Type 1 Diabetes: Living With the Disease

What Increases Your Risk

Type 1 diabetes puts you at risk for high and low blood sugar and complications.

Risk factors for high and low blood sugar

• Age. Adolescent girls are at great risk for high blood sugar, which can lead to diabetic ketoacidosis. Girls are often concerned about their weight and body image and they may skip insulin injections to lose weight.¹
• Tight blood sugar control. Tight control of blood sugar helps prevent complications, such as eye, kidney, heart, blood vessel, and nerve disease. But it does put you at risk for frequent low blood sugar levels. Tight control means keeping your blood sugar at a normal or near-normal level.
• Adolescence. The rapid growth spurts and changing hormone levels of adolescence can make it difficult to keep blood sugar levels within your target range. This is the blood sugar goal you set with your health professional.
• Psychiatric conditions. Eating disorders, depression, anxiety disorder, panic disorder, and addiction to alcohol or drugs increase the risk of frequent high and low blood sugar levels.¹

Risk factors for complications

It is hard to know why some people develop complications and others do not. Factors that contribute to the risk of complications include:

• Having one complication. If you have one complication from diabetes, you have a greater chance of getting other complications.
• Ongoing high blood sugar over time. If your blood sugar levels are high most of the time, you have a higher chance of getting complications.
• Length of time you have the disease. The longer you have diabetes, the more likely you are to develop complications, even if you control your blood sugar levels.
  • Diabetic retinopathy. About 60% of people with type 1 diabetes get diabetic retinopathy after 10 years. Almost all have it to some degree after 20 years.² About 25% get the advanced stage (proliferative retinopathy) after 15 years.²
  • Diabetic nephropathy. Diabetic nephropathy eventually occurs in 20% to 30% of all people with type 1 and type 2 diabetes.³ Without treatment to slow kidney disease, most people with diabetic nephropathy will move from the early stage to the advanced stage of nephropathy in 10 to 15 years.³ Children who get nephropathy usually show the first signs of the condition after puberty.
  • Heart and large blood vessel disease. About 73% of adults with diabetes have high blood pressure. People with diabetes are 2 to 4 times more likely to die from heart disease or to have a stroke.⁴
  • Diabetic neuropathy. Most people with diabetes develop some diabetic neuropathy over the years. But only about 13% to 15% of people with diabetes have symptoms of neuropathy.⁵
• Other risk factors. Other factors that can raise your chance of getting complications include:
  • Smoking.
  • High blood pressure.
  • High cholesterol.
  • Family history of heart disease.
  • Peripheral arterial disease.
  • Psychiatric disorders (such as depression) which can affect how much you want to take care of your diabetes.
  • Family history of diabetic complications.
  • Not having coverage from your provincial plan or private health insurance for supplies and other medical expenses related to diabetes care.

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Author:	Alison Allen Robin Parks, MS	Last Updated: February 23, 2007
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Matthew I. Kim, MD - Endocrinology & Metabolism Donald Sproule, MD, CM, CCFP, FCFP - Family Medicine
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