Type 1 Diabetes

Type 1 diabetes is much less common than type 2. About 5 to 10 out of every 100 people with diabetes have type 1.

It often starts in children, teens and young adults, but it can begin at any age, including later in adulthood.

• Type 1 diabetes with symptoms: blood sugar is high and insulin is needed.

Type 1 diabetes is not caused by eating sugar or by weight. Things that raise the chance include:

• A parent, brother or sister with type 1 diabetes
• Certain genes passed down in families
• Having another autoimmune condition, such as thyroid disease
• Possible triggers in the environment, such as some viral infections (still being studied)

Symptoms can come on quickly, over a few weeks. Watch for:

• Being very thirsty and urinating a lot, or new bedwetting in a child who was dry at night
• Being very hungry
• Losing weight without trying
• Feeling very tired or weak
• Blurry vision
• Moodiness or irritability
• Nausea, vomiting, belly pain, fruity-smelling breath or fast breathing (signs of a dangerous buildup of ketones)
• At your visit, your provider checks your weight, blood pressure, heart rate and breathing, and looks for signs of dehydration. Over time, they examine your feet, skin and insulin sites (for lumps or changes) and check your thyroid.

Lab tests your provider may order include: blood glucose, hemoglobin A1C, urine or blood ketones, and a basic metabolic panel (to check for acid buildup, kidney function and salts). To tell type 1 from type 2, tests may include diabetes autoantibodies (such as GAD) and C-peptide (a sign of how much insulin your body still makes).

After diagnosis, regular tests may include A1C, a cholesterol panel, kidney tests (urine albumin and metabolic panel), and thyroid tests. You'll also need regular dilated eye exams with an eye doctor, and we refer you for that.

If someone has symptoms of high ketones (vomiting, fast breathing, confusion), they need emergency care right away, not an office visit.

Type 1 diabetes is managed every day by you, with your care team's support. Your plan usually includes:

• Insulin every day: long-acting (background) insulin plus mealtime insulin, by shots or an insulin pump.
• Checking blood sugar often, with a meter or a continuous glucose monitor (CGM). Some pumps and CGMs work together to adjust insulin automatically.
• Learning to count carbohydrates and match insulin to meals and activity.
• Knowing how to spot and treat low blood sugar, and keeping fast sugar and, if prescribed, glucagon, such as Baqsimi or Gvoke (glucagon), with you.
• Having a sick-day plan, including when to check ketones. Never stop insulin when you are sick unless your provider tells you to.
• Regular activity, with blood sugar checks before, during and after.
• Yearly eye exams, foot checks, kidney and cholesterol tests, and support for the stress of daily diabetes care.

Type 1 diabetes is lifelong. There is no cure today, but treatment and technology keep improving.

Keeping blood sugar close to target lowers the risk of long-term problems with the eyes, kidneys, nerves and heart. There will be good days and hard days. Your care team is there to help you adjust, and no one can promise a specific result.

Dr. Moaddel manages type 1 diabetes directly. He adjusts your insulin plan, orders your tests, reviews your numbers with you and helps you keep up with eye, foot and kidney checks.

In select cases, such as insulin pump care or more complex situations, we partner with an endocrinology specialist and keep your records connected so you don't have to start over.

We're at 7230 Medical Center Dr, Suite 100, West Hills, CA 91307.