The Language of Type 1 Diabetes
Our T1Dictionary helps guide you through the language of Type 1 Diabetes. Either enter a word in the search or scroll down for the full list.
These systems monitor your blood-sugar levels and automatically provide insulin — much like a normal pancreas would do naturally — with the help of a sophisticated computer algorithm.
These are immune markers, called antibodies, which are directed at one’s own body. If you have two or more autoantibodies, your chances of developing Type 1 Diabetes are nearly 100%
An autoimmune condition is when your immune system, which normally keeps your body safe against disease, attacks itself. Other examples of autoimmune conditions include multiple sclerosis (MS) and rheumatoid arthritis. In Type 1 Diabetes, the immune system attacks and destroys your insulin-producing beta cells.
Immune responses against a person’s own healthy cells and tissues. In Type 1 Diabetes, the autoimmune response targets the insulin-producing beta cells of the pancreas.
Basal insulin (also known as background insulin) keeps blood-sugar levels stable during periods of fasting, such as between meals or during sleep. It plays a vital role in managing Type 1 Diabetes.
Beta cells are located within the islet in the pancreas, and their primary function is to synthesize, store and release insulin. In Type 1 Diabetes, beta cells are destroyed and with them, the body’s ability to produce insulin
Blood glucose levels are measured in units called mmol/L (pronounced milli-moles-per-litre). The ideal ranges are:
- Before meals: 4-7 mmol/L
- Two hours after meals: 8-9 mmol/L
- At bedtime: 6-10 mmol/L
You may need to consult your doctor and change your treatment plan if:
- Blood glucose is consistently lower than 4 mmol/L or higher than 10 mmol/L before meals
- Blood glucose is consistently lower than 6 mmol/L or higher than 12 mmol/L at bedtime
Blood glucose goals may be modified for children and others who are at greater risk of hypoglycaemia. In the US, blood glucose levels are measured in mg/dl (milligrams per decilitre). That’s why you’ll occasionally read about blood glucose readings that seem very high, like 140 or 220. To convert the American scores back to mmol/L, just divide the number by 18.
Monitoring lets a person know when insulin may be needed to correct high blood sugar levels or when carbohydrates may be needed to correct low blood sugar levels. Knowing your blood-sugar levels and acting accordingly is crucial to managing Type 1 Diabetes.
Sometimes people with Type 1 Diabetes take an extra amount of insulin, often with a meal or snack, to cover an expected rise in blood sugar — this is called a bolus.
Type 1 Diabetes that is hard to control. It is characterized by wide variations or “swings” in blood-sugar levels, going from too high (hyperglycemia) to too low (hypoglycemia) very quickly.
People with Type 1 Diabetes must count each carbohydrate gram they eat or drink. Based on that count, they dose insulin using an “insulin-to-carb” ratio, which helps maintain stable blood-sugar levels after eating. The insulin-to-carb ratio is determined by a person’s doctor, called an endocrinologist.
This device will automatically track your blood-sugar levels every few minutes, day and night, allowing users to see whether their levels are trending high or low before they become dangerous. CGM use has significantly improved Type 1 Diabetes management, helping people avoid blood-sugar highs and lows and the complications that these bring.
As of 2019 the Australian Federal Government has increased their subsidy support for CGM’s in Australia. The following people may be eligible:
- Children and young people aged under 21 years with Type 1 Diabetes
- People with Type 1 Diabetes aged 21 years or older who have valid concessional status and have a high clinical need
- Women with Type 1 diabetes who are actively planning pregnancy, pregnant, or immediately post-pregnancy
- Children and young people under 21 years with conditions very similar to Type 1 Diabetes who require insulin
The Program is administered by the NDSS and you can find out more about this initiative here.
Is when someone ignores their Type 1 Diabetes because they are frustrated and ‘over’ managing it. Most people with T1D will experience this at some point in time.
This is the scientific name for the group of diseases commonly referred to as diabetes. This includes Type 1 Diabetes, Type 2 Diabetes and Gestational Diabetes. As well as rarer forms of diabetes which have been recently identified: LADA or Type 1.5 Diabetes, MODY – Maturity Onset Diabetes of the Young and Neonatal Diabetes
Having very high blood-glucose levels for an extended period can lead to Diabetic Ketoacidosis (DKA). DKA happens when the body starts to burn fat and body tissue for energy. This releases toxic acids called ketones that build up in the blood and urine. DKA is a life-threatening condition, most common at diagnosis, and can occur when you’re ill, during a growth spurt or puberty, or if you haven’t taken your insulin. The main symptoms of DKA include:
- heavy or laboured breathing;
- nausea and vomiting;
- excessive thirst;
- stomach pains;
- stupor or unconsciousness.
