Type 1 Diabetes Diagnosis and Treatment

Type 1 diabetes is a chronic condition that happens when your pancreas produces little to no insulin. Getting the right diagnosis as soon as possible is very important to keep you in good health.

Whether you’re looking for information for yourself or a loved one, we can help you figure out the process from diagnosis to effective treatments.

How is type 1 diabetes diagnosed?

If your health care provider thinks you might have type 1 diabetes, they will review your medical history, perform a physical exam and order blood tests.

Your provider may begin by asking you about your symptoms and when they began. They will also ask about any risk factors for diabetes, such as family history of the disease. The provider will also check you for signs of the disease, like unexplained weight loss, frequent urination and/or thirst and exhaustion. 

Blood tests used to diagnose type 1 diabetes

A blood test to measure blood glucose (blood sugar) levels is an important part of getting a diagnosis. When checking for type 1 diabetes, your provider will also look for special proteins called antibodies in the blood. These antibodies can tell us if the body is mistakenly attacking its own insulin-producing cells in the pancreas.

Your provider may use a few tests to make an accurate diagnosis. 

Depending on your tests, you may be required to fast (not eat) beforehand. Your provider will let you know if you need to fast.

Non-fasting blood tests

• Hemoglobin A1c Test: An HbA1c test is the main blood test used to diagnose type 1 diabetes. It tests your average blood sugar levels for the last two to three months. The test results will fall into one of three categories:
  • Normal: Below 5.7%
  • Prediabetes: 5.7% to 6.4%
  • Diabetes: 6.5% or higher
• Random blood-glucose test: This test, also called a random plasma glucose test or RPG, can be done at any time. It can be done through a finger prick or a vein in your arm (intravenously). If your level is 200mg/dL (milligrams of sugar per deciliter) or above, you may have diabetes, especially if you also have symptoms such as thirst and having to pee more often than usual. 

Fasting blood sugar tests

• Fasting blood tests (fasting plasma glucose test or FPG): This blood test is often recommended first thing in the morning after fasting (no food or drinks except water) for eight to ten hours. Test results are as follows:
  • Normal: Below 99 mg/dL
  • Prediabetes: 100 mg/dL to 125 mg/dL 
  • Diabetes: 126 mg/dL or above
• Oral glucose tolerance tests (OGTT): This test shows if your body has problems handling the sugar you get from food and drink. It is used to diagnose type 1 diabetes but is also used to diagnose gestational diabetes (diabetes that happens during pregnancy). You will fast for eight to ten hours, then have your blood drawn. After this blood test, you will be given a drink that contains a concentrated amount of glucose (sugar). Then you will have your blood drawn one, two and three hours after you have the sugary drink.  The results after two hours will help your provider make a diagnosis:
  • Normal: 140 mg/dL or below 
  • Prediabetes: 140 mg/dL to 199 mg/dL
  • Diabetes: 200 mg/dL or higher 

If you are diagnosed with diabetes, your provider may do other tests to distinguish between type 1 and type 2 diabetes. This is because the two conditions often require different treatments. Your provider may also check your eyes, kidneys and heart to check if there is any damage due to diabetes.

What is the treatment for type 1 diabetes?

If you’re diagnosed with type 1 diabetes, it’s natural to feel worried. But thanks to early detection and management, many people with type 1 diabetes lead healthy lives.

During treatment, your team of diabetes specialists may include your health care provider, endocrinologists (hormone specialists), diabetes educators, nutritionists or dietitians, pharmacists and other specialty providers. The main goal of treatment is to keep your blood glucose (sugar) levels within a healthy range. Keeping your blood sugar under control helps you feel better and lowers your chances of developing problems.

Your treatment plan will most likely include glucose monitoring, medication, a healthy eating plan, regular exercise and education. 

• Insulin therapy: All people with type 1 diabetes must take insulin daily to keep blood glucose levels as close to normal as possible. Insulin can be delivered through shots with a needle or through an insulin pump, a small device you attach to your body that releases insulin. There are many types of insulin, including short-acting, rapid-acting, intermediate-acting, long-acting and ultra-long-acting insulin.
• Monitoring: Your diabetes team will tell you how often you need to check your blood sugar levels. This information is important as it helps you and your team track your progress and make any necessary changes to your treatment plan. Keeping track of your levels may involve a fingerstick and a glucose meter to measure blood sugar or using a continuous glucose monitoring (CGM) device to provide ongoing, real-time data on your blood sugar, which may offer better control and awareness.
• Education: Educate yourself and your loved ones about type 1 diabetes. Understanding the condition and its management are important for making informed decisions.
• Healthy eating and carb counting: Along with taking insulin, the best treatment is eating a balanced diet and managing your carbohydrate intake. You’ll learn how to count the amount of carbs in your diet and how to match your insulin to what you eat.
• Physical activity: Keeping active can help maintain blood sugar levels. Talk to your provider before starting any new activity. 
• Other medications: Some people with type 1 diabetes may also be prescribed high blood pressure, cholesterol-lowering and/or blood thinning medications.
• Stress management: Stress can affect blood sugar levels, so it’s important to learn about relaxation techniques, meditation and other stress-reducing practices.
• Regular check-ups: Keep up with your medical appointments. Regular check-ups allow your care team to monitor your overall health and adjust your treatment plan.
• Creating an emergency plan: Your diabetes team will help you plan for situations like hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), or diabetic ketoacidosis (DKA, not having enough insulin in your body). Make sure family, friends and a trusted co-worker know your plan and can help you, if needed.

Managing type 1 diabetes is a team effort. By making small, consistent changes, you can take control of your health. If you have questions, contact your provider or diabetes care team at Banner Health.

Next step: Learn more about your diabetes care and management.