Type 1 diabetes used to be called “juvenile” diabetes because it most frequently occurs in children and young adults under the age of 20. However, because we now know it is possible for adults to also develop Type 1 diabetes, the name juvenile is no longer used. It has also been called “insulin dependent,” because people living with Type 1 diabetes must inject insulin.

Why is injected insulin required? In Type 1 diabetes, the body no longer produces its own insulin. Insulin is created in the pancreas, by cells called beta cells. It seems that when a person develops Type 1 diabetes, these beta cells are being destroyed through an autoimmune response. Insulin is necessary for the body to be able to correctly use blood glucose. Without insulin, blood glucose can't be used, and therefore the body doesn't get the energy it needs.

And, without insulin, blood glucose simply stays in the blood stream. A normal blood glucose level—that is, in a healthy person without diabetes—is about 100 mg/dL. It is not uncommon, however, for a person with Type 1 diabetes to have blood glucose levels four to six times that amount at the time of diagnosis! These high blood glucose levels make the blood stream thick and syrupy. This condition leaves the person extremely dehydrated, thirsty, hungry, rapidly losing weight, drowsy and often nauseated. In extreme cases, a person might become unconscious. A resulting condition called diabetic ketoacidosis, if not treated immediately, can even lead to death.

When you have Type 1 diabetes, you must inject insulin. The discovery of insulin in 1922 was a landmark in medical history. Before injectable insulin was available, Type 1 diabetes was fatal. But medical insulin makes it possible for people with Type 1 diabetes to live long, healthy lives.

The “honeymoon” period
Sometimes a person with Type 1 diabetes who has just started insulin therapy will enter into a “honeymoon” period, when insulin needs suddenly decline. In fact, some people wonder if they have been misdiagnosed, as they start to use less and less of the injected insulin.

There is a simple explanation for this event. Some people with Type 1 diabetes do still have some functioning beta cells at the time of their diagnosis. By helping the body to start managing diabetes, the insulin actually relieves the pressure on those remaining beta cells and allows them to continue producing insulin. As a result, the body needs less insulin injected. Those beta cells, however, are soon destroyed by the autoimmune response that produced Type 1 diabetes. The “honeymoon” period can be as short as a few months, or as long as two years—but eventually the honeymoon will be over. A complete dependence on injected insulin will begin.

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