Type 1 Diabetes: AccentHealth

Learn more at http://www.Ah.health.harvard.edu/diabetes1

Diabetes is a disease marked by high amounts of sugar in the bloodstream. Type 1 diabetes, once called juvenile-onset diabetes, usually begins early in life, though it can also start in adulthood. It does not go away and requires life-long treatment. By taking insulin to control blood sugar and adopting healthy lifestyle choices, people with type 1 diabetes can live long, healthy lives.

Talk to your doctor:

Whether this is your first visit or a follow up ask your doctor:

*What are the results of my most recent blood tests?

*Should I change my diet, exercise routine or medications based on those tests?

*What are the warning signs that my blood sugar is too low?

*What are the warning signs that my blood sugar is too high?

*Do I have signs of problems related to my diabetes?

Should I see an eye doctor, foot doctor or other specialist?

*Tell your doctor about any side effects you think your medications are causing.

What is Type 1 Diabetes?

Trouble making insulin leads to Type 1 diabetes:

*When you eat, your body breaks down food into a simple sugar called glucose. Glucose is also called blood sugar. Your body’s cells use glucose for energy.

*The body also makes hormone called insulin. Insulin travels in the blood and tells cells to absorb glucose from the bloodstream.

*In Type 1 diabetes, the body doesn’t make enough insulin. Without insulin, sugar can’t get into cells.

*As a result, sugar builds up in the bloodstream.

High blood sugar can have immediate effects, like blurry vision. It can also cause problems over time like heart disease or blindness.

Why type 1 diabetes happens:

No one knows why some people get type 1 diabetes. Genes play a role as can infection with certain viruses. During such an infection, the body mistakenly attacks and damages the insulin-making cells.

How can my doctor tell I have diabetes?

Your story of your health and how you are feeling can alert your doctor to test you for type 1 diabetes. In addition, two simple blood tests can show if your blood sugar is too high.

Fasting blood sugar:

*A blood sugar sample is taken after you have fasted, meaning you have not eaten for at least eight hours.

*A normal fasting blood sugar level is under 100 mg per deciliter (mg/dl) of blood. A fasting blood sugar level above 126 mg/dL means you have diabetes.

Hemoglobin A1c:

*This blood test shows your average blood sugar level over the last three months.

*People without diabetes usually have a hemoglobin A1c reading under 5%. A reading above 6.5% usually means diabetes.

Symptoms of Type 1 Diabetes:

Type 1 diabetes usually occurs in children and young adults but it can appear at any age.

Symptoms include:

*Intense Thirst

*Needing to urinate often

*Losing weight without trying

*Unexplained hunger or tiredness

*Sores that heal slowly

*Dry, itchy skin

*Numbness or tingling in your feet or hands

*Blurred vision

*Unexplained yeast infections in a girl or young woman

*Bed wetting in a child who has previously been dry.

Complications:

Years high blood sugar can take a toll on the body. It can lead to:

*Loss of memory

*Stroke

*Loss of vision or blindness

*Gum disease and tooth loss

*Heart Disease

*Kidney Damage

*Nerve Pain

*Hard to treat foot infections that can lead to amputation

By working closely with your doctor to keep blood sugar in check, you can avoid many of these problems.

Taking Control of Type 1 Diabetes:

Six basic steps to controlling type 1 diabetes:

*Use insulin: People with type 1 diabetes need to take insulin to help their bodies use sugar.

*Check your blood sugar: Check your blood sugar as needed with a handheld meter or a continuous sensor. Have a hemoglobin A1c test every three to six months

*Exercise Regularly:

Stay physically active throughout the day. This is an important way to improve your health and control your blood sugar. Regular exercise increases the effect of insulin, which helps control blood sugar.

Try to do moderate intensity exercise, like brisk walking for a minimum of 30 minutes most days of the week and resistance exercise, like lifting weights two to three times a week.

*Lose weight if you need to:

Being overweight makes your tissues less sensitive to insulin. There is no sure fire diet to help people with diabetes lose weight. Eating less by controlling portions and cutting back on-or cutting out-sugary foods and beverage is a good place to start.

Eat Healthy diet:

Healthy eating for people with diabetes is pretty much the same as for everyone else. Your diet should center on vegetables, fruits, whole grains, legumes (peas and beans), nuts, lean meats and low fat dairy products

Take Steps to protect your heart:

Diabetes makes you much more likely to develop heart disease than people without diabetes. So pay close attention to other factors that raise your chances of heart trouble.

Work with your doctor to keep blood sugar under control and keep other health problems in check. You will feel better and help stave off long term complications.

