How does adult onset Type I diabetes work? Is it “burnout” of the body’s ability to make insulin? Why isn’t it noticed sooner? Does good lifestyle prevent symptom development?
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The leading theory is that there’s some trigger for an autoimmune condition which leads to your own immune system destroying your insulin producing (beta) cells in the pancreas..
Diagnosed at 49 with Type 1. I was healthy, ran with my dogs daily, non drinker and living a healthy life. No history of Type 1 in my family.
Got Covid and my pancreas died.
Type one can be triggered with trauma, illness or just plain old genetics. If there’s a history of type one, you are at risk. In my case it was Covid which triggered it. Lifestyle has nothing to do with type one.
Good lifestyle reduces the risk of autoimmune diseases in general, but we don’t know how to prevent them.
If we knew what caused this we could save a lot of people from a lot of suffering but we don’t, and that’s the ELI5 answer.
Something causes the body’s immune system to start attacking its own cells. Could be stress, could be a recent infection of another pathogen, could be something else. If it starts attacking beta cells in the pankreas, you get type I diabetes. I got hypothyroidism, which is a condition very similar to diabetes except the thyroid is involved instead of the pankreas.
Eating well, exercising etc etc is always good advice for all aspects of your body but nothing will make you immune towards these kinds of things.
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The cause is the destruction of the pancreas’s insulin-producing beta cells; this is what makes it distinct from type 2, which actually is a lessening of the body’s ability to utilize insulin. As for why the body would suddenly turn on itself and destroy those beta cells, there isn’t a single cause that science has conclusively identified.
Everybody’s story is different, but mine is fairly typical – it developed at age 18 after a pretty severe and to this day undiagnosed infection that laid me up in bed for a week. After I got better, I started dropping muscle and fat very, very slowly, but by the time I’d started college about 6 months later, I had lost over 30 pounds and was on the brink of collapse.
It’s just a very gradual onset thing that’s easy to ignore until you’re suddenly very seriously ill, and people can be in denial that something so severe could actually be wrong with them. I know that I was. I felt like an idiot telling people I thought I was sick, and I was so emaciated and weak I didn’t recognize myself in the mirror.
A healthy lifestyle cannot prevent type I diabetes, but it helps immensely once you’re on insulin. Eating a healthy diet and exercising regularly has helped me maintain an average blood sugar that’s very close to that of a normal person for almost 15 years now, and I am completely free of complications. Multiple doctors have told me that I will likely live a normal lifespan if patterns hold. It’s not a death sentence at all – one’s lifestyle can have a very powerful impact on their quality of life. Perhaps more than any other disease that comes to mind.
I was 28. Pancreas took a shit and I had no idea. Bad times ensued. Drs said it was genetics and it just took longer to happen. I’ve had three different endos though and they’ve all said different things so who really knows?
Diagnosed at 53. My diet was shit, I lived on Coca Cola and at the time I was penniless and living on Top Ramen and oatmeal for a year or so with LOTS of sugar on the oatmeal.
No history in family and no triggering illness though I was DEEPLY depressed at the time. I went about a year undiagnosed as I had no insurance. My friends and family insisted I go to a doctor as I had lost 80 pounds which put me about 40 lbs under weight and I looked like death warmed over.
Doc tried to treat me as T2 but that was a failure. Once I got on insulin my health turned around and my weight has been locked in at 165 at 5′ 10″ for several years and I just got my A1C to 6.9 I still live on Coke but I just use a lot of insulin.
You eat the wrong stuff for long enough, have a poor diet etc etc.
Pancreas starts to gives out over time, not producing enough insulin, thats type 2, you produce some insulin, but not enough.
If you don’t change lifestyle etc, pancreas gives up and produces no insulin, that’s type 1
This is how my diabetes team dummed it down for my stupid brain
Edit: ignore me, I’m dumb
It works the same way it does in pediatric-onset (kids) autoimmune diabetes. There’s a (presumed) pre-existing genetic predisposition (some gene variants have been identified as having higher risk, but they are not always present), and then some environmental insult to the immune system pulls the trigger. The immune system then attacks the cells that make insulin, eventually killing them off.
The big difference is that as a general rule, your immune system gets weaker as you age, so onset of symptoms is likely to be slower the older the person is. When you combine that with the previous incorrect assumption that autoimmune diabetes ONLY developed in children (or at the absolute latest in the early 20s), you get LOTS of misdiagnosed adults.
Medications for T2D typically DO work initially, and can compensate for declining insulin production by increasing sensitivity to insulin, but eventually fail, which further contributes to incorrect assumptions by medical professionals about the cause of the elevated blood sugars.
I realize that’s not really an ELI5, but it’s a complicated subject, and diabetes (in general) happens/develops via a number of different mechanisms, with most people having aspects of more than one. They can exacerbate each other, with lots of interplay, so even the current definitions of types (with a few exceptions) are not 100% for almost anyone.
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