Diabetes

Who Gets Diabetes Type 1

Type 1 Diabetes affects 5 to 10% of the total population, about 300,00 people in the US.  Diabetes Type 1 also known as Diabetes mellitus Type 1 has previously been called:

  • Juvenile-onset diabetes
  • Childhood diabetes
  • Insulin-dependent diabetes (IDDM)

Diabetes type 1 has been known as childhood and juvenile diabetes because it is diagnosed most often when a person is young; however, Type 1 Diabetes can be diagnosed in adults as well.  Today, diabetes Type 1 is the preferred name.

What is type 1 diabetes?

Type 1 diabetes occurs when the body either completely stops producing insulin or makes only very small amounts of insulin, which means that the body does not have enough insulin to use the body’s glucose for energy.

Type 1 diabetes is believed to be caused by the one or more of these triggers: certain types of viral infections, an inherited defect and/or an autoimmune disorder. In the auto-immune process, cells that normally defend the body destroy its own insulin-producing cells in the pancreas (the Islets of Langerhans).

Why do you need Insulin?

The pancreas in the back of the abdomen has 2 main jobs: produce a digestive juice that helps digest food and produce the hormone insulin.

Insulin is the main hormone that controls the flow of glucose in and out of the body’s cells. The autoimmune damage to the pancreas by diabetes type 1 prevents the pancreas from producing much if any insulin.

When you eat food, the body breaks it down to glucose, which then enters the bloodstream. Insulin manages the levels of glucose in the body and moves glucose from the bloodstream into the cells where glucose is used for energy.

If there is not enough insulin or there is too much glucose in the body, then the body will be unable to control the glucose in the bloodstream and it will be elevated. High blood glucose levels are dangerous because elevated glucose in the bloodstream can damage our body, specifically:

  • Heart
  • Kidneys
  • Blood vessels
  • Eyes
  • Nerves
  • Feet

Glucose is one of the major fuels used by the cells in our body for energy. If the glucose is elevated in the bloodstream, then that means that the body is not getting the necessary glucose that the cells need to function. Specifically the brain and nervous system use only glucose for energy, whereas most of the other cells in the body can also use fat for energy.

As a result of the lack of insulin output in Type 1 diabetes, the blood sugar level climbs and glucose starts to appear in urine.

What are the symptoms of Type 1 Diabetes?

When glucose is unable to be used effectively by the cells and the bloodstream has elevated glucose levels, then a person with untreated Type 1 diabetes will develop symptoms such as:

  • Increased thirst
  • Frequent urination
  • Weight loss without trying (even though appetite can increase)
  • Extreme hunger
  • Flu-like symptoms, Fatigue and tiredness
  • Abdominal pain
  • Dehydration
  • Nausea/vomiting
  • Blurry vision
  • Itchiness, especially around the genitals, caused by overgrowth of yeast (thrush)
  • Other infections on the skin (Un-healing wounds, yeast infections and boils)

If you have these symptoms, make an appointment with your doctor to be tested for diabetes.

A family history of diabetes makes it much more likely that you will be predisposed to also have diabetes. Type 1 diabetes is much less common than Type 2 diabetes.

How is Diabetes Type 1 diagnosed?

Diabetes type 1 is diagnosed by assessing symptoms and a blood test. One or more of the following blood tests can be used for diagnosis:

  • Fasting plasma glucose test (FPG)

– After fasting for 8 or more hours, FPG test is done. A blood sugar of 126 mg/dL or higher may indicate you have diabetes.

  • Hemoglobin A1C test (Hb A1C)

-The A1C test is a common and simple blood test. You don’t need to fast, change your diet or medications before the taking the A1C test. A sample of blood will be drawn at a lab from a vein in your arm. An A1C result of 6.5 % or higher may indicate you have diabetes.

  • Oral glucose tolerance test (OGTT)

-Similar to the FPG test, you fast for 8 or more hours and then have blood sugar checked. Then you drink a high-glucose drink and then check the blood sugar 2 hours after. A blood sugar reading of 200 mg/dL or more could indicate diabetes.

  • Random plasma glucose test

-This test is run on a small blood sample that has been taken (you do not have to fast prior to the test). A random blood sugar reading of 200 mg/dL or more may indicate diabetes.

If the blood test you have done is positive for diabetes, then your doctor will most likely repeat the test on a different day before a final diagnosis is made.

How is Type 1 Diabetes treated?

The goal of diabetes treatment and management is to control and maintain stable blood sugar levels.

You will need to check your blood sugar levels frequently throughout the day. This will be done using a blood glucose meter as directed by your physician. Together with your health care diabetes management team, you will establish your individual treatment plan, your goal blood sugar levels as well as your insulin medication and potentially oral medications.

You and your diabetes team (doctor, nurse, dietitian, PA, NP, etc) will help guide through the learning process as you create a diabetes treatment and management plan that is best for you.

There are 3 main aspects of your treatment plan:

  • Insulin therapy

– Most everyone with type 1 diabetes will need to have regular insulin injections during a day. Insulin provides the body’ with enough insulin to control blood glucose levels, since the body cannot produce much if any insulin. While monitoring the blood sugar levels, insulin needs may change. Insulin pens and insulin pumps that are worn on the body are available –discuss your options with your doctor.

  • Nutrition

– Eat a healthy, balanced diet high in fiber, vegetables, fruits and whole grains. Minimize sweets and white flours and sugars; monitor carbs. Try to eat 5-6 small meals/snacks a day to prevent drops and spikes in blood sugar levels and eat low glycemic foods. You can work with a dietitian/nutritionist to design a nutrition plan that fits you.

  • Exercise

– Exercise can help you maintain stable blood sugar levels and increase your energy levels as well as help reduce heart disease risks and high cholesterol, and maintain a healthy weight. Exercise can affect your blood sugar levels –monitor for hypoglycemia. Always talk with your doctor before starting an exercise program.

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