Endocrinologists are doctors who specialise in Type 1 Diabetes care. People with Type 1 Diabetes must work closely with their Endocrinologists to determine the insulin doses and lifestyle changes needed to manage their blood-sugar levels
Gestational Diabetes is different to a woman with Type 1 Diabetes who is pregnant. Gestational Diabetes affects about two to five per cent of pregnant women. Pregnant women produce large amounts of hormones, which can cause the body to become resistant to the effects of insulin. By the time a woman reaches the end of the third trimester, her insulin requirements have tripled. If the pancreas is unable to match this increased demand, blood-glucose levels start to rise. In most cases, blood glucose returns to normal after pregnancy. However, women who have had Gestational Diabetes have a higher risk of eventually developing Type 2 Diabetes.
A hormone produced by the alpha cells in the pancreas that raises blood-sugar levels. It’s available by prescription, and may be used to treat severe low blood sugar (hypoglycemia)
Glucose Responsive Insulin (GRI) or Smart Insulin is a form of insulin designed to be administered into the body and react as needed, mimicking as closely as possible the function of naturally produced insulin. GRI is designed to work when blood glucose levels rise above healthy levels and to be inactive when blood glucose levels are in, or below, the standard value. GRI can respond to meal-induced rises in blood glucose more rapidly and naturally than conventional fast-acting insulins ultimately leading to improved glucose control and longer-term outcomes. GRI will not lead to insulin-mediated hypoglycaemia, which is one of the most feared and severe side effects of insulin treatment experienced by people with Type 1 Diabetes. See our Research and Subscribe to be kept up-to-date on the development of Glucose Responsive Insulin.
HbA1c is a form of Hemoglobin that is covalenty bound to glucose. See HbA1C for more information
Measuring HbA1c in the blood is used to reflect average blood-sugar levels over a period of three months in people with Type 1 Diabetes.
When you check your blood glucose level you are measuring how many molecules (or mmol) of glucose are in your blood stream at the time
of monitoring. However, your HbA1c result looks at your overall blood glucose control for the preceding two to three months. Glucose in your bloodstream will attach itself to the haemoglobin part of your red blood cell. If there is a lot of glucose in your blood-stream, this will result in a higher number of haemoglobin with glucose attached. The haemoglobin with attached glucose is referred to as HbA1c or glycated haemoglobin. As your blood cells, and therefore your haemoglobin, live for around 120 days, the HbA1c test gives you an idea of how your blood glucose levels have been tracking over the same time period.
Ideally, you should aim to keep your HbA1c as close to 7% or (53 mmol/ mol) as possible, as long as this can be achieved without significant episodes of hypoglycaemia.
Research has shown that keeping your HbA1c near this can significantly reduce your risk of developing the long- term complications.
There is a period of time following diagnosis when most people experience a “Honeymoon Phase” in which their remaining beta cells still function and the body is able to produce some of its own insulin. The Honeymoon Phase typically lasts a few months to a year post-diagnosis. During this time physicians will support blood-glucose management with low-dose insulin treatments. Eventually, the remaining healthy cells will die off and insulin dosages will need to be increased.
There will be times when you haven’t taken enough insulin to match the carbohydrate that you have eaten, which means that your blood glucose level will be too high. This is known as hyperglycaemia, or a ‘hyper’ for short. A hyper doesn’t carry the same immediate risk as a hypo, but frequent high blood glucose increases the risks of developing complications, so it’s important to minimise this as much as possible. It can also make you feel pretty unwell if you are hyper for too long. High blood glucose can be reduced by regularly testing your blood glucose and matching insulin to food intake, exercise and all the other factors, as closely as possible. If you are worried about how often you have high blood glucose, talk to your healthcare team for help on how to tackle it. New technologies like Continuous Glucose Monitors make blood glucose testing easier, but regular testing with a meter will also help.
