Here’s how it works, at least as far as current research has shown.
Type 1 is an autoimmune disorder. Current theory suggests that individuals can inherit a genetic susceptibility to immune system dysfunctions and autoimmune disorders. That susceptibility lurks below the radar, manifesting sometimes as other problems like asthma, eczema, and allergies.
Researchers believe that the “switch” triggering the development of T1 gets “tripped” by some kind of environmental circumstance, such as exposure to toxins, exposure to viruses, etc. Once this happens, the body’s immune system begins to attack itself. In the case of an individual developing T1, her body identifies the specific pancreatic cells that produce insulin (called “beta” cells) as being invaders and begins to fight them—much like it does when it detects and attacks viral and bacterial infections. Over time, the beta cells are destroyed—leaving the pancreas unable to produce insulin.
The body uses insulin to “unlock” cells so that they can absorb and convert glucose (from consumed carbohydrates) in the bloodstream into energy. As the body’s ability to produce insulin is decreased and eventually eliminated, the cells cannot use glucose. So, the glucose (or “sugar”) remains in the bloodstream, clogging up and inhibiting every single internal system from doing its job effectively.
Meanwhile, the cells are starving, and so the body begins to break down fat stores to use for energy. So while the T1 individual is desperately consuming carbohydrates—usually in the form of simple sugars—she also loses weight at a rapid pace. Digestion of these fats releases acids into the bloodstream that poison the body (a process called ketoacidosis). Eventually, the body engages in a series of processes designed to eliminate excess glucose and acid in the blood (through increased urination, vomiting and Kussmaul breathing). Poisoning, dehydration, and cellular starvation continues.
This process will eventually kill a person with T1. Even when T1 is properly managed, things can go wrong and people can die. T1 is a life-threatening disease, every single day in the life of the person who has it.
Type 1 Diabetes is NOT the same thing as Type 2 Diabetes. In my opinion, these two diseases should not share a name.
People with T1 are insulin dependent, except in very specific circumstances where the pancreas may still be producing bits of insulin as the death of beta cells unfolds. If someone does not need insulin when she consumes carbohydrates, she does not have T1.
The onset of T1 is not caused by the consumption of too much sugar, an overall “bad” diet, lack of exercise, laziness, or whatever other character flaws often attributed to people with diabetes in general.
T1 cannot be controlled or cured by a “better” diet, “more” exercise, “better” self-control, or other character attributes that people with T1 are often accused of lacking.
T1 cannot be reversed, at least not right now. There is astonishing research being done that aims to try to get the body to regenerate beta cells or use transplanted beta cells in order to produce insulin again. Time will tell…