Symptoms of T1D often develop rapidly (days to weeks) and include:

• Hyperglycemia: Persistent high blood glucose levels.
• Excessive Thirst & Urination (polydipsia and polyuria).
• Unexplained Weight Loss: Despite increased hunger (polyphagia).
• Fatigue and Weakness: Due to cellular glucose deprivation.
• Blurred Vision: Fluid shifts affecting the eyes.
• Diabetic Ketoacidosis (DKA): A life-threatening emergency marked by fruity breath, nausea, vomiting, and confusion (Mayo Clinic).

Note: Children and adolescents are most commonly diagnosed, but T1D can occur at any age (WHO).

1. Autoimmune Destruction:
   • Immune cells attack pancreatic beta cells, halting insulin production. Associated with autoantibodies (e.g., GAD65, IA-2) (Lippincott Review of Pathology).
2. Genetic Predisposition:
   • HLA gene variants (e.g., HLA-DR3/DR4) increase susceptibility.
3. Environmental Triggers:
   • Viral infections (e.g., enteroviruses), vitamin D deficiency, or early dietary factors (Lange Textbook of Clinical Pharmacology).

Key Insight: T1D is not caused by lifestyle factors like diet or obesity, distinguishing it from type 2 diabetes.

While T1D is not currently preventable, emerging strategies focus on:

• Screening High-Risk Individuals:
  • Relatives of T1D patients can test for autoantibodies to enable early intervention (WHO).
• Clinical Trials:
  • Immunotherapies (e.g., teplizumab) to delay progression in autoantibody-positive individuals (Lippincott Textbook of Pharmacology).

1. Insulin Therapy(BNF Guidelines):

• Basal Insulin: Long-acting (e.g., insulin glargine) to maintain baseline glucose levels.
• Bolus Insulin: Rapid-acting (e.g., insulin aspart) to manage meals and correct hyperglycemia.
• Delivery Methods: Injections, insulin pumps, or inhalers.

2. Blood Glucose Monitoring:

• Continuous Glucose Monitors (CGMs): Real-time tracking (e.g., Dexcom G6).
• Flash Monitors (e.g., FreeStyle Libre).

3. Emerging Technologies:

• Closed-Loop Systems (artificial pancreas): Automatically adjust insulin delivery (Mayo Clinic).

4. Adjunctive Therapies:

• Dietary Management: Carbohydrate counting and balanced nutrition.
• Exercise: Improves insulin sensitivity and cardiovascular health.

• Acute: Hypoglycemia, DKA.
• Chronic:
  • Retinopathy: Leading cause of blindness.
  • Neuropathy: Nerve damage causing pain/numbness.
  • Nephropathy: Kidney failure requiring dialysis.
  • Cardiovascular Disease: 2–4x higher risk of heart attack/stroke (WHO).

• Psychological Support: Address anxiety/depression linked to chronic disease management.
• Education: Structured programs (e.g., DAFNE) teach insulin dosing and carb counting.
• Advocacy: Connect with organizations like JDRF for resources and research updates.

Type 1 diabetes demands vigilant management, but advances in insulin delivery, monitoring, and immunotherapy are transforming outcomes. Early diagnosis, patient education, and access to technology are critical for reducing complications and improving quality of life.

Checklist for Patients:

• Regular HbA1c testing (goal <7%).
• Annual eye/kidney screenings.
• Emergency glucagon kits for severe hypoglycemia.