Type 1 Diabetes: Living With the Disease - What Happens

What Happens

Your experience with type 1 diabetes will be different from that of other people. But your treatment will be the same: taking insulin, eating a balanced diet that spreads carbohydrate throughout the day, getting regular exercise, and checking your blood sugar levels.

If you work closely with your health professional and follow your treatment, you will feel better and more in control of your life. You also may prevent or delay complications.

Not everyone with diabetes develops complications from the disease. Keeping blood sugar levels within a normal or near-normal range may prevent or delay complications. If your adolescent with diabetes tightly controls his or her blood sugar, he or she can avoid developing complications in young adulthood.

Injected insulin cannot perfectly match the action of a working pancreas, so you will have high and low blood sugar levels from time to time. If your blood sugar stays above your target range for a long time, your blood vessels and nerves may be damaged. This damage can lead to:

• Microvascular disease, which affects your eyes or kidneys. Diabetic retinopathy and diabetic nephropathy develop without early signs. For more information, see the topics Diabetic Retinopathy and Diabetic Nephropathy. You are also at risk for other eye diseases, such as cataracts and glaucoma.
• Macrovascular disease, which affects your heart and your body's large blood vessels. Diabetes damages the lining of large blood vessels. They become clogged with hard, fatty deposits called plaque. This process, called atherosclerosis, narrows the vessels. A heart attack or stroke may occur when the blood vessels that supply your heart and brain are affected. Peripheral arterial disease develops when the large vessels in your legs are affected. This leads to problems with blood circulation in your legs and feet and causes changes in the skin color, decreased sensation, and leg cramps. For more information, see the topics Heart Attack and Unstable Angina and Peripheral Arterial Disease of the Legs.
• Diabetic neuropathy, which affects the nerves in your body. Diabetic neuropathy can decrease or block the movement of nerve signals through your organs, legs, arms, and other parts of your body. Nerve damage can affect functioning of internal organs, such as the stomach (gastroparesis), and your ability to feel pain when injured. When blood vessels and nerves are affected, bone and joint deformities can develop, especially in your feet (Charcot foot). For more information, see the topic Diabetic Neuropathy.

People with diabetes often already have other health problems. These may include high blood pressure and high cholesterol. Or, they may develop them as diabetes progresses. These conditions, along with smoking, can cause diabetes complications or can make existing ones worse. Not smoking and controlling your blood pressure and cholesterol level can help prevent or help slow complications.

Other health problems in adolescents

Studies have found that adolescent girls are at higher risk than other people for diabetic ketoacidosis; they may skip insulin doses to lose weight.¹

Eating disorders are also common among adolescents and young adults with diabetes. Eating disorders and the tendency to skip insulin injections can cause swings in blood sugar levels outside the target range. Eating disorders need to be diagnosed and treated as quickly as possible to prevent serious health problems.