Understanding What Type

1 Diabetes Is (and Isn’t)
T1DM, simply stated, is an autoimmune disease. Immunity is what protects you from foreign invaders like bacteria and viruses. In autoimmunity, your body mistakenly acts against your own tissues. In T1DM, the immune cells and proteins react against the cells that make insulin, destroying them. (Insulin is the chemical or hormone that controls the blood glucose; glucose is sugar that provides instant energy.)

Although it often begins dramatically, T1DM doesn’t occur overnight. Many patients give a history of several months of increasing thirst and urination,among other symptoms. Also, T1DM usually begins in childhood, but some folks don’t develop it until they’re adults. In either case, to verify a diagnosis of T1DM, a sample of blood is taken and its glucose level is measured. If the patient is fasting, the level should be no more than 125 mg/dl; if there’s no fast, the level should be no more than 199 mg/dl. For further confirmation,tests should be done at two different times to check for inconsistencies.However, a person with a blood glucose of 300 to 500 mg/dl who has an acetone smell on his breath clearly has T1DM until proven otherwise.

So how is type 1 diabetes different from type 2 diabetes (T2DM)? The central problem in T2DM isn’t a lack of insulin but insulin resistance; in other words,the body resists the normal, healthy functioning of insulin. Before the development of T2DM, when a person’s blood glucose is still normal, the level of insulin is abnormally high because the person is resistant to the insulin and therefore more is needed to keep the glucose normal.To complicate matters, a type of diabetes called Latent Autoimmune Diabetes in Adults (LADA) is a cross between T1DM and T2DM; a person with LADAexhibits traits of both diseases. Chapter 2 details the basics of T1DM, including how insulin works, what goes wrong when blood glucose levels are too high, the specific symptoms to watch
for, and gathering a team of doctors and other specialists after a diagnosis.Chapter 3 fully explains how T2DM and LADA are different from T1DM.