Overview
Type 1 diabetes is a lifelong disease that develops when the pancreas stops producing insulin. Insulin lets sugar (glucose) enter body cells, where it is used for energy.
Without insulin, sugar remains in the blood and the blood sugar level rises above what is safe for the body. If the blood sugar level becomes very high, a life-threatening emergency (diabetic ketoacidosis) can develop. Over time, persistent high blood sugar levels damage blood vessels and nerves throughout the body and increase the risk of eye, heart, blood vessel, nerve, and kidney disease.
Type 1 diabetes can develop at any age; however, it usually develops in children and young adults, which is why it was formerly called juvenile diabetes. It has also been called insulin-dependent diabetes mellitus (IDDM) because insulin injections must be taken daily. About 5 to 10% of all people with diabetes have type 1 diabetes.
Cause
Type 1diabetes develops because of an autoimmune response in which the body does not recognize some of its own cells and destroys them. In type 1 diabetes, the cells that produce insulin are destroyed. What causes the autoimmune response is unknown. Some people inherit a tendency for the disease. However, the disease may not develop even in these people without the presence of environmental factors, such as exposure to certain viral infections.
Symptoms of type 1 diabetes usually develop quickly, over a few days to weeks, and are caused by blood sugar levels rising above the normal range (hyperglycemia).Early symptoms may be overlooked, especially if the person has recently had on illness, such as influenza.
Early symptoms include:
- Frequent urination, which may be more noticeable at night. Some young children who have learned to use the toilet may start wetting the bed during naps or at night.
- Extreme thirst and a dry mouth.
- Weight loss
- Increased hunger, sometimes
Sometimes the blood sugar level rises very high before a person knows something is wrong. Because insulin is not available, the cells in the body are unable to get the sugar they need for energy. When the cells do not receive sugar, the body begins to break down fat for energy. When this happens, ketones or fatty acids are produced and enter the bloodstream, causing the chemical imbalance called diabetic ketoacidosis, which is an emergency situation.
Symptoms of very high blood sugar include
- Flushed, hot, dry skin.
- Loss of appetite, abdominal pain, and vomiting.
- A strong, fruity breath odor (similar to nail polish remover or acetone).
- Fast and shallow breathing.
- Restlessness, drowsiness, difficulty waking up, confusion, or coma. Young children may lack interest in their normal activities.
Exams & Tests
A medical history, physical exam, and blood tests are required to make the diagnosis of type 1 diabetes.
Treatment Overview
MANY PEOPLE find out that they have type 1 diabetes when they are admitted to a hospital for diabetic ketoacidosis. If their symptoms are severe, they may need to be closely monitored in an intensive acre unit. Treatment for diabetic ketoacidosis includes fluids given through a vein (intravenous, or IV), insulin to decrease blood sugar level, and close monitoring for changes in the person’s condition.
Type 1 diabetes requires lifelong treatment to keep blood sugar levels within a safe range. People with type 1 diabetes often experience blood sugar levels outside of safe range. Blood sugar levels below a safe range (hypoglycemia) can develop quickly and lead to an emergency in only a few minutes. On the other hand, high blood sugar levels (hyperglycemia) usually develop slowly over hours or days.
Treatment includes
- Monitoring blood sugar levels several times a day using a home blood sugar meter.
- Taking several insulin injections every day or using an insulin pump.
- Eating a balanced diet that spreads carbohydrates throughout the day, to prevent high blood sugar levels after meals.
- Regular physical exercise, because exercise helps the body to use insulin more efficiently.
- Regular medical checkups, to monitor and adjust treatment as needed.
Screening tests and exams need to done regularly to monitor for the development of complications from diabetes, such as eye, kidney, heart, blood vessel, and nerve diseases.
Treatment for children includes all of the above measures to keep blood sugar levels within a safe range. It should also allow for normal growth and development.
People with type 1 diabetes can live long, healthy lives if they keep their blood sugar levels as close to normal as possible. The right combination of foods, physical activity, and insulin each day is required to achieve this goal. When a small child has diabetes, the parents assume the responsibility for balancing these factors; as the child grows and develops, he or she assumes more and more responsibility for the diabetes care.
Dietary choices
Note: All people with diabetes should seek medical advice before they make any dietary changes.
- Carbohydrates: Eating carbohydrate-containing foods, whether high in sugar or high in starch (such as bread, potatoes, processed breakfast cereals, and rice), raises blood sugar levels. The blood sugar-raising effect of a food, called its “glycemic index”, depends on how rapidly its carbohydrate is absorbed. Many starchy foods have a glycemic index similar to sucrose (table sugar). Foods with a low glycemic index include beans, peas, fruit, and oats. Most doctors recommend that diabetics reduce their intake of sugar from snacks and processed foods, and replace these foods with high-fiber, whole foods. This tends to lower the glycemic index of the overall diet and has the additional benefit of increasing vitamin, mineral, and fiber intake.
- Vegetarian diet: People with diabetic nerve damage who switch to a vegan diet (no meat, dairy, or eggs) have reported improvement after several days. Fats from meat and dairy may also promote heart disease, the leading killer of people with diabetes.
- Protein: Switching to a high-or low-protein diet should be discussed with a doctor.
- Weight loss: Being overweight increases the need for insulin. Excess abdominal weight makes the body less sensitive to insulin.
Natural remedies
Nutritional Supplements
- Alpha lipoic acid: 600mg one to three times per day.
- Chromium: 200 to 1,000 mcg per day
- Evening primrose oil (EPO): 4 grams per day for six months.
- Magnesium: 300 to 1,000 mg per day.
Herbs
- Cayenne (Capsicum frutescent) (topical cream containing capsaicin for neuropathy): May be applied four times per day for severe pain. Use under a doctor’s supervision.
Natural remedies
- Exercise: Exercise helps decrease body fat and improves insulin sensitivity. Exercisers are less likely to develop 2 type w diabetes than are sedentary people, and exercisers with type 1 require less insulin. However, exercise can induce low blood sugar. Therefore, diabetics should never begin an exercise program without consulting a healthcare professional.
- Alcohol: Moderate drinking by healthy people improves glucose tolerance. However, alcohol has been reported to worsen glucose tolerance in the elderly and in diabetics in some studies. Diabetics who drink have also been reported to have a high risk for eye and nerve damage. People with diabetes should limit alcohol intake to two drinks per day.
- Quit smoking: Diabetics who smoke are at higher risk for kidney damage, heart disease, and other diabetes-linked problems. Smokers are more likely to become diabetic than are non-smokers.
