Type 1 Diabetes

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Type 1 diabetes is an autoimmune condition in which your body’s immune system attacks the insulin-producing cells in the pancreas, so you make little or no insulin.¹ Without insulin, glucose (sugar) builds up in your blood instead of being used by your cells for energy.¹

What Is Type 1 Diabetes?

If you have type 1 diabetes, you will need to take insulin every day to control your blood glucose.¹ It’s usually diagnosed in children or young adults, but it can happen at any age.¹ There’s no cure yet, but it can be effectively managed with insulin therapy, regular glucose monitoring, and good self-care.¹

Unlike type 2 diabetes, type 1 isn’t caused by lifestyle or weight — it’s an autoimmune disease, not preventable with diet or exercise.¹

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Symptoms

Common signs of type 1 diabetes include:

  • Feeling very thirsty
  • Urinating often (frequent toilet visits)
  • Eating more but losing weight
  • Feeling tired or weak
  • Blurred vision¹

In some cases, type 1 diabetes may first present as diabetic ketoacidosis (DKA), a medical emergency. Symptoms of DKA include: fast breathing, a “fruity” breath (like nail polish remover), nausea or vomiting, abdominal pain, dehydration, and confusion.¹

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Causes

The cause of type 1 diabetes isn’t fully understood. Most often, it’s an autoimmune reaction: your immune system targets and destroys the β-cells in the pancreas that produce insulin.¹ There is also a genetic component — having a close relative with type 1 diabetes significantly increases your risk.¹

Mayo Clinic researchers are investigating new immune-modulating treatments and earlier diagnostic strategies to help delay or modify disease progression in early-stage type 1 diabetes.²

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How Type 1 Diabetes Is Diagnosed

If your doctor suspects type 1 diabetes, they will likely do:

  • In the health care practitioner’s rooms, a random glucose level (finger prick)¹
  • Further laboratory blood tests to check fasting glucose and HbA1c
  • Urine tests for ketones, especially if you’re unwell and suspect DKA.¹
  • Tests for autoantibodies (immune markers) and C-peptide, to see how much insulin your body still makes.¹

Prompt diagnosis is important: a recent study in South Africa launched by the University of Pretoria found that better data on how many people have type 1 diabetes in the country is urgently needed to improve care delivery.³

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Treatment

  • Insulin therapy is the foundation of treatment. Available types are rapid, short, intermediate, long-acting, or premixed insulin, via injections or an insulin pump.⁴
  • Work with a diabetes educator, endocrinologist or specialist to learn how to match your insulin doses to your food intake, activity, and blood sugar levels.¹
  • Frequent blood glucose monitoring is key. According to South Africa’s Diabetes SA, people using insulin several times a day should check their blood sugar at least three times daily.⁵
  • In some cases, continuous glucose monitoring (CGM) and insulin pump therapy are used—but access is limited and costly in many parts of South Africa.⁶

Regular checkups are essential: you’ll need routine monitoring of blood pressure, kidney function, eyes and feet, and emotional well-being.

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Living with Type 1 Diabetes

Self-care essentials

  • Learn carbohydrate counting: understanding how many carbs you eat helps effects your blood glucose level and need to adjust your insulin.⁷
  • Stay physically active: exercise helps your body use glucose better and can improve insulin sensitivity.⁸
  • Eat a balanced, consistent diet to help keep your blood sugar stable.⁷
  • Be prepared for “sick days”: have a plan for how to manage your insulin, food, and glucose during illness.

Support matters

  • Join local support groups: organisations like Diabetes South Africa (“Diabetes SA”) and Sweet Life provide peer support, resources and education.⁹

 

In public clinics across South Africa, the “TIME” leaflet (endorsed by SEMDSA – Society for Endocrinology, metabolism and Diabetes of South Africa) offers practical tips for managing insulin injections, developed in collaboration with leading endocrinologists.¹⁰

Engage a dietitian experienced in type 1 diabetes. Dietitians frequently use methods like carbohydrate counting, glycaemic index, portion control, and “healthy plate” approaches to support T1D patients.¹¹

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Diet & Nutrition Tips

For daily care & stability:

  • Focus on consistent carbohydrates: try to eat similar amounts of carbs at each meal so your insulin dosing can be predictable.
  • Choose high-quality, slow-release carbohydrates: whole grains, legumes, fruits, vegetables — these help smooth post-meal glucose rises.
  • Include lean protein and healthy fats in each meal to support stable energy and reduce blood sugar spikes.
  • Work with your dietitian to tailor your eating plan and match insulin to your food.

For low blood sugar events:

  • Always keep “fast-acting carbs” on hand: glucose tabs, fruit juice, regular soft drink (non-diet) are commonly used.
  • After treating hypoglycaemia, eat a light snack that has both carbs and protein (e.g., apple + peanut butter), so your blood sugar stays stable.

For longer-term health:

  • Maintain regular meal patterns and avoid skipping meals.
  • Reduce highly sugary, processed foods — they make blood sugar harder to control.
  • Stay hydrated: water should be your main drink.
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Disclaimer

This brochure is for educational purposes only and is not intended to provide a diagnosis or treatment or replace the advice of your doctor, pharmacist, primary health care nurse or other health care provider. You are advised to discuss any questions or concerns you have with your health care provider.

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  1. Mayo Clinic – Type 1 diabetes: symptoms & causes Mayo Clinic
  2. Mayo Clinic – Immune-modulating therapy in early type 1 diabetes Mayo Clinic
  3. University of Pretoria – South Africa Type 1 Diabetes Burden Study University of Pretoria+1
  4. SEMDSA (South African) diabetes guidelines on insulin therapy KZN Health
  5. Diabetes South Africa – self-monitoring glucose targets diabetessa.org.za
  6. South African diabetes advocacy petition for CGM access IOL
  7. Dietary management practices in KZN dietitians for T1DM hsag.co.za+1
  8. Mayo Clinic – importance of exercise and diabetes care Mayo Clinic
  9. Diabetes SA / Diabetes Advocacy groups in South Africa SA Diabetes Advocacy
  10. Sweet Life – Type 1 leaflet in public clinics (“TIME” leaflet) sweetlife.org.za+1
  11. Health SA Gesondheid – dietary management in KwaZulu-Natal PMC
  12. Centre for Diabetes & Endocrinology (CDE), South Africa cdediabetes.co.za+1

This referenced content has been reviewed by Dr Helen Sammons, who is a qualified medical doctor with extensive experience in the private healthcare sector of South Africa, particularly in the disciplines of general practice.

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