5 Common Misconceptions About Type 1 Diabetes Risk
Diabetes is increasing at an alarming rate—which could be why myths and misconceptions about the disease abound. For starters, not all diabetes is alike. There is type 1, which is characterized by a lack of production of the hormone insulin; and type 2, which is caused by the body’s inability to use insulin effectively. Both involve a problem with the body’s production or use of insulin, which moves glucose (sugar) from your blood into your cells. There’s also pre-diabetes, a serious health condition in which blood-sugar levels are higher than normal, but not yet high enough to be diagnosed as diabetes.
According to the Centers for Disease Control and Prevention, diabetes affects 11 percent of the U.S. population, about 37 million Americans. Driven by the increased prevalence of obesity and other lifestyle-related conditions, it’s considered one of the country’s fastest-growing chronic diseases. And researchers predict a substantial increase in cases across the globe by the year 2045, when the International Diabetes Federation projects that one in eight adults across the world will be living with diabetes.
However, when you break the cases down by type, things get a bit lopsided. Type 1 diabetes (T1D) is less common than type 2 diabetes (T2D), accounting for only about 5 to 10 percent of people with diabetes overall. The result of an autoimmune reaction, T1D is most often diagnosed in children and young adults, but it can occur at any age. Unlike T2D, which is greatly affected by poor diet and a lack of exercise, no one knows exactly how to prevent T1D—but it can be effectively managed. Yet while there are treatments, it’s important to know fact from fiction. Below, we explain some of the most common myths and misconceptions about T1D, so you can decide whether you or someone you know should be screened.
Myth: If A Family Member Has T1D, You’re Likely To Have It Too
Reality: Having a first-degree relative, such as a sibling, child, or parent, or perhaps even a second-degree relative, such as a cousin, with T1D may increase your risk of developing it. Yet most people who develop T1D have no relatives with T1D at all, says Kevin Peterson, MD, MPH, vice president of primary care at the American Diabetes Association. “Although siblings and children of people with diabetes have a higher risk of developing diabetes, the vast majority of siblings do not develop T1D,” he says. In fact, 85 percent of people with T1D have no one else in their family with the condition.
In comparison, T2D has far more of a hereditary component. “You have a higher risk of developing diabetes if your parent or sibling has type 2 diabetes than if they have type 1,” says Susan Spratt, MD, an endocrinologist and an associate professor of medicine at Duke University School of Medicine. “Type 1 diabetes occurs in primary relatives around 7 percent of the time, whereas type 2 diabetes occurs more commonly in other first-degree relatives.”
Myth: T1D Is A Childhood Disease Caused By Eating Too Much Sugar And Junk Food
Reality: Type 1 diabetes used to be referred to as “juvenile diabetes,” so it’s no surprise that there are still people who think of it in those terms. But it can develop at any age. There’s also no evidence that eating too much sugar can cause T1D, says Dr. Peterson. “Sugar and other carbohydrates should be balanced to maintain good health after a diagnosis is made, but eating sugar doesn’t cause diabetes,” he says.
It’s important to remember that T1D is caused by an autoimmune reaction that ultimately destroys the cells in the pancreas that make insulin. Scientists don’t know the exact cause, but they know that genetics as well as external factors such as viruses and environmental toxins can play a role—which makes screening paramount when risk factors such as family history are present.
Myth: Everyone Over The Age Of 45 Should Be Screened For Type 1 Diabetes
Reality: “Screening is not considered for T1D unless the patient has a first-degree relative with it,” says Dr. Spratt. “It involves testing for antibodies that cause type 1 diabetes, which is expensive and not always covered by insurance, plus an oral glucose-tolerance test, which measures how well your body can process sugar.”
That said, everyone over the age of 45 should be screened for type 2 diabetes, according to Dr. Spratt. “And if you have a risk factor for type 2, such as hypertension, pre-diabetes, a family history, or heart disease, you should be screened earlier,” she says. Screening options for T2D include a fasting glucose test, an oral glucose-tolerance test, or a hemoglobin A1c test.
Myth: Symptoms Of T1D Can Take Time To Develop
Reality: Not really, but it partially depends on your age. Symptoms of T1D can develop in just a few hours or days in young people, but in adults the symptoms often take a bit longer—a few days or weeks. Either way, “symptoms for T1D begin quickly, usually within days to weeks,” Dr. Peterson says.
Typical symptoms include increased thirst, increased urination, increased appetite, fatigue, and persistent infections. “Other symptoms can include an unintended loss of weight over several weeks, blurred vision, or the onset of skin rashes,” Dr. Peterson says. Once these symptoms appear, they can be severe and, left untreated, can lead to serious—even fatal—health problems.
Myth: T1D Can Be Reversed And Cured
Reality: Type 1 diabetes is due to an autoimmune destruction of the beta cells in the pancreas that make insulin. And before T1D becomes apparent clinically, more than 90 percent of the pancreas has been destroyed, says Dr. Spratt. “This makes it difficult to intervene with anti-autoimmune drugs, because once the pancreas cells are destroyed, there is no bringing them back,” she says. Thus, there is no cure for type 1 diabetes. However, early screening can help slow its progression.
Managing T1D requires keeping a close eye on insulin levels, diet, and exercise. Most people with it need synthetic insulin every day and also need to keep their blood sugar within a healthy range. And since several factors affect your blood-sugar level, managing T1D is often highly individualized.
Treatment options may include insulin pumps and the transplanting of islet cells (groups of cells in the pancreas), but neither is foolproof yet. Insulin pumps, for example, can measure blood sugar in the subcutaneous tissue and deliver the appropriate amount of insulin, but “the glucose in the subcutaneous tissue is about an hour behind the blood levels, and insulin delivered by pumps to the subcutaneous tissues requires time to be absorbed,” Dr. Peterson says. “A pump is always a little behind what a pancreas would do.” Still, there is hope in the science community that we may find a cure for diabetes in the future.
When And How To Be Proactive About T1D
Even though anyone at any age can develop T1D, there is a spike in diagnoses between the ages of 4 to 7 and 10 to 14. A promising new study suggests that the immunotherapy drug teplizumab may cause children recently diagnosed with T1D to need less supplemental insulin to keep their blood sugar in a healthy range, but T1D remains a complicated disease to manage for many people.
“Blood tests can identify the presence of auto-antibodies that indicate an increased risk of developing T1D, allowing individuals at high risk to take medicine that may delay the onset of the disease,” says Dr. Peterson. “However, a consensus doesn’t exist among medical experts about who should be checked for the auto-antibodies, or at what age.”
Given that, anyone with symptoms of T1D, or a first- or even second-degree relative with T1D, should tell their healthcare provider, and consult on the appropriate course of action. If T1D is left untreated, it can cause diabetic ketoacidosis, a life-threatening condition in which the body starts breaking down fat and muscle as an alternative source of energy. The sooner T1D is diagnosed, the better the chances of reducing complications and managing the disease before they become serious.
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