Nick Jonas has been open in the past about having type 1 diabetes, and he even co-founded the organization Beyond Type 1 in 2015 to educate people about the disease. This weekend, Jonas marked the 13-year anniversary of his diagnosis, sharing a poignant message with fans on Instagram.
"The picture on the left is me a few weeks after my diagnosis,” he wrote, referencing a photo of himself from 13 years ago. “Barely 100 pounds after having lost so much weight from my blood sugar being so high before going to the doctor where I would find out I was diabetic. On the right is me now. Happy and healthy. Prioritizing my physical health, working out and eating healthy and keeping my blood sugar in check. I have full control of my day to day life with this disease, and I’m so grateful to my family and loved ones who have helped me every step of the way. Never let anything hold you back from living your best life."
As Jonas's post illustrates, diabetes is a complex condition and often isn't straightforward to diagnose or manage.
Type 1 diabetes, the type Jonas has, is a chronic condition in which the pancreas makes little or no insulin. Type 1 diabetes is much less common than type 2 (which affects the way the body processes blood sugar); only about 5 percent of people with diabetes have type 1 diabetes, according to the Centers for Disease Control and Prevention (CDC).
Type 1 diabetes is caused by an autoimmune reaction where the body destroys the cells in the pancreas that make insulin, a hormone needed to allow glucose (sugar) to enter your cells to produce energy, the Mayo Clinic explains. This can go on for months or years until you actually start to have symptoms. Although it's possible to be diagnosed in adulthood, most people with type 1 diabetes are diagnosed in childhood or adolescence.
Your blood sugar level is incredibly important to many systems in your body. So early symptoms of type 1 diabetes can appear in a bunch of different ways.
For instance, you might feel thirstier and pee more frequently thanks to the way diabetes impacts the kidneys, Leigh Tracy, R.D., L.D.N., a certified diabetes educator at the Endocrinology Center at Mercy Medical Center, tells SELF. “When blood sugar levels are high, the kidneys work harder to filter the blood and absorb the excess sugar in the blood stream,” she explains. “When the kidneys are not able to manage the load of excess sugar in the blood, the sugar and fluid from tissue are excreted in the urine.” You become dehydrated, which makes you feel thirsty, she explains. But because you’re also drinking more liquids, you pee even more.
Your body’s inability to use that sugar as energy may lead to feelings of extreme hunger, fatigue, weakness, and unintended weight loss (like in Jonas's case), Mark Schutta, M.D., medical director of the Penn Rodebaugh Diabetes Center, tells SELF. "If you’re not utilizing fuel (glucose), [it] starts to accumulate in the blood stream, and you tend to lose weight," he says. But this isn't usually gradual weight loss: It's common for someone to be diagnosed with type 1 diabetes after they lose 20 pounds in six to eight weeks, Dr. Schutta says.
Some people also experience blurred vision as an early symptom of type 1 diabetes. When your blood sugar levels are high, fluid in the tissue in the macula (a small area in the middle of your retina) of your eyes can leak—and that can cause blurry vision, Colin A. McCannel, M.D., professor of clinical ophthalmology and medical director of the UCLA Stein Eye Center in Santa Monica, Calif., tells SELF.
Because the symptoms of type 1 diabetes can be vague and nonspecific, they can be easy to write off. But letting diabetes go untreated can lead to serious complications.
Untreated diabetes can lead to nerve damage, pain or numbness in the hands and feet, kidney disease, vision problems, heart disease, and strokes, Sarah Rettinger, M.D., an endocrinologist at Providence Saint John’s Health Center in Santa Monica, tells SELF. (But not everyone who has diabetes develops these complications.)
And the first step to treating diabetes is an accurate diagnosis, which is usually done with the help of a simple blood test known as the glycated hemoglobin (A1C) test, which measures the percentage of oxygen-carrying proteins in your red blood cells that have sugar attached to them, the Mayo Clinic says. The less well-controlled your blood sugar level is, the higher your A1C score will be, meaning you'll have more hemoglobin with sugar attached.
If the A1C test isn’t available, or if you have a condition that can interfere with the results (like being pregnant), your doctor may recommend that you take a random blood sugar test (which takes your blood sugar level at any given time) or a fasting blood sugar test (which checks your blood sugar level after you fast overnight).
Because these tests are also often used to diagnose type 2 diabetes, you'll likely need further testing to check for autoantibodies that are often predictive of type 1 diabetes, Dr. Schutta says, such as glutamic acid decarboxylase antibody. Your doctor will also probably give you a urine test to look for ketones (byproducts from the breakdown of fat), which can help differentiate between type 1 and type 2 diabetes.
Any time you're experiencing symptoms that you're unsure about or you feel like something is off with your body, it's important that you check in with your doctor. This way, you can get a diagnosis as quickly and early as possible.