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By Dr. Nikita Toshi +2 more


Type 1 diabetes is a chronic disease which is on the rise in India. Type 1 diabetes is an autoimmune condition caused by a deficiency of insulin and resultant high blood sugars. In the last 25 years, awareness and further studies about type 1 diabetes have revealed many aspects of the condition, such as its epidemiology, genetics, disease burden and immune and B-cell phenotypes.

Ongoing research on the part of the U.S Food and Drug Administration (FDA) recently (November 2022) ended with the medication Tzeild (teplizumab-mzwv), which is being said can help delay the onset of type 1 diabetes stage 3 in adults and in children 8 years and above who have been diagnosed with type 1 (stage 2). The approval of the medication in the form of an injection is significant because it provides a new treatment method for at-risk patients.

In this article, let us understand a little more about type 1 diabetes- its causes, symptoms, its stages and how to manage it.


There are four stages of Type 1 diabetes:

  • Pre-stage 1.

Genetic analysis helps identify underlying genotypes commonly associated with type 1 diabetes. As per research, a particular region called the HLA region on Chromosome Six is responsible for up to 50% of the risk of developing the condition. A close bloodline, such as a sibling or a relative with type 1 diabetes, can also put you at greater risk.

  • Stage 1.

In this stage, one diabetes-related autoantibody is detected within the blood. Since diabetes is an autoimmune (a disease wherein the immune system of the body begins to attack its healthy cells) condition, autoantibodies, at this point, have already started attacking the beta cells within the pancreas.

  • Stage 2.

At this stage, two or more autoantibodies related to diabetes are present in the blood. While beta cells continue to be attacked by the immune system, insulin deficiency leads to a blood sugar level rise as a result of glucose intolerance. Beta cell dysfunction is severe at this stage but still without symptoms.

  • Stage 3.

In stage 3, there is a considerable loss of beta cells due to autoimmunity. Symptoms are visible, making it easier to diagnose type 1 diabetes. Some of these symptoms include:

Ø Blurry vision

Ø Excessive hunger

Ø Constant urge to urinate

Ø Severe fatigue

Ø Sudden and unexplained weight loss


The exact cause of type 1 diabetes remains unknown to doctors. Some possible reasons can include the following:

  • Exposure to certain environmental elements, viruses etc. 
  • Genetics, such as being related to a sibling or a close relative.

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How to manage your diabetes

There is no cure for type 1 diabetes; however, it needs to be managed with the help of appropriate treatment, which includes dietary changes, medications, regular blood glucose monitoring at home and specific lifestyle changes:

  • Diet: When you have been diagnosed with diabetes, you need to emphasise consuming a diet packed with whole foods like vegetables, fruits, lean protein and whole grains such as sprouts salad. At the same time, you must be careful about limiting certain foods such as saturated fat, trans fat, salt and sugar.
  • Medications: Standard medications for diabetics include insulin injections along with certain other medications that help to maintain blood sugar stability. The recently FDA-approved drug, Tzeild (teplizumab-mzwv), also adds a different dimension to the standard course of treatment of people with type 1 diabetes (stage 2).

As with all medications, there can be a few side effects with Tzield. These can include rash, headache and lowered levels of white blood cells.

  • Lifestyle changes: You have to build a healthy and mindful lifestyle to manage your diabetes daily. This will include a minimum of 30 minutes of physical activity. You can engage in brisk walking or even medium-intensity strength or cardio training. You will also be asked by your doctor to cut back on drinking and smoking in case you have a habit.
  • Glucose monitoring: Regular blood glucose monitoring is now easy with the availability of glucometer devices and strips on the market. A glucometer device takes a small amount of blood from your finger by pricking it. This drop of blood needs to be placed on the strip. Nowadays, many devices are available in different price ranges. This makes daily monitoring at home easy and hassle-free.

Also Read: What Level of Blood Sugar is Dangerous? A Complete, Research-Based Guide


The right way to manage your diabetes is to reach out to your doctor, who will suggest a customised treatment plan based on your overall health, medical records and age. Depending on your diagnosis, your doctor may also recommend you to other specialists, such as a dietitian, an endocrinologist and a professional diabetes care and education specialist (CDCES). You must increase your awareness about your diagnosed condition and adhere strictly to whatever treatment plan chalked out for you by your doctor to lead a happy and normal life with your loved ones. The discovery and FDA approval of the drug, Tzeild, opens up a new door for at-risk patients and gives them more time to delay its onset. 

Disclaimer: The information included on this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.


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