Dealing with and Reducing Type 1 Diabetes Problems

Having type 1 diabetes (T1D) increases the risk of developing various health complications, especially when blood glucose levels are not well-managed over time. The longer a person lives with T1D, the greater the likelihood of experiencing these complications.

Common Long-Term Complications of Type 1 Diabetes

• Heart Disease and Stroke: High blood glucose can damage blood vessels, raising the risk of coronary heart disease and stroke. Managing cholesterol and blood pressure alongside blood glucose is crucial to reduce this risk.

• Kidney Disease: Elevated blood sugar can damage the kidneys' filtering units, leading to kidney disease or failure. About one-third of people with T1D develop kidney disease, though most do not progress to kidney failure. Early detection and treatment are important.

• Eye Problems: High blood glucose can cause diabetic retinopathy, damaging the retina’s blood vessels and potentially leading to vision loss. Other eye issues include diabetic macular edema and cataracts, which are more common in people with T1D.

• Nerve Damage (Diabetic Neuropathy): Persistently high blood sugar can damage nerves, causing numbness, pain, or loss of sensation, especially in the feet and legs. Up to 50% of people with diabetes experience neuropathy.

• Foot Problems: Nerve damage and poor circulation can cause sores that heal poorly, sometimes leading to amputation. Regular foot care and monitoring are essential.

• Other Risks: T1D is linked to higher risks of some cancers, gum disease, sexual dysfunction, and a higher chance of developing other autoimmune diseases like coeliac disease.

Acute Complications Specific to T1D

• Diabetic Ketoacidosis (DKA): A serious condition caused by insufficient insulin leading to high ketone levels. It requires immediate medical attention.

• Hypoglycemia Unawareness: Some individuals may not notice low blood sugar symptoms, increasing the risk of severe hypoglycemia and potential coma.

Role of Technology in Reducing Complications

• Continuous Glucose Monitors (CGMs): CGMs provide real-time tracking of glucose levels, helping to detect trends and prevent dangerous highs and lows. Early and sustained use of CGMs has been shown to improve long-term blood sugar control (lower HbA1c) and reduce emergency visits related to diabetes.

Importance of Regular Medical Checkups

Annual and routine checkups are essential to catch complications early and prevent progression. These include:

• Blood pressure, cholesterol, and weight monitoring

• Foot exams to check for neuropathy and sores

• Eye exams by specialists experienced in diabetic eye disease

• Kidney function tests

• Dental checkups every six months

Regular visits also provide opportunities to discuss treatment, lifestyle, and medication adherence with healthcare providers.

Lifestyle Measures to Lower Risk

• Maintaining blood glucose near target levels through insulin management

• Eating a balanced diet and regular exercise

• Avoiding smoking

• Managing blood pressure and cholesterol

These steps, combined with technology and medical care, help reduce the risk of complications and improve quality of life for people with T1D.

In summary, type 1 diabetes increases the risk of serious long-term complications affecting the heart, kidneys, eyes, nerves, and feet, especially if blood sugar is poorly controlled over time. Tools like continuous glucose monitors and automated insulin delivery systems significantly aid in better glucose management, reducing these risks. Regular health checkups and proactive lifestyle management are key strategies to detect and prevent complications early.

𝗣𝗿𝗼𝗳(𝗗𝗿) 𝗧𝗶𝗿𝘁𝗵𝗮𝗻𝗸𝗮𝗿 𝗠

MBBS, MD (Internal Medicine), DNB ( Internal Medicine) , 

MRCP ( UK) , MRCP ( Edinburgh), FRCP (Edinburgh)

Member of National Academy of Medical Sciences New Delhi( MNAMS)

Professor & Senior Consultant KIMS Bengaluru

Physician & Diabetologist .