Systems Affected A chronic condition in which the pancreas produces little to no insulin, a hormone needed to allow glucose (sugar) to enter cells to produce energy. This happens because the body begins to attack the insulin-creating beta cells in the islet tissue of the pancreas. Genetics or exposure to certain viruses may contribute to the development of Type 1 Diabetes.
Heart and blood vessels - Dramatically increases your risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of the arteries (atherosclerosis), and high blood pressure. Nerve damage - Excess sugar can injure the walls of the capillaries that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar could cause you to eventually lose all sense of feeling in the affected limbs. Damage to the nerves that affect the gastrointestinal tract can cause problems with nausea, vomiting, diarrhea, or constipation. Kidney damage - The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage it's filtering system. This can lead to kidney failure or irreversible end-stage kidney disease. Eye damage - Diabetes can damage the blood vessels of the retina, which can potentially lead to blindness. Its also increases the risk of other serious vision conditions, such as cataracts and glaucoma. Foot damage - Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become infected, will heal improperly, and may ultimately require toe, foot, or leg amputations. Skin and mouth conditions - Bacterial or fungal infections in these areas. Pregnancy complications - High blood sugar levels can bring about the risk of miscarriage, stillbirth, and birth defects are increased when diabetes isn't well-controlled. For the mother, diabetes increases the risk of diabetic ketoacidosis, diabetic eye problems, prenancy-induced high blood pressure, and preeclampsia. Symptoms
DiagnosisGlycated hemoglobin (A1C) test: Indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes.
Random blood sugar test: A blood sample will be taken at a random time. A random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes. Fasting blood sugar test: A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered pre-diabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. |
Treatment
INSULIN TREATMENT: Anyone who has type 1 diabetes needs lifelong insulin therapy. After the diagnosis, there may be period of time during which blood sugar is controlled with little or no insulin. However, relapse is certain. Types of insulin are many and include:
ADMINISTRATION: Injections. You can use a fine needle and syringe or an insulin pen to inject insulin under your skin. If you choose injections, you'll likely need a mixture of insulin types to use throughout the day and night. Multiple daily injections that include a combination of a long-acting insulin, such as Lantus or Levemir combined with a rapid-acting insulin, such as Apidra, Humalog or Novolog, more closely mimic the body's normal use of insulin than older insulin regimens that only required one or two shots a day. Three or more insulin injections a day has been shown to improve blood sugar levels. An insulin pump — a device about the size of a cell phone worn on the outside of your body. A tube connects a reservoir of insulin to a catheter that's inserted under the skin of your abdomen. This type of pump can be worn in a variety of ways, such as on your waistband, in your pocket, or with specially designed pump belts. There's also a wireless pump option. You wear a pod that houses the insulin reservoir on your body that has a tiny catheter that's inserted under your skin. The insulin pod can be worn on your abdomen, lower back, or on a leg or an arm. The programming is done with a wireless device that communicates with the pod. Pumps are programmed to dispense specific amounts of rapid-acting insulin automatically. This steady dose of insulin is known as your basal rate, and it replaces whatever long-acting insulin you were using. When you eat, you program the pump with the amount of carbohydrates you're eating and your current blood sugar, and it will give you what's called a "bolus" dose of insulin to cover your meal and to correct your blood sugar if it's elevated. Some research has found that in some people an insulin pump can be more effective at controlling blood sugar levels than injections. But many people achieve good blood sugar levels with injections, too. MEDICATIONS: Pramlintide (Symlin). An injection of this medication before you eat can slow the movement of food through your stomach to curb the sharp increase in blood sugar that occurs after meals. High blood pressure medications. Also known as angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). These medications also can help keep your kidneys healthy. Aspirin. Baby or regular aspirin daily to protect your heart. Cholesterol-lowering drugs. Cholesterol-lowering agents known as statins. Cholesterol guidelines tend to be more aggressive for people with diabetes because of the elevated risk of heart disease. ARTIFICIAL PANCREAS: Closed-loop insulin delivery, also known as the artificial pancreas. It links a continuous glucose monitor to an insulin pump. The device automatically delivers the correct amount of insulin when the monitor indicates the need for it. Life ExpectancyMen with type 1 diabetes lose about 11 years of life expectancy compared to men without the disease. And, women with type 1 diabetes have their lives cut short by about 13 years.
People with Type 1 Diabetes are constantly having to make sure their glucose level is between 70 and about 120. If they are above or below those marks, they must take insulin, usually via injection. Case Study |