When your blood glucose level drops below 4mmol/L, this is called hypoglycaemia, or a ‘hypo’ for short. Hypo’s arise when you have too much insulin in your blood stream. This may be because: you accidentally injected more than you needed, you’ve been very active, you haven’t eaten or you’ve had less carbohydrate than you thought. Approximately 40% of insulin-treated people experience episodes of severe hypoglycemia. A hypo can be a scary thing to go through, but it can be managed effectively. Most of the time, low blood sugar is caught early on, with symptoms such as sweating, fatigue, hunger and/or irritability. Action is then taken to bring the blood sugar back to normal range. See Managing T1D for more information
Some people cannot tell when their blood sugar is too low. This is called “hypoglycemia unawareness.” Some people are naturally unaware of hypos. Even if you have been aware of them previously, frequently having a hypo might make it harder for you to recognise the symptoms. The obvious signs of shaking and sweating seem to go and a feeling of vagueness might be your only sign. This is often referred to as hypo unawareness. To avoid this from happening, it’s important to let your doctor or healthcare team know if your blood glucose level is dropping below 4 mmol/L regularly (more than three to four lows in a week, or less if you are newly diagnosed).
Immunosuppressive drugs stop or restrict the bodies immune system. In Type 1 Diabetes islet transplantation treatments immunosuppressive drugs can be used to stop the body attacking new beta cells. See our Research for more information.
A hormone produced in the pancreas which regulates the amount of glucose in the blood. Insulin is made synthetically and is the only current therapy for treating T1D. Insulin can be basal (slow-acting) or bolus (fast-acting
A small computer that administers insulin via a tiny tube under the skin. Users set the device to give a steady trickle of insulin continuously throughout the day and extra (bolus) doses of insulin at meals and at times when blood sugar is too high. See Insulin Pump Program for more details on available subsidies
Islet cells are clusters of cells in the pancreas that produce hormones, including insulin. Beta cells are located within the islet in the pancreas
Juvenile Diabetes is a colloquial name used to descripe Type 1 Diabetes. As the majority of people with T1D are diagnosed before the age of 19 and Type 2 Diabetes is very uncommon in children. T1D is often referred to as Juvenille Diabetes. The term can be misleading as you cannot ‘grow out’ of T1D and of the 120,000 people in Australia living with T1D 85% are over the age of 18.
DKA happens when the body starts to burn fat and body tissue for energy. This releases toxic acids called ketones that build up in the blood and urine.
MODY – Maturity Onset Diabetes of the Young – is a rare form of diabetes (3% of those diagnosed under the age of 30). MODY is caused by a change in a single gene. This means there is a 1 in 2 chance of inheriting MODY from an affected parent and it runs in families. The most common genes that cause MODY are HNF1A, HNF4A, HNF1B and glucokinase. The condition presents differently depending on which gene is affected. It is important to know which gene is causing MODY, as treatment varies accordingly. Some forms of MODY may require insulin injections, while others are treated using drugs to boost insulin production in the pancreas. One form of MODY requires no treatment at all. MODY is typically diagnosed under the age of 25, often with a family history of diabetes.
Neonatal Diabetes is a rare form of Diabetes that develops in babies under 6 months old. Neonatal Diabetes is caused by a change in a single gene. Treatment for Neonatal Diabetes varies depending on which gene is affected. Neonatal Diabetes may be either transient or permanent. Transient Neonatal Diabetes typically disappears during infancy, but may reappear during adolescence. Permanent Neonatal Diabetes is a lifelong condition. A genetic test can be used to confirm Neonatal Diabetes and work out which gene is affected. It is important to know which gene is the culprit, as treatment varies accordingly. Some forms of Neonatal Diabetes may require insulin injections, while others are treated using drugs to boost insulin production in the pancreas.
N.B. Because it’s very rare, babies with Neonatal Diabetes may mistakenly be diagnosed with Type 1 Diabetes. Evidence suggests however that Type 1 Diabetes is not found in babies under 6 months old. If you or your child were diagnosed with Type 1 Diabetes under the age of 6 months, speak to your healthcare team.
Excessive Thirst. When it comes to Type 1 Diabetes and thirst, polydipsia can be dangerous. Prolonged dehydration can lead to nausea, dizziness, headaches and fainting. If you have Type 1 Diabetes, but have not yet been diagnosed, this dehydration has the potential to lead to Diabetic Ketoacidosis which can lead to organ failure, coma or death. Another concern is that extreme dehydration can also make your blood-sugar levels rise more quickly than normal since less urine—and glucose—is being expelled.
