What Is Type 1 Diabetes ?
Type 1 diabetes is a chronic condition that usually starts
in childhood, but can occur in adults (30 to 40-year-olds). In type 1 diabetes,
the pancreas produces very little insulin. Insulin helps cells in the body
convert sugar into energy. When the pancreas cannot make enough insulin, sugar
starts to build up in the blood, causing life-threatening complications.
Individuals with type 1 diabetes must take some form of insulin for the rest of
their lives.
What Are The
Symptoms?
Unusual Thirst
Symptoms
Unusual thirst is a very common symptom of type 1 diabetes.
This condition causes the kidneys to remove excess sugar in the blood by
getting rid of more water. The water is removed through urination, causing
dehydration and dehydration causes you to drink more water.
Weight Loss Symptoms
Patient with type 1 diabetes develop unintentional weight
loss and an increase in appetite because blood sugar levels remain high and the
body metabolizes fat for energy. Disrupted glucose metabolism also causes
patient to feel a lack of energy and drowsy for extended periods Excess
urination also cause weight loss because many calories are leaving the body in
urine.
Skin Problems Symptoms
The disruption in glucose metabolism in patient with type 1
diabetes causes skin changes. Type 1 diabetics are at a higher risk for
bacterial infections and fungal infections. Poor blood circulation in the skin
may also occur. Patient with type 1 diabetes are often infected with fungal
infections caused by the yeast Candida albicans. Common fungal infections
include athlete's foot, vaginal yeast infection in women, jock itch, ringworm,
and diaper rashes in babies. Diaper rash caused by the yeast Candida albicans
can spread to other areas of the body such as the stomach and legs.
Other Dangerous Signs
and Symptoms
Patient with untreated type 1 diabetes can experience
serious symptoms such as blurry vision, numbness or tingling in the extremities
(especially the feet), loss of consciousness, fatigue, fruity breath, dry
mouth, and diabetic coma. In contrast to high sugars in the blood, occasionally
patient with type 1 diabetes can get low blood sugars (hypoglycemia) when their
blood glucose level falls suddenly.
In patient with type 1 diabetes, loss of consciousness,
diabetic coma, and in some cases hypoglycemia, are medical emergencies. Some
people who are undiagnosed may have no warning signs, yet still can develop
diabetic coma or hypoglycemia
Ketoacidosis Symptoms
The problem with type 1 diabetes is that the person's cells
are deprived of the sugar they need for energy. Without the insulin produced by
the pancreas, sugar has difficulty entering the body's cells. Consequently, the
body cells start burning fat for energy, which causes ketones to build up in
the blood. These acids can change the person's blood pH level and can trigger a
life-threatening coma. This is termed diabetic ketoacidosis. Diabetic
ketoacidosis is a medical emergency that needs to be treated quickly, usually
in a hospital setting. Symptoms of diabetic ketoacidosis include the following:
- Flushed,
hot, dry skin
- Blurred
vision
- Feeling
thirsty and excess urination
- Drowsiness
- Rapid,
deep breathing
- Fruity
breath odor
- Loss
of appetite, belly pain, and vomiting
- Confusion
What is the
Difference between Type 1 and Type 2 Diabetes?
Type 1 diabetes usually starts in childhood or young
adulthood, whereas type 2 diabetes usually starts in adulthood. In patient with
type 1 diabetes, the body's immune system attacks and destroys pancreatic cells
(Beta cells) that produce insulin. In patient with type 2 diabetes, the
pancreas is not attacked and usually produces insulin. However, patient with
type 2 diabetes, for numerous reasons, cannot use the available insulin effectively.
Patient with type 2 diabetes can have the same symptoms as
patient with type 1 diabetes, but patient with type 1 diabetes usually have
symptoms occur more rapidly. Type 1 diabetes cannot be prevented, but type 2
diabetes can be prevented or delayed with a healthy lifestyle.
What Causes Type 1
Diabetes?
When the body’s immune system destroys beta cells in part of
the pancreas, type 1 diabetes develops. Beta cells in the pancreas produce
insulin. Researchers are not sure why a person's immune system attacks its own
insulin producing cells. However, researchers and clinicians suspect that
genetic susceptibility and environmental factors raise the risk for developing
type 1 diabetes.
Scientists have identified genes and gene regions that raise
the risk of developing type 1 diabetes, but they are not the only factors that
cause the disease. Researchers suggest that environmental triggers such as a
viral infection or perhaps dietary or pregnancy-related factors may also play a
role in developing type 1 diabetes
Who Gets Type 1
Diabetes?
Although type 1 diabetes can develop at any age, about
two-thirds of new cases are diagnosed in individuals under the age of 19.
Researchers have noted two peak times for development of type 1 diabetes; the
first is in early childhood and the second occurs at puberty. Type 1 diabetes
affects males and females equally, and is more common in Caucasians than in
other ethnic groups. A family history of type 1 diabetes also increases one’s
risk for developing type 1 diabetes.