Monitoring blood sugar:

People with type 1 diabetes need to check their blood sugar several times a day. Important times to check include:

*Before breakfast, lunch, dinner and snacks.

*Before bed

*Before and after exercise

*Before driving a car

The most common way to test blood sugar is with a glucose meter:

*Get a drop of blood from a finger or forearm. Most people use a spring loaded device that pierces the skin. These come with most meters.

*Place the blood sample on a special strip that is inserted into the meter or contained in it. Within seconds, you will get a blood sugar reading.

Some people with type 1 diabetes use a continuous glucose monitor. This is a small sensor placed under the skin of the abdomen. It sends blood sugar readings every few minutes to a receiver that can be carried in a pocket or purse.

Using Insulin:

People with type 1 diabetes need to take insulin to replace what their bodies aren’t making.

You can’t take insulin as a pill because your digestive system would destroy it before it got into your bloodstream. Instead you have to inject insulin using a needle and syringe, a special insulin “pen” or a pump. A new form of insulin can be inhaled as a powder.

There are several types of insulin. Some begin acting very quickly but don’t last long, some take a while to act but last for up to a day and others are in between. Some people need just one type; others need a combination.

Signs of Trouble:

It can be difficult to perfectly match a dose of insulin to a meal or exercise. That can lead to low blood sugar (hypoglycemia). Warning signs of low blood sugar include:

*Blurred vision

*Feeling ‘shaky’

*Feeling dizzy or lightheaded

*Sweating

*Rapid heart rate

*Irritability

*Confusion

In severe cases, hypoglycemia can cause loss of consciousness seizures or coma:

*Check your blood sugar: If you think your blood sugar is low and you can check it do that.

*Eat some sugar: Fruit juice, candy, glucose tablets and non-diet soda are good choices. If you can’t check your blood sugar but feel it is low, go ahead and eat some sugar.

*Always carry a source of fast-acting sugar with you: high blood sugar (hyperglycemia) often has no warning signs. If your blood sugar is persistently over 300 mg/dL talk with your doctor as soon as possible.

Diabetic Ketoacidosis:

When cells most use fat for energy because they aren’t getting enough sugar, they create a waste product called ketones. A high level of ketones is toxic. Your doctor may want you to check your urine at home for ketones. Warning signs of diabetic ketoacidosis include:

*Unexplained nausea or vomiting

*Abdominal pain

*Unexplained weight loss’

*Breath that smells ‘fruity or sweet

If you have large amounts of ketones in your urine, call your doctor or seek emergency care right away.

Planning meals and snacks:

Changing what you eat and how much you eat can help you control your blood sugar. Your body turns carbohydrates (grains, fruits, vegetables, dairy foods and sweets) into blood sugar.

You need some carbs for energy. The trick is eating a moderate amount of carbs at each meal or snack along with some healthy proteins and fats.

Instead of White Rice -Brown Rice

Instead of White Bread-Whole grain bread

Instead of Bagel-Oatmeal or bran cereal

Instead of Potatoes-Beans

Instead  Sugar-sweetened soda-Seltzer

How much carbohydrate you eat determines how much insulin you need to take before eating.

*Choose whole grain or foods made from them whenever possible. They turn into sugar more slowly.

*Balance carbohydrates with healthy protein and fats. Eat chicken or turkey, fish, beans, nuts or peanut butter, low-fat cheese and olive or vegetable oil.

*Cut back on or cut sugary foods like pastries, sweetened cereals and sugar sweetened beverages.

Protect your heart with the ABC’s:

Pay close attention to the ABC’s of diabetes care. This can help lower your chance of having a heart attack or stroke and other diabetes related problems.

A: A1c sugar test:

You and your doctor will set a goal for hemoglobin A1c, that’s right for you. If you are newly diagnosed with type 1 diabetes, try for an A1c of 7% or lower.

B: Blood Sugar

A1c for readings less than 140/90 Hg

C: Cholesterol

Talk with your doctor about how to keep your cholesterol in a healthy range. Many people with diabetes benefit from taking a cholesterol lowering drug called a statin. To keep blood pressure in a healthy range, cut back on the amount of sodium (salt) you eat.

Connecting with a nutritionist or dietitian can help you plan meals and snacks that will be good for your blood sugar and your overall health.

Get more information on type 1 diabetes:

http://www.AH.health.harvard.edu/diabetes1

Disclaimer: This information was taken from the AccentHealth and Harvard Medical School pamphlet and I give them full credit for the information. Harvard Health Publications content should not be used for diagnosis or treatment or as a substitute fro visits to your medical provider. Always seek the advice of your health care provider if you have questions regarding your health or any medical condition.