Type 1 Diabetes Information
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About Type 1 Diabetes
Type 1 diabetes affects about 3 million Americans and can occur at any age. It is most commonly diagnosed in children and adults younger than 30, but more adults are being diagnosed with type 1 diabetes during adulthood. A diagnosis of type 1 later in life is sometimes called Latent-Autoimmune Diabetes in Adults (LADA).
Symptoms of type 1 diabetes include:
- increased thirst
- increased hunger
- rapid weight loss
- blurred vision (temporary)
- fatigue (tiredness)
- frequent urination
The Cause of Type 1 Diabetes
Experts now know that type 1 diabetes occurs when the immune system attacks the insulin- and amylin-producing beta cells in the pancreas of people who are genetically at risk for developing type 1. Researchers aren't sure why the immune system destroys these beta cells, though some believe certain viruses, yet to be determined, may be to blame.
Diabetes can be diagnosed when blood glucose levels (blood sugar) are higher than normal. Glucose is released into the bloodstream as food is broken down into glucose through digestion. Typically, glucose enters the body's cells with the help of insulin. Glucose is the cell's main source of energy.
In people with type 1 diabetes, the pancreas no longer produces insulin, which causes blood glucose levels to rise unless insulin is taken by injection or insulin pump. High blood glucose levels without available insulin cause two problems:
- The cells cannot use glucose for energy, leading to fatigue and rapid weight loss, among other problems.
- High blood glucose levels can lead to complications such as neuropathy, heart disease, eye damage, and kidney disease.
What's Happening Inside
1. After you eat, food is broken down into molecules the body can use for energy and repair. The carbohydrate in foods is broken down into glucose.
2. Glucose (shown here as purple hexagons) enters the bloodstream.
3. The beta cells in the pancreas no longer make insulin (shown here as yellow dots).
4. Insulin is injected just under the skin subcutaneously in the abdomen, arms, legs, or several other places. Insulin helps the glucose get into the body's cells to be used for energy.
How Type 1 Diabetes Is Diagnosed
Type 1 diabetes can be diagnosed with one of two simple blood tests.
As of 2010, the American Diabetes Association, in its Standards of Medical Care for Diabetes, recommend the hemoglobin A1C (abbreviated simply as A1C) blood test to determine the diagnosis of diabetes. Internationally this is becoming the preferred test rather than a blood glucose check, which only shows a blood glucose result at one point in time. The A1C test is able to detect the ups and downs of blood glucose over the last two to three months. It's also more convenient because fasting isn't required.
Normal: Less than 5.6%
Prediabetes: 5.7% to 6.4%
Diabetes: Greater than 6.5%
Blood glucose results, either fasting or random, can also be used to diagnose diabetes.
- Fasting blood glucose test: Taken after 12 hours of fasting (though water is permitted), this test indicates diabetes if blood glucose levels are higher than 126 mg/dL.
- Random blood glucose test: Taken anytime (non-fasting), this test indicates diabetes if blood glucose levels are higher than 200 mg/dL and the person has symptoms of diabetes (i.e., thirst, blurred vision, weight loss). If one result does not clear indicate pre-diabetes or diabetes, a second blood glucose measure should be done.
Type 1 Diabetes Treatment
With good blood glucose control over the years, people with type 1 diabetes can live a long and healthy life. Along with blood glucose control, control of blood pressure and blood lipids is also very important to reduce the risks of diabetes complications, such as heart disease, blindness, or kidney failure. Treatment for type 1 diabetes includes:
1. Insulin: People with type 1 diabetes require insulin injections to survive because they don't produce insulin on their own. The point of insulin therapy is to provide the insulin the body would make normally. There are several options for insulin delivery, including:
- Insulin pens that look like a very thick ink pen and have one type of insulin in the cartridge (a needle is placed on the pen for injections)
- Insulin pumps that connect to the body through a catheter and inject insulin based on rates that are set up or determined at meals and snacks
- Syringes filled with insulin
There are also a variety of insulin types, including rapid-acting, intermediate-acting, and long-acting.
Tracking Blood Glucose
2. Monitoring: People with type 1 diabetes need to eat meals at regular times and test their blood glucose several times a day to make decisions about the amount of insulin they need to take.
Blood glucose monitoring also helps a person with type 1 detect blood glucose extremes such as high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia).
To monitor blood glucose:
- Prick the finger (the most common location) with a small needle (lancet).
- Place a very small drop of blood on a test strip and insert it into a glucose meter to measure the amount of glucose in the blood.
Most meters can store a large number of glucose readings over time. To make changes in a treatment plan, people with diabetes and their health-care providers can monitor glucose meter results.
In addition, standards of diabetes care recommend occasional A1C testing (also called glycosylated hemoglobin), which measures blood glucose levels over the prior two to three months. The American Diabetes Association recommends people with diabetes have an A1C of 7 percent or less.
3. Healthful Meal Plan: Meal planning is necessary to maintain good glucose control and to predict the amount of insulin needed. To manage diabetes and prevent complications, a healthful meal plan should be rich in whole grains, fresh fruits, and vegetables and low in saturated and trans fat.
4. Exercise: Physical activity can help reduce blood glucose levels, maintain a healthy weight, and lower the risk of diabetes-related complications. However, exercise can also cause blood glucose to go too low. People with type 1 diabetes should talk with a physician about how to adjust insulin and how to adjust carbohydrate intake before starting an exercise program.
Type 1 Diabetes Risk Factors
Because it is not known what causes the immune system to attack the insulin-producing beta cells, it's impossible for researchers to predict who will develop type 1 diabetes. There may be a heightened risk for people with a parent or sibling who has type 1 diabetes.
Adult Onset of Type 1 Diabetes
Sometimes referred to as diabetes type latent autoimmune diabetes of adulthood (LADA, slow-onset type 1 is rare, though the number of cases seems to be increasing.
The cause of LADA seems to be the same as traditional type 1 diabetes -- an autoimmune attack that results in the pancreas no longer producing insulin. Many people with LADA are initially misdiagnosed with type 2 diabetes because they are older than 30 (most people with type 1 are diagnosed as children or young adults). Further testing is often required for a correct diagnosis.