Haims: Type 1 diabetes, a different animal

In my last column, I wrote an educational piece about diabetes. There are many promising advancements for people who have the disease. While the column was meant to provide education about the disease, and possible remedies, I fell short on addressing notable differences between type 1 and type 2 diabetes.

In type 2 diabetes, the body does not make good use of the insulin it produces. Ninety percent of all diabetes cases are type 2 and it is most common among adults. I had also mentioned that we can best manage pre-diabetes and diabetes by adopting good lifestyle choices. This starts by exercising, avoiding sugary beverages, drinking lots of water, reducing the amount of foods we consume that are high in carbohydrates, and above all, managing our weight.

For type 2 diabetes, lifestyle choices may have positive affects. However, where I fell short in addressing is this is not the case for type 1 diabetes. Type 1 diabetes is a different animal.

---

---

You may or not know that insulin is the key hormone in regulating diabetes. It is made in the pancreas in clusters of cells called islets. One of the ways diabetes develops is when cells within our body cannot get the fuel they need because the hormone insulin is unavailable to help glucose get from the bloodstream into muscle, fat and other cells to be stored as fuel.

The main difference between type 1 and type 2 diabetes is that type 2 diabetes develops over time and is frequently associated with lifestyle choices. While people with type 2 diabetes may still produce insulin within the pancreas, it may not be effective enough in getting glucose from our bloodstream to our cells.

---

---

Conversely, type 1 diabetes is an autoimmune disease. It’s a genetic condition that occurs because the body’s immune system mistakenly attacks the cells that produce insulin. Therefore, there is little or no insulin produced. As a result, blood glucose levels increase which can damage organs, blood vessels and nerves. The disease can cause life-threatening complications.

The cause of type 1 diabetes is not clear. Most often it is a result of insulin-producing cells being destroyed. However, genetics family history, viruses, age and exposure to environmental factors can all play a part.

Type 1 diabetes most often develops in young adults. However, it can affect people at any age. Current data indicates that “in the United States, 1 in 300 children and adolescents develop type 1 diabetes by age 20, but 1 in 40 offspring of mothers with type 1 diabetes and 1 in 15 offspring of fathers with type 1 diabetes develop type 1 diabetes.” 

Currently, treating type 1 diabetes is done by taking insulin via injections or by use of an insulin pump. For those that take injections, people have to check blood sugar levels frequently throughout the day to maintain target specific levels. At best, this is cumbersome, as it is generally recommended that blood sugar levels be checked before meals, before bed, before exercising and even prior to driving.

For some people, insulin pumps are an option. These fairly small, computerized devices are worn outside of the body. The pumps contain a reservoir that delivers small doses of short-acting insulin. However, the use requires training to fill the reservoir, priming the delivery tube, disconnecting the device, and troubleshooting.

New research is providing hope for addressing this disease. In November 2022, the FDA approved a new drug called teplizumab. Researchers believe that the drug may be able to delay the development of type 1 diabetes. There is also hope for another drug called verapamil. This drug has been approved to treat high blood pressure, but researchers believe that there is hope the drug will work similarly to teplizumab by keeping the body’s immune response system from attacking the insulin-producing cells.

Further research indicates that there may hope for a cell replacement therapy device in development called PEC-Direct. The device is a small pouch implanted under the skin that contains stem cells that in time may turn into insulin-producing pancreatic cells.

For those with type 1 diabetes who have to manage interpersonal, emotional, and physical challenges, promising therapies are on the horizon. 

Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He is an advocate for our elderly and available to answer questions. His contact information is VisitingAngels.com/comtns and 970-328-5526.