target range. And it can prevent health problems. This is also true for regular check-ups, lab tests, and exams. Complications that may happen include:

  • Eye problems

  • Kidney disease

  • Nerve damage

  • Digestion problems

  • Sexual problems

  • Tooth and gum problems

  • Skin and foot problems

  • Heart and blood vessel disease

Your diabetes can be managed

Managing type 1 diabetes has both physical and emotional challenges. But you can do well by sticking to your medicine and glucose monitoring schedule. You can balance your medicine, your daily exercise, and your nutrition plan. Over time, these things will get easier to do.

Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Online Medical Reviewer: Robert Hurd MD
Date Last Reviewed: 3/1/2022
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