What is type 1 diabetes?
Type 1 diabetes is a chronic, progressive autoimmune condition
That means it needs to be managed for life and it gets worse over time in stages. You can think of an autoimmune disease like a programming error in the immune system. The immune system is programmed to protect people from harmful threats. But with autoimmune type 1 diabetes, the immune system mistakenly thinks healthy cells, called beta cells, are a harmful threat and attacks them.
Beta cells make insulin—and people need insulin to convert blood sugar into energy. Insulin helps your body stay healthy. Without enough insulin, your blood sugar level stays higher than normal, and serious, potentially life-threatening complications like diabetic ketoacidosis (DKA) can happen.
This is also the point when lifelong lifestyle changes and insulin injections are needed.
What are beta cells?
They’re small but central to T1D
In T1D, the immune system doesn’t destroy all beta cells overnight, it happens gradually. That means there’s a critical window to detect the disease early, even before symptoms appear.
Every time beta cells make insulin, they also release a protein called c-peptide — they’re always produced together, like twins. By checking c-peptide levels doctors can see if your body is still making insulin.
- More c-peptide: your body is still producing insulin.
- Little or no c-peptide: your body may no longer be making enough or any insulin which is common in type 1 diabetes.
Watch the video to learn more about beta cells and why early screening matters.
The risks are real
Diabetic ketoacidosis (DKA) is a dangerous complication of autoimmune T1D. It can happen when the blood becomes acidic (when ketones are present) because the body doesn’t have enough insulin to let blood sugar into your cells. DKA can cause coma, brain damage, and even death.
Type 1 diabetes progresses in stages
Each stage is defined by how many beta cells remain. As more beta cells are lost your body becomes less able to produce insulin and in turn regulate blood sugar levels.
Stage
1
- Beta cell attack begins
- Blood sugars are within a normal range
- No visible signs or symptoms
- Insulin is not needed
- Presence of 2 or more T1D autoantibodies
Stage
2
- Beta cell attack continues
- Blood sugars are higher or lower than a normal range
- Still no visible signs or symptoms
- Daily insulin is not needed
- 2 or more T1D autoantibodies are present
Stage
3
- A significant number of beta cells have been damaged
- High blood sugar (hyperglycemia)
- Body no longer able to make enough insulin to control blood sugar levels
- 1 or more T1D autoantibodies may be present
- Visible signs and symptoms appear, and daily insulin dependence begins
*This stage is when type 1 diabetes is typically diagnosed
Stage
4
- Few-to-no beta cells remaining
- Long term T1D
- Dependence on external insulin to control blood sugar
- Health complications common
- T1D-related autoantibodies may no longer be present
- Daily insulin usage continues
You don't have to be caught off guard!
A diagnosis of autoimmune type 1 diabetes often comes without warning and in a traumatic way like an emergency room visit. Early screening could help.
What’s the honeymoon phase?
After a stage 3 T1D diagnosis, some people go through a short “honeymoon phase.” During this time, the pancreas may still make small amounts of insulin, which can make blood sugar a little easier to manage. The phase doesn’t last forever — it might be weeks or even months — but it can give you and your care team time to adjust, learn about T1D, and prepare for long-term management with daily insulin.
Researchers are studying new ways to address the progression of T1D including during or after the honeymoon phase. Talk to your doctor about what the latest research may mean for you.
You can spot type 1 diabetes early
When the attack on beta cells begins, proteins called T1D-related autoantibodies appear in the blood.
A screening test can find these autoantibodies in the blood. If screening finds 2 or more T1D-related autoantibodies, it's a sign that type 1 diabetes has begun.
