Type 1 diabetes is a chronic condition characterized by a smaller production of insulin or no insulin at all. This condition is also known as insulin-dependent diabetes or juvenile diabetes. Insulin is a hormone necessary to allow the glucose to enter the cells to create energy. Type 1 diabetes affects the entire body including the heart, blood vessels, eyes, nerves, kidneys and other organs. Long-term complications tend to develop gradually, over the decades, sometimes being even life-threatening. Keeping the glucose levels close to normal as much as possible can help reduce the risk of having long-term complications. 

Type 1 Diabetes Complications

Some of the common complications include:

1. Diabetic Ketoacidosis

It is a life-threatening complication of diabetes due to a complete lack of insulin, which leads to the production of ketones (blood acids). Ketones are caused by fat breakdown that tend to build up in the blood and urine. Diabetic ketoacidosis can lead to coma and death.

Characteristic signs and symptoms include fatigue, dry mouth, dry and warm skin, frequent urination, thirst, nausea, vomiting, deep and rapid breathing, increased heart rate, fruity breath odor, etc.

The treatment includes a rapid replacement of fluids combined with low-doses of insulin and potassium replacement.

2. Hypoglycemia

It is a common type 1 diabetes complication which occurs when the levels of sugar in the blood are below 70 mg/dL. Hypoglycemia is a manageable type 1 diabetes complication. However, in some patients, it can be even life-threatening when its signs and symptoms are not recognized on time, or if these patients continue to take insulin and other hypoglycemic drugs. Characteristic signs and symptoms of hypoglycemia include rapid heartbeat, sweating, trembling, hunger, weakness, disorientation, etc. Rarely, it can lead to coma, seizures, and even death.

3. Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)

HHNS is one of the type 1 diabetes complications. It is characterized by increased levels of sugar in the blood and dehydration, triggered by an infection or another severe illness.

Signs and symptoms include high fever, high levels of glucose in the blood, dry mouth, extreme thirst and dry skin. It can eventually lead to seizures, coma, and even death.

4. Heart Disease and Stroke

Heart diseases and stroke are common among diabetic patients, no matter if they are suffering from type 1 or type 2 diabetes. The progression of atherosclerosis is more rapid among diabetic patients, leading to coronary artery disease, heart attack, and stroke. People suffering from type 1 diabetes also tend to have a higher blood pressure due to the damage of the kidneys, which will also increase their risk for coronary artery disease, heart attack, and even heart failure.

5. Kidney Damage (Nephropathy)

Nephropathy is one serious type 1 diabetes complication. Over the time, the kidney glomeruli, tiny filters in the kidneys, get damaged and leak the protein into the urine. This kidney damage eventually leads to a kidney failure, and diabetic nephropathy is one of the leading causes of end-stage renal disease (ERSD).

Characteristic signs and symptoms include swelling of the feet and ankles, fatigue, itchiness and a pale color of the skin. Once kidney failure occurs, dialysis and kidney transplantation are the only treatment. 

6. Neuropathy

It is a common diabetes complication. There are two main types of neuropathy: peripheral neuropathy and autonomic neuropathy. Peripheral neuropathy is a condition that affects the nerves of the toes, feet, legs, arms, and hands. Characteristic signs and symptoms include a burning sensation, loss of sense of warm and cold, tingling, weakness, numbness, etc. Autonomic neuropathy is a condition that affects the nerves that help regulate the function of the heart, bowel, bladder, digestive system and the sexual function as well.

7. Foot Ulcers and Amputations

Foot ulcers are common type 1 diabetes complications due to a poor blood circulation and peripheral neuropathy. Foot ulcers lead to lower limb amputations. Diabetic patients who have a long history of diabetes are overweight, and smoke are at a higher risk of having foot ulcers. Foot ulcers usually occur on the big toe, resulting from infections or any injury of the blood vessels. Numbness due to neuropathy puts these patients at a higher risk for injuries as they may not be aware of them.

Neuropathic arthropathy also known as Charcot foot is another degenerative condition that affects the bones and joints of the feet. The foot starts to get swollen, red and warm, starting even to deform. The bones may crack, splinter and even erode, while the joints may change their shape and even become unstable.

8. Retinopathy and Eye Complications

Diabetes affects the entire body, including the eyes. Diabetes is the leading cause of blindness. The most common eye disorder is diabetic retinopathy. Diabetic patients are also at a higher risk for glaucoma and cataracts. Diabetic retinopathy is a medical condition characterized by a damage of the retina, which generally occurs in two phases. The first phase is known as the non-proliferative phase during which the blood vessels of the retina get damage and weaken. The second phase is known as the proliferative phase during which new and abnormal blood vessels start to grow on the surface of the retina. 

9. Infections

People with diabetes are at a higher risk for influenza and complications like pneumonia. Diabetic patients should have the annual influenza vaccination and the vaccination against pneumococcal pneumonia in order to prevent these respiratory infections. Type 1 diabetes complications are also infections of the urinary tract, especially among women. In general, these infections of the urinary tract are more likely to get complicated and they are more difficult to treat. Diabetic patients are more likely to suffer from hepatitis B, which is transmitted through blood and other body fluids. People are exposed to the virus through sharing blood glucose monitors and finger-stick devices. Everyone newly diagnosed with diabetes should receive a hepatitis B vaccination.

10. Periodontal Disease (Gum Disease)

Diabetic patients are more likely to produce less saliva and have less collagen as well as a poor circulation of the blood in the gums. Diabetic patients are more likely to have more plaques than others. The level of the sugar in the mouth is higher due to a higher level of sugar in the blood. All of these factors contribute in the development of the gum disease, eventually leading to signs and symptoms like sensitive gums, painful gums, bleeding of the gums, discolored gums, etc. Regular dental checkup are necessary for the right diagnosis and for the treatment of periodontal disease.

11. Miscarriage and Stillbirth

Being pregnant and suffering from diabetes put you at a higher risk of miscarriage and stillbirth. It is very important to have controlled levels of blood sugar before pregnancy and during the whole 10 months of the pregnancy. Controlled levels of blood sugar during the first few weeks of the pregnancy will protect the developing baby from serious birth defects.