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How does type 1 diabetes actually work?

What happens when your body suddenly stops making the one hormone that keeps your blood sugar in check?

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This video is part of “Innovations In: Type 1 Diabetes,” an editorially independent special report that was produced with financial support from Vertex.

Have you ever thought about how your body turns food into energy? Or just how carefully it has to manage that process?

When we eat, the glucose from our food gets stored in the liver as glycogen. And based on our body's needs, the liver will convert that glycogen back into glucose so that it can travel through the blood and get to our cells, which turn that glucose into energy.


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Meanwhile, our pancreas produces a hormone called insulin whose job is to go into the blood and tell our cells to take in that glucose. That also makes insulin a regulator of our body's blood sugar levels, preventing the complications that can happen when our levels are too high or too low.

When the pancreas stops producing insulin, glucose doesn't enter our cells. Instead, it accumulates in the bloodstream. In some people, the pancreas stops making insulin altogether. This condition is known as type 1 diabetes.

While the exact cause is mysterious, we know the disease happens because immune cells target and attack insulin-producing cells in the pancreas called beta cells. As those cells get destroyed, the body stops producing insulin and loses the key regulator of blood sugar levels. That in turn can drive a number of symptoms including fatigue and weakness.

Over the 20th and 21st centuries, scientists have developed technologies that have made type 1 diabetes treatable. These include meters to check blood glucose levels and pumps that give small doses of insulin. And with advances in construction and software, these tools have become smaller and more portable. Despite these advances, scientists are still pursuing a cure for type 1 diabetes.

Fonda Mwangi is an award-winning senior multimedia editor at Scientific American and showrunner of Science Quickly. She previously worked at Axios, the Recount and WTOP News. She holds a master’s degree in journalism and public affairs from American University in Washington, D.C.

More by Fonda Mwangi

Deboki Chakravarti is a freelance science writer making videos and podcasts out of western Massachusetts. She has a Ph.D. in Biomedical Engineering.

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Mary Budwick is a creative designer who lives in Atlanta, Ga.

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