Diagnosis and Treatment
Simple blood tests can indicate the presence of abnormal
sugar levels in the blood. If a person has any symptoms of diabetes, a fasting
blood sugar test or even a random blood sugar test is usually the first step in
diagnosis. A hemoglobin A1c test can reveal average blood sugar levels for the
past 2 to 3 months. In most cases these tests are repeated on at least two
separate days. Other tests used are the glucose tolerance test or testing for
specific antibodies in the blood.
High Blood Pressure
Risks
Type 1 diabetes damages arteries and makes them susceptible
to hardening (atherosclerosis), which can lead to high blood pressure and other
heart and circulation problems. Unfortunately, undiagnosed or prolonged high
blood sugar levels can result in damage to organ systems in the body over time.
Patient with type 1 diabetes have a high risk of vision problems, heart
disease, stroke, kidney failure, gum disease, tooth loss, and nerve damage
(especially in the hands and feet). Other organs may also be damaged
Monitoring Blood
Sugar Levels Treatment
For patient with diabetes, complications that can damage
organs can be prevented or reduced by regulating their blood sugar level. This
is done by pricking the finger and putting a drop of blood on a test strip. The
strip is then placed in a monitor that reads the glucose level. Close
monitoring of glucose levels allows the individual to regulate their blood
sugar by either medication if the sugar is high, or taking in sugar if the
level is low. If a person with diabetes is able to keep blood sugar levels in
or near the normal range, they will decrease the likelihood of developing
complications and have more energy and fewer problems related to diabetes
Measuring Blood Glucose (Sugar) Levels
There is a test called the hemoglobin A1c blood test that is used to help determine how well a person is managing their blood glucose levels. This test is taken at the doctor's office and measures how well the blood sugar has been controlled over a 2 to 3 month span. If the results show poor blood sugar control (high A1c levels), it suggests that the person's insulin therapy, dietary habits, and/or physical activity be modified to lower blood sugar levels into a more normal range.
Continuous Glucose
Monitoring (CGM) Treatment
Another device that measures glucose is termed a continuous
glucose monitoring system (CGM). This system consists of a tiny sensor under
the skin to check blood sugar levels. It send the information to a cell phone
sized device that records an average glucose value every five minutes for about
72 hours. CGM is now accepted for long term use in some patients with models
that turn off insulin infusion when sugars start to drop.
Insulin Shots
Treatment
Every person with type 1 diabetes needs to take insulin to
help their body process sugar in the blood. Most people with type 1 diabetes
take insulin in the injectable form and require several shots per day. There
are different types of insulin available.
- Rapid-acting
insulin starts to work within a few minutes and lasts for a couple of
hours.
- Regular
or short-acting insulin takes about 30 minutes to work and lasts 3-6
hours.
- Intermediate-acting
insulin takes 2-4 hours to work and lasts up to 18 hours.
- Long-acting
insulin can work for an entire day.
You and your doctor can adjust your insulin shots based on
results of blood sugar testing. As previously stated, the goal is to keep
glucose levels in the blood within normal range as often as possible.
Insulin can be injected using a needle and syringe, a
cartridge system, or a pre-filled pen system. Inhaled insulin, insulin pumps,
and a quick-acting insulin device can also be used. If injecting insulin into
your body the best place is the abdomen, but the arms, thighs, and buttocks are
also effective.
What Does Insulin Do?
Insulin is a hormone from the pancreas that allows sugar to
enter the cells. Insulin also lowers the amount of sugar in the bloodstream.
Without insulin, sugar is unable to enter the cells. This means that cells that
make up muscles and other tissues will not be able to receive their main source
of energy. Patient with type 1 diabetes will have a buildup of sugar in the
bloodstream, causing life-threatening conditions.
Insulin Side Effects
- Low
blood sugar
- Headache
- Flu-like
symptoms
- Weight
gain when you first start using insulin
- Lumps,
scars, or rash at injection site
Insulin Shock
Although insulin is a wonderful drug that helps people with
diabetes, it needs to be used carefully. If a person takes too much insulin it
is possible the blood sugar level will lower into dangerous levels. This
situation is termed an insulin reaction (low blood sugar due to excessive
insulin).
Too much insulin can result in symptoms that may be mild,
moderate, or severe, depending on how low and how long the low blood sugar
levels exist in a person's blood. Some signs and symptoms of low blood sugar
include fatigue, excessive yawning, mild confusion, decreased coordination,
sweating, muscle twitching, and pale skin. As these symptoms get progressively
worse, seizures, loss of consciousness, and even death may occur.
People with diabetes, especially type 1 diabetes, are
advised to carry about 15 grams of a quick-acting carbohydrate at all times.
Quick-acting carbohydrates are foods or drinks containing glucose that is
rapidly absorbed into the body and the blood. Examples include a half-cup of
fruit juice or a non-diet soda, five Life Savers (small hard candies), two
tablespoons of raisins, one cup of milk, or three glucose tablets. These
carbohydrates may resolve mild to moderate insulin reactions. For severe
reactions, a drug called glucagon should be injected under the skin by a family
member or friend familiar with treating severe insulin reactions and the person
should be seen by a medical health care professional.
