Just the Facts About Type 1 Diabetes
In type 1 diabetes, the body does not make insulin. Insulin is needed for the body to use glucose (sugar) from food for energy. You probably have many questions. It will be helpful to learn about healthy living with diabetes. There is a lot of information available and many tools to help you.
You will want to learn about high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia) and ketoacidosis. You will also want to learn about testing your blood sugar level, meal planning, the benefits of exercise and more.
For more information about type 1 diabetes, visit these web sites:
Hyperglycemia (high blood glucose) means that the amount of sugar in your bloodstream is higher than it should be. The symptoms of hyperglycemia include blurry vision, headache, increased thirst, increased urination, irritability, tiredness, and unexplained weight loss over a period of time.
When you have diabetes, eating a larger meal than usual, missing a dose of medication or insulin, being sick, inactive, or being stressed can cause your blood sugar to be high. It is important to know if your blood sugar is high and to take action to bring it back into a healthy range.
If you have high blood sugar, it is helpful to understand the cause. You may want to think about your management plan and what might be happening to cause this increase in blood sugar.
Low blood sugar (hypoglycemia) describes a blood sugar less than about 70 mg/dl (3.9 mmol/L), but some people feel symptoms when blood sugar is a little higher than that. Low blood sugar can occur if there is too much insulin in your system, or if you have not eaten enough or skipped a meal, or if you have done too much activity without enough carbohydrate to meet the demand of the activity. The symptoms of hypoglycemia include feeling shaky, sweaty, weak, dizzy, irritable, extremely hungry, and having a headache.
If you become hypoglycemic, do the following things:
- If possible, test your blood sugar level to verify it.
- Take some type of fast-acting sugar, like 3 glucose tablets (you can buy these at the drug store), a ½ cup of fruit juice, 3-4 pieces of hard candy, a small box of raisins or ½ cup of regular soda (not diet).
If you are not feeling better in 10-15 minutes, it is best to re-test and have more sugar if needed.
Standards of Medical Care in Diabetes, American Diabetes Association, 2008
Ketoacidosis is a serious condition that may happen in people with type 1 diabetes. Ketoacidosis happens when there is too little insulin in the bloodstream to help the sugar get into cells and the body looks for other kinds of fuel to burn. When the body burns stored fat, ketones begin to build up in the body. Ketones get removed from your bloodstream through the urine.
The first warning signs of ketoacidosis are:
- Thirst or a very dry mouth.
- Frequent urination.
- High blood sugar levels.
- Ketones in your urine.
Then other symptoms also appear:
- Constantly feeling tired.
- Dry or flushed skin.
- Nausea, vomiting, or abdominal pain.
- A hard time breathing.
- Fruity odor to your breath.
- A hard time paying attention; being confused.
Your healthcare team will tell you when you should test for ketones. It is also a good idea to test at the following times:
- Before breakfast. This is called the fasting blood sugar.
- Your blood sugar is 250 mg/dL (13.9 mmol/L) or higher for two tests in a row.
- You are sick (even with a cold), because being sick can cause you to have ketones.
- You are vomiting or have diarrhea.
- You are under stress or are upset.
- You are pregnant.
Blood Sugar Testing
To take care of your diabetes and your health, it is important to keep your blood sugars in balance. Self-monitoring of blood glucose on a regular basis is an important tool to help you do that. Sometimes you feel just fine, but only a blood sugar test can tell you if your blood sugar is in your target range.
Some feel that self-monitoring may be bothersome, inconvenient, even annoying, but testing will let you know if your meal plan, medicine, and activity are working for you. Self-testing is knowledge and knowledge is power. Knowing more about your blood sugar levels can help you and your healthcare team make better decisions about your overall diabetes management plan.
How Does Blood Testing Help Me Day-to-Day?
Research shows that keeping blood sugar levels in an acceptable target range helps prevent the complications associated with diabetes. You can lower your risk for eye problems, kidney disease, nerve damage, and heart problems. And, understanding how to balance your blood sugar levels can help you feel better day to day. High blood sugars can make you feel sluggish, and cause thirst and frequent urination. Low blood sugars can make you feel shaky and sweaty and, because low blood sugar requires immediate action, episodes of low blood sugar can significantly interrupt your day. Talk to your healthcare provider about starting self-monitoring of blood glucose.
Meal Planning
Food gives us the energy we need to do all the things we love to do every day; it is the fuel that your body cells need to be able to think, work, and play. Nutrition is important for everyone and meal planning is an important part of any diabetes management plan. Your healthcare team will help you make a meal plan that is just for you. Your plan will include foods from all food groups. There is no reason that you can’t still have all your favorite foods – it’s a matter of planning the best types and amounts of foods for you.
Activity
Stay active. Activity can be helpful in managing blood sugar. Activity may help you burn calories, lose weight, feel better, handle stress effectively, increase strength, increase your circulation, and help your heart and lungs. Half an hour of physical activity a day can help to reduce your risk of developing complications. And the great thing about it is that you don’t need to join a gym or buy expensive exercise equipment to stay healthy. Enjoying the things you like to do, such as walking, swimming, even housework, can be beneficial. It is a good idea to check with your healthcare team before starting an exercise program, especially if you have not been in the habit of regular activity.
There are 4 main types of insulin available. These vary in the time it takes to reach the bloodstream and begin lowering glucose levels (onset), length of time the insulin is working at maximum strength (peak time), and the entire span of action for lowering glucose levels (duration).
The 4 main types of insulin are:
- Rapid-acting, such as insulin lispro, insulin aspart, and insulin glulisine. A bolus or "mealtime" insulin.
- Short-acting insulin or regular insulin. Another bolus or "mealtime" insulin.
- Intermediate-acting or NPH. A basal insulin that lasts for longer periods of time and aims to provide background insulin.
- Long-acting insulin, such as insulin glargine (Lantus™) and insulin detemir (Levemir™).
Also, a basal insulin that lasts for longer periods of time.
Your Family and Friends
Anyone who will support you is part of your team. Let your friends and family help you take good care of yourself. It is a good idea to have a family member attend diabetes-education classes with you. This will not only give you a second set of eyes and ears, but also means that you will have someone to help you who understands how all the aspects of your diabetes management plan work.
Your Healthcare Team
There are many healthcare professionals who can be part of your healthcare team. You may not always be able to engage all potential team members, but it is useful to understand how each can provide information, support, and care. A variety of healthcare providers can help you learn about diabetes and how to take good care of yourself. Working with healthcare providers is a two-way street; they need you to tell them how things are working and when you need help. You are the key member of the team.
Diabetes Education
Diabetes education is recommended for people with diabetes. Many hospitals and clinics or physician offices have diabetes education programs. To find a diabetes education program near you, look up the ADA or the AADE websites. Diabetes self-management can help you optimize blood sugar levels, prevent complications, and maximize your quality of life with diabetes. Diabetes educators provide information about the day-to-day aspects of diabetes care, such as how to administer medications (including insulin), check blood sugar levels, identify symptoms of hypoglycemia or hyperglycemia, and adjust treatment on sick days. Diabetes educators should also address psychosocial issues, since emotional well-being improves diabetes outcomes.