Excessive hunger or appetite as a symptom of disease.
Polyuria occurs when your body urinates more frequently—and often in larger amounts—than normal. Polyuria in Type 1 Diabetes occurs when you have excess levels of sugar in the blood. Normally, when your kidneys create urine, they reabsorb all of the sugar and direct it back to the bloodstream. With Type 1 Diabetes, excess glucose ends up in the urine, where it pulls more water and results in more urine.
Pre-diabetes is where blood glucose levels are higher than normal, although not high enough to be diagnosed with Type 2 Diabetes. Pre-diabetes has no signs or symptoms. Two million Australians have pre-diabetes and are at high-risk of developing Type 2 Diabetes.
Rapid-acting insulin (also known as fast or short-acting, bolus or mealtime insulin) is usually taken just before a meal, snack or drink containing carbohydrates to minimise the rise in blood sugar which follows eating.
Type 1 Diabetes related complications can include:
- eye disease, such as Diabetic Retinopathy;
- nerve damage, such as Diabetic Neuropathy;
- kidney disease, such as Diabetic Nephropathy;
- heart disease and stroke, such as Cardiovascular Disease.
The risk of all complications can be reduced by up to 76% with tight glucose management (such as that aided by technology).
Understand more about complications:
The early stage of Diabetic Retinopathy, known as “background” Diabetic Retinopathy, unfolds as the walls of the retina weaken from high blood sugar and high blood pressure, developing small, dot-like bulges, or “micro-aneurysms,” which can leak fluid or blood into the surrounding tissue. In the second, more destructive stage, called Proliferative Diabetic Retinopathy, new blood vessels form on the retina in response to the damage. When called to the spot where damage occurred, the cells generate new blood vessels as part of the repair.
Diabetic Neuropathy is the medical name given to progressive damage to the nervous system caused by Type 1 Diabetes. Diabetic Neuropathy can lead to a loss of feeling in the hands and feet. Reduced circulation resulting from high blood glucose impairs normal wound healing in the extremities, so minor damage can linger and develop into permanent injury. At the same time, Neuropathy can cause severe pain in limbs that otherwise have reduced normal sensation.
Diabetic kidney disease or Diabetic Nephropathy is a slow deterioration of the kidneys and kidney function which, in more severe cases, can eventually result in kidney failure, also known as end-stage renal disease, or ESRD.
HEART DISEASE AND STROKE
Cardiovascular Disease is a range of blood vessel system diseases that includes both stroke and heart attack. The two most common types of Cardiovascular Disease are Coronary Heart Disease, caused by fatty deposits in the arteries that feed the heart, and hypertension, or high blood pressure.
Type 1 Diabetes (T1D) is an autoimmune disease destroying our body’s ability to process sugar by attacking the beta cells in our pancreas that produce the hormone insulin. Insulin helps convert sugar into the fuel our bodies need. Without insulin, sugar builds up in our blood stream in life-threatening amounts. Multiple times each day insulin needs to be injected into the body of someone living with T1D. There is no way to prevent Type 1 Diabetes and there is no cure. More…
Up to a third of people who were initially diagnosed as having Type 2 Diabetes (T2D) actually have latent autoimmune diabetes of adults (LADA), sometimes refer to as Type 1.5 Diabetes. People with LADA have features of both Type 1 Diabetes (T1D) and T2D – their immune system attacks the cells of the pancreas that produce insulin, but they may also develop insulin resistance. The destruction of the insulin producing cells is much slower in LADA than in T1D. A blood test is needed to tell the difference between T2D and LADA. Some people can manage LADA on diet, exercise and tablets in the initial months or years following diagnosis. However, most will move onto insulin therapy at some point.
Type 2 Diabetes (T2D) is by far the most common type of diabetes. People with T2D either don’t make enough insulin or make insulin that the body can not use properly. The cells in the body become resistant to insulin, making a greater amount of insulin necessary to keep blood glucose levels within a normal range. Eventually, the pancreas can wear out from producing extra insulin, and it may start making less and less. T2D can usually be managed through diet, exercise, and self-monitoring blood glucose, at least in the first few years following diagnosis. However, T2D is a progressive condition, and most people will need to take tablets and/or inject insulin after living with it for five to 10 years.
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