Insulin Pump Treatment
Although many people administer insulin through several
shots per day, some people may be able to utilize an insulin pump. This pump
delivers insulin around-the-clock by pushing insulin through a thin tube
inserted into the person's skin. The insulin pump can be programmed to deliver
exact amounts of insulin in a continuous dose as well as deliver extra doses
certain times, typically when eating. People with diabetes are encouraged to
discuss the advantages and disadvantages of this insulin delivery system with
their doctor.
Pancreatic Islet Cell
Transplant
Some people with diabetes fail insulin therapy and may have
reactions to the insulin that is injected. These people may be candidates for a
procedure that some clinicians consider experimental. The procedure is a
transfer of healthy insulin-producing cells from a donor into the pancreas of
the patient with type 1 diabetes. Although there are benefits to this
procedure, there are also drawbacks including medications with serious side effects
that must be used to prevent rejection of the donor cells, and the probability
that the transplanted cells may only function for a few years.
Artificial Pancreas
Researchers are attempting to develop an artificial
pancreas. This device is a combination of an insulin pump and continuous glucose
monitoring system controlled by a computer program. The goal for the system is
to release insulin in response to blood sugar levels and to reduce the release
of insulin if blood sugar levels drop. The goal is to have a device that mimics
the function of a normal pancreas. Some early trials of experimental devices
suggest this device may be available in the future.
Type 1 Diabetes and Life Scenarios
Exercise
People with type 1 diabetes benefit from exercise, but they
need to take precautions to prevent sudden drops in blood glucose levels.
Diabetics should check their blood sugars before exercising and may require
eating a snack before or during exercise. They may need to adjust their insulin
dosage before exercising to ensure they stay within normal ranges of blood
glucose. People with type 1 diabetes may also need to check their urine for
ketones – ketones suggest that your blood sugar is too high. Strenuous activity
needs to be avoided if ketones are detected or if your blood sugar level is
either high or low before exercise.
Diet
People with type 1 diabetes, like everyone else, need to eat
a well-balanced diet. This will help their insulin therapy and reduce the
chance of diabetic complications. There is no “diabetes diet”. Even a person
with type 1 diabetes can eat sweets as long as it is part of a well-balanced
diet. That is not to say they can eat anything all the time, but they need to
consider how sweets can fit into their well-balanced diet. Type 1 diabetics should
also consider the fact that carbohydrates raise blood sugar levels faster than
any other food. Food low in carbs, but high in calcium, potassium, fiber,
magnesium, and other vitamins are excellent food choices for diabetics.
Consider the following guidelines when planning your meals:
- Eat
less unhealthy fat
- Get
enough fiber
- Keep
track of carbohydrate consumption
- Keep
track of carbohydrates in sugar-free foods
Healthcare workers such as dietitians can help people with
diabetes plan a well-balanced and varied diet.
Pregnancy
Women with type 1 diabetes need to let their doctors know if
they plan to become pregnant. Poor control of their blood sugars may cause
complications such as birth defects. Planning ahead, even before conception, to
control blood sugar levels can lower the risk of miscarriage and birth defects.
During pregnancy, it is important to test blood glucose often and keep your A1c
below 7%. Good blood sugar control can reduce other complications during
pregnancy such as high blood pressure or retinal damage in the mother.
Preeclampsia is a condition that 18%-30% of pregnant women
with diabetes develop. Preeclampsia develops after the 20-week mark and is
characterized by high blood pressure and proteins in the urine. It is important
to treat preeclampsia, if untreated it may harm the baby and put the mother at
risk for stroke and seizures. Once the baby is born and if the mother is
breastfeeding, it is important for her to check her glucose levels frequently.
Juvenile Diabetes
Diagnosis of diabetes in children is a life-changing
situation because it affects the whole family. Parents must help children
monitor blood sugar and plan family meals that are appropriate for the child
with diabetes and other family members. Insulin dosages must be monitored and
blood sugar levels need to be checked by the child’s caregivers.
Diabetes in children is a 24-hour-a-day problem that needs
to be considered when a child is attending school and participating in
extracurricular activities. Parents and their children need to make
arrangements to follow through with insulin treatments even while the child is
at school. These arrangements need to be planned in advance, as not every state
or school may participate in the child’s care the same way.
REFERENCES:
- Diabetes.org:
"Skin Complications"
- DiabetesForecast.org:
"A Guide to Pregnancy With Diabetes"
- Hormone.org:
"What Does Insulin Do"
- Medscape:
"Type 1 Diabetes Mellitus"
- MedicineNet
Headache is defined as a pain arising from the head or upper neck of the body. The pain originates from the tissues and structures that surround the skull or the brain because the brain itself has no nerves that give rise to the sensation of pain (pain fibers). The thin layer of tissue (periosteum) that surrounds bones, muscles that encase the skull, sinuses, eyes, and ears, as well as thin tissues that cover the surface of the brain and spinal cord (meninges), arteries, veins, and nerves, all can become inflamed or irritated and cause headache. The pain may be a dull ache, sharp, throbbing, constant, intermittent, mild, or intense.
