Type 1 Diabetes

Overview

Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin, a hormone necessary for the body to use sugar (glucose) for energy. It typically develops during childhood or adolescence, although it can appear in adults as well. Type 1 diabetes has no cure, and management involves controlling blood sugar levels through insulin, diet, and lifestyle changes to prevent complications.

Understanding the disease

Symptoms

Type 1 diabetes symptoms include feeling more thirsty than usual, urinating a lot, bed-wetting in children who have never wet the bed during the night, feeling very hungry, losing weight without trying, feeling irritable or having other mood changes, feeling tired and weak.

Risk Factors

The risk factors for developing type 1 diabetes include:

1. Family history: Having a parent or sibling with type 1 diabetes increases the risk.
2. Genetics: Certain genes can increase the risk of developing type 1 diabetes.
3. Geography: The number of people with type 1 diabetes tends to be higher as you travel away from the equator.
4. Age: Type 1 diabetes can appear at any age, but it appears at two noticeable peaks: the first peak is in children between 4 and 7 years old, and the second is in children between 10 and 14 years old.

Development

Type 1 diabetes develops when the pancreas is unable to produce enough insulin, a hormone that regulates the movement of sugar into the cells. This insulin deficiency occurs due to the destruction of insulin-producing cells in the pancreas. The exact cause of this destruction is not entirely understood, but genetics and some viruses may play a role. Type 1 diabetes typically appears during childhood or adolescence, but it can also develop in adults. There is no cure for type 1 diabetes, and treatment focuses on managing blood sugar levels using insulin, diet, and lifestyle changes to prevent complications.

Assessment and Diagnosis

Triage

You should see a healthcare provider if you notice any symptoms of type 1 diabetes, such as feeling more thirsty than usual, urinating a lot, bed-wetting in children who have never wet the bed during the night, feeling very hungry, losing weight without trying, feeling irritable or having other mood changes, or feeling tired and weak.

Diagnosis

The most common method to diagnose type 1 diabetes is through the glycated hemoglobin (A1C) test, which measures your average blood sugar level over the past 2 to 3 months. An A1C level of 6.5% or higher on two separate tests indicates type 1 diabetes. If the A1C test is not available or inaccurate due to certain conditions, other tests may be used, such as a water deprivation test, urine tests, blood tests, or a random blood sugar test. It's important to consult with a healthcare provider for an accurate diagnosis and appropriate treatment plan.

Management and Treatment

Complications

The potential complications of type 1 diabetes include kidney disease, eye damage, skin conditions, slow healing, hearing impairment, sleep apnea, foot damage, skin and mouth conditions, and pregnancy complications. Type 1 diabetes, if not well-controlled, can also lead to nerve damage, poor blood flow, and increased risk of infections. It is essential to manage blood sugar levels to prevent or minimize these complications.

Treatment

To treat type 1 diabetes, careful management is essential. Follow these steps:

1. Commit to managing your diabetes: Take your medications as recommended, learn about type 1 diabetes, and incorporate healthy eating and physical activity into your daily routine. Establish a relationship with a diabetes educator and seek help from your healthcare team when needed.
2. Identify yourself: Wear a tag or bracelet indicating you have diabetes, and keep a glucagon kit nearby in case of a low blood sugar emergency. Educate your friends and loved ones on how to use the kit.
3. Count carbohydrates: Learn to count the amount of carbohydrates in the foods you eat to ensure you're giving yourself enough insulin for proper glucose utilization. Consult a registered dietitian for a personalized meal plan.
4. Engage in regular aerobic exercise: After getting your healthcare provider's approval, choose enjoyable activities like walking or swimming and aim for at least 150 minutes of moderate aerobic exercise per week, with no more than two days without any exercise.
5. Work with your team: Develop a relationship with a certified diabetes education specialist and collaborate with your diabetes treatment team for support.
6. Schedule regular checkups: In addition to yearly physical exams, attend regular eye exams, as diabetes checkups do not replace these appointments.
7. Consider other medications: Your healthcare provider may prescribe medications like ACE inhibitors, ARBs, aspirin, or cholesterol-lowering drugs to manage various aspects of diabetes and improve overall health. Remember that there is currently no fully closed loop system that doesn't require user input, but clinical trials are ongoing to advance these technologies.

Preparing for medical consultation

To prepare for an appointment for type 1 diabetes, take the following steps:

1. Note any symptoms: Write down any symptoms you're experiencing, including those that may seem unrelated to diabetes. This information will help your healthcare provider understand your overall health and any potential issues.
2. Gather personal information: Prepare a list of key personal information, such as any major stresses, recent life changes, and your typical daily diet. This information will help your healthcare provider understand your lifestyle and how it may be impacting your diabetes management.
3. Make a list of medications: Create a list of all medications, vitamins, or supplements that you're taking. This includes any insulin, oral medications, or other diabetes-related drugs.
4. Bring your glucose records: For regular checkups, bring records of your glucose values or your meter to your appointment. This will allow your healthcare provider to review your blood sugar levels and provide appropriate guidance.
5. Prepare a list of questions: Write down questions to ask your healthcare provider, such as inquiries about insulin therapy, blood sugar monitoring, low and high blood sugar treatment, ketones, nutrition, and carbohydrate counting.
6. Consider bringing a family member or friend: Having someone accompany you to the appointment can be helpful, as they can remember information, act as an advocate, and help you understand the information provided by your healthcare team. By being well-prepared for your appointment, you can ensure that you and your healthcare provider have a productive conversation about your type 1 diabetes management.