Diabetes Type 1

Type 1 diabetes (T1D) is when the body's immune system destroys the cells in the pancreas that make insulin. Without insulin, sugar can't get into cells, and levels build up in the blood. It is most often diagnosed in children, teenagers, and young adults — but can occur at any age. Unlike type 2 diabetes, lifestyle doesn't cause it, and insulin is essential from diagnosis.

Classic presentation — learn these

• Excessive thirst and frequent urination — including new bedwetting in a previously dry child.
• Rapid weight loss despite eating.
• Constant hunger or loss of appetite.
• Fatigue, blurred vision.
• Fruity breath, rapid breathing, vomiting, abdominal pain, confusion — diabetic ketoacidosis (DKA), a medical emergency.

When to see a Health Expert urgently

• Any child with thirst + frequent urination + weight loss → fingerstick blood sugar the same day. A 2-minute test that saves lives.
• Fruity breath, rapid breathing, vomiting, drowsiness — possible DKA — dial 112 or go to hospital immediately.
• In India, T1D is often misdiagnosed as "viral infection" or "gastroenteritis" when DKA is already setting in. Any of the symptoms above deserve a blood sugar check.

Diagnosis

• Raised blood sugar on fingerstick or venous blood.
• HbA1c; urine ketones.
• Antibodies (GAD, IA-2, insulin) confirm type 1 (not always needed).
• Thyroid and coeliac screening — commonly associated conditions.

Treatment — insulin, for life

• Multiple daily injections (basal-bolus) or insulin pump.
• Blood glucose monitoring — fingersticks or continuous glucose monitors (CGMs).
• Carb counting and insulin matching — older children and families learn this.
• Nutrition — balanced, not restrictive; children with T1D eat normal Indian food with insulin matched.
• Exercise — important but needs adjustment to avoid hypos.
• Hypoglycaemia management — 15g sugar + recheck in 15 min (see Hypoglycaemia page).
• Sick-day rules — insulin goes up, not down, during illness; never stop insulin.

India-specific practical points

• T1D is not rare in India — incidence is rising; care access varies widely.
• Insulin is on the essential-medicines list and must be available at government hospitals; state schemes supply insulin and consumables free for many children; ask the social worker / charitable trust.
• Support organisations — Juvenile Diabetes Research Foundation India (JDRF), Sweet Angels, and local parent groups provide practical help and solidarity.
• School and travel — every T1D child needs a school plan (hypoglycaemia kit, permission to test and eat). Many schools need education — persistent advocacy matters.
• Don't ever stop insulin — unregulated "natural cures" for T1D have killed children. Biomedical treatment is the only known effective treatment.