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Type 1 diabetes can develop in anyone at any age, including people in their 20s. Kayla Penniman, a registered nurse at Penn Medicine and certified diabetes educator, wants people to know that young adults can develop type 1 diabetes too.
Penniman has both personal and professional experience in this area. Her twin brother was diagnosed with type 1 diabetes when they were both 9 years old. As a child, she attended diabetes classes to support him. Now, as a health care professional, Penniman works with adults with all types of diabetes.
Penniman recently spoke with myT1Dteam to help young people in their 20s — and those who love them — better understand this complex autoimmune condition.
The short answer is yes, you can be diagnosed with type 1 diabetes in your 20s. However, you might need to push for an accurate diagnosis. According to the American Diabetes Association, adults who develop type 1 diabetes are often misdiagnosed with type 2 diabetes due to a lack of awareness that type 1 can develop at any age. Type diabetes can affect anyone, regardless of body type, biological sex, or race/ethnicity.
If you experience any symptoms of type 1 diabetes, schedule an appointment with your health care provider for an accurate diagnosis.
Common symptoms include:
To confirm or rule out a diagnosis of type 1 diabetes, your doctor will likely request one or more blood tests to check your blood glucose levels. Hyperglycemia (high blood sugar) is a common symptom of diabetes, but it can also occur in other conditions. Penniman explained that your doctor will review your medical history and test your blood for C-peptide levels and autoantibodies. People with type 1 diabetes typically have lower levels of C-peptide, a protein that reflects how much insulin your body is producing. They also have autoantibodies that mistakenly attack the insulin-producing cells in the pancreas.
It’s also possible that something other than type 1 diabetes is causing your symptoms. Penniman explained that maturity-onset diabetes of the young (MODY) or other conditions can lead to hyperglycemia. Only your health care provider or a doctor specializing in endocrinology or diabetes can accurately assess your situation and determine the underlying cause.
If you receive a type 1 diabetes diagnosis in your 20s, you may face challenges that many of your peers won’t understand. With the right diabetes care and the support of family members and friends, however, you can still lead a happy and fulfilling life.
According to Penniman, one challenge young people with diabetes face is a disruption to their social life, such as drinking alcohol. “Drinking is a big deal,” she said.
However, alcohol can increase your risk of hypoglycemia (low blood sugar) because it affects your liver’s ability to control your blood glucose levels. “Hypoglycemia education is a big focus,” Penniman said.
Alcohol can also slow down food digestion. If you take insulin before a meal and drink alcohol, the insulin could affect your blood sugar levels before the food breaks down into glucose, leading to a higher risk of low blood sugar. Heavy alcohol consumption can also damage your pancreas, the organ that is already struggling to make enough insulin.
If you plan to drink alcohol with type 1 diabetes, talk to your health care provider first. They can provide guidelines for how much and how often to drink and how to adjust your insulin dosage or timing. They can also check to make sure alcohol won’t interfere with any of your medications.
Penniman explained that body image issues, including eating disorders, are another concern for young people with type 1 diabetes. While some are embarrassed to wear a visible continuous glucose monitor (CGM) or insulin pump, others use their type 1 diabetes diagnosis as a high-risk weight-loss solution.
“Intentionally skipping insulin doses for the purpose of losing weight is incredibly dangerous,” Penniman warned.
Diabulimia is a life-threatening eating disorder that can affect people with type 1 diabetes. People with diabulimia restrict their insulin doses to force the body to break down fat and muscle for energy, which can lead to weight loss. In the short term, not having enough insulin can lead to other health problems and severe diabetes complications, including diabetic ketoacidosis (DKA). DKA occurs when the body lacks enough insulin, leading to the buildup of ketones, which are acidic substances that can cause the blood to become too acidic.
Penniman explained that in the long term, not having enough insulin can lead to complications like kidney failure and even the need for limb amputation. The latter may be necessary because prolonged high blood sugar can cause nerve damage and poor circulation, leading to severe infections that cannot heal properly.
If you are struggling with body image, talk to your doctor or a mental health professional. Your school may also have support groups for young people with chronic health conditions like diabetes.
Another challenge you might face if you have type 1 diabetes in your 20s is access to health care and the financial means to pay for treatment. Inadequate access to healthy food, which is essential for maintaining stable blood sugar levels, can also be a challenge. Penniman said socioeconomic factors like income and health care access can affect diabetes care and management. These factors can affect people of any age.
For example, some young people live in food deserts, geographic areas where access to fresh fruits, vegetables, and other healthy food options is limited or nonexistent. Additionally, some may not live near qualified health care professionals who specialize in diabetes management, which can further complicate receiving appropriate care. Penniman also highlighted that significant outcome differences can exist based on race due to racial disparities and a history of structural racism in health care.
While these and other challenges shouldn’t prevent you from enjoying your 20s, you might need to ask for help, be proactive, and spend time learning how to live well with type 1 diabetes.
When you live with a chronic health condition like type 1 diabetes, educating yourself can help you:
Penniman recommends checking out diabetes self-management education and support (DSMES), a federal program for diabetes education available throughout the United States. The program is generally covered by insurance, and your doctor can provide a referral.
“It’s extremely comprehensive for diabetes education,” Penniman said of DSMES. “It’s an underutilized program, especially among older adults and the very young.”
Other places to look for help include:
In addition to learning about type 1 diabetes, Penniman said practicing self-care is essential. This can include:
If you think having one-on-one support might help you, ask your care team to recommend a diabetes educator in your area. Penniman explained that certified diabetes educators take the doctor’s treatment recommendations and help the person with diabetes understand and follow them.
If you have questions about type 1 diabetes, talk to your health care provider, a certified diabetes educator, or an endocrinologist who treats diabetes.
On myT1Dteam, the social network for people living with type 1 diabetes and their loved ones, members come together to ask questions, give advice, and share their stories with those who understand life with type 1 diabetes.
Were you diagnosed with type 1 diabetes in your 20s? What tips or questions do you have for other young people? Share your experience in a comment below, or start a conversation on your Activities page.
Sarika Chaudhari, M.D., Ph.D.
completed her medical school and residency training in clinical physiology at Government Medical College, Nagpur, India.
Learn more about her here.
Suzanne Mooney
writes about people, pets, health and wellness, and travel.
Learn more about her here.
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