Type 1 diabetes is a condition that requires careful management, often starting with hospitalization upon diagnosis due to its rapid onset and severe symptoms. If you’ve recently been diagnosed with type 1 diabetes, you’ll likely have frequent check-ups initially to gain control over your blood sugar levels. These appointments involve reviewing your blood sugar monitoring results, urine tests, and records of meals, snacks, and insulin doses. Finding the right insulin dosage to match your eating and activity habits can take several weeks.
As your condition stabilizes, follow-up visits will become less frequent. However, these visits remain crucial for monitoring and preventing long-term diabetes complications. Your healthcare provider will likely involve a team, including a dietitian, clinical pharmacist, and a certified diabetes care and education specialist (CDCES), to support you in managing your diabetes effectively.
Ultimately, you are the central figure in managing your diabetes. Understanding the fundamental aspects of diabetes management is essential. This includes recognizing and treating both low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia), planning meals with carbohydrate counting, administering insulin, monitoring blood glucose and urine ketones, adjusting insulin and food intake during exercise, managing sick days, and knowing where to obtain and properly store diabetes supplies.
The Vital Role of Insulin and Its Origin
Insulin is a hormone that plays a critical role in regulating blood sugar. It works by allowing sugar (glucose) to move from the bloodstream into cells, where it can be used for energy. Insulin is produced in the pancreas, an organ located behind the stomach. Within the pancreas are clusters of cells known as the islets of Langerhans. Specifically, beta cells within these islets are responsible for producing insulin.
In individuals with type 1 diabetes, the body’s immune system mistakenly attacks and destroys these beta cells. This autoimmune reaction leads to a significant reduction or complete cessation of insulin production. As a result, people with type 1 diabetes require external insulin to survive and manage their blood sugar levels.
Without sufficient insulin, glucose cannot enter cells effectively and builds up in the bloodstream, leading to hyperglycemia. This is why insulin therapy is the cornerstone of treatment for type 1 diabetes.
Insulin Therapy for Type 1 Diabetes
Since the body of someone with type 1 diabetes does not produce enough or any insulin, it must be replaced through medication. Insulin cannot be taken orally because stomach acid would break it down before it could be absorbed into the bloodstream. Therefore, insulin is typically administered through injections under the skin using syringes, insulin pens, or insulin pumps. Inhaled insulin is also an available option.
Different types of insulin vary in how quickly they start working and how long their effects last. Your healthcare provider will determine the most suitable types of insulin for you and prescribe the appropriate timing for their use. Sometimes, different types of insulin may be mixed in a single injection to achieve optimal blood sugar control, while others should never be mixed.
Most individuals with type 1 diabetes require two main types of insulin:
- Basal Insulin: This is a long-acting type of insulin that works continuously throughout the day and night. It helps to regulate the glucose produced by your liver between meals and during sleep, providing a background level of insulin.
- Meal-time (Bolus or Prandial) Insulin: This is a rapid-acting insulin taken just before meals. It helps to manage the rise in blood sugar that occurs after eating carbohydrates. It works quickly to move glucose from the meal into your cells for energy or storage.
Your healthcare provider or a certified diabetes educator will provide detailed instruction on how to administer insulin injections. While parents or guardians may initially give injections to younger children, most teenagers around the age of 14 can learn to inject themselves.
Inhaled insulin, available as a powder, is a rapid-acting option inhaled just before meals. Your provider can advise if inhaled insulin is appropriate for your specific needs.
Adjusting insulin dosage is a crucial aspect of diabetes management. You’ll need to learn how to modify your insulin intake based on factors like:
- Exercise: Physical activity can lower blood sugar levels, so insulin adjustments may be necessary before, during, and after exercise.
- Illness: Being sick can affect blood sugar levels, often increasing them. Sick day management plans often involve insulin adjustments.
- Dietary Changes: Changes in meal size or carbohydrate content will require adjustments to meal-time insulin doses.
- Travel: Time zone changes and altered routines during travel can impact insulin needs.
Healthy Eating and Exercise in Diabetes Management
Monitoring your blood sugar levels regularly helps you understand how different foods and activities affect your glucose levels. This knowledge empowers you to adjust your insulin doses to match specific meals or activities, preventing both hyperglycemia and hypoglycemia.
Organizations like the American Diabetes Association and the Academy of Nutrition and Dietetics offer valuable resources for planning healthy, balanced meals. Consulting a registered dietitian or nutritionist can also provide personalized guidance.
Regular physical activity is highly beneficial for blood sugar control. Exercise helps your body use insulin more effectively and burns extra calories, contributing to weight management and overall health. However, it’s essential to consult your healthcare provider before starting any new exercise program, especially with type 1 diabetes, as specific precautions may be needed.
Monitoring and Managing Blood Sugar Levels
Regular blood sugar monitoring is essential for effective diabetes management. Using a glucose meter to check your blood sugar and recording the results provides valuable data on how well your diabetes is being controlled. Discuss with your provider and diabetes educator how often you should check your blood sugar.
A glucose meter typically requires a small blood sample obtained by pricking your finger with a lancet. The blood is placed on a test strip, which is then inserted into the meter to provide a blood sugar reading.
Continuous Glucose Monitors (CGMs) are another option. These devices measure glucose levels in the fluid under your skin continuously throughout the day and night. CGMs are particularly useful for people using insulin pumps, but can also benefit those who don’t. Many CGMs eliminate the need for frequent finger pricks.
Maintaining a log of your blood sugar readings, whether on paper or electronically, is crucial for both your self-management and for your healthcare team to assess your progress and make necessary adjustments to your treatment plan. You and your provider should establish target blood sugar ranges for different times of the day and create a plan of action for when your blood sugar levels fall outside of these targets.
The A1C test is a blood test that provides an average blood sugar level over the past 2-3 months. It is a key indicator of long-term blood sugar control. For most adults with type 1 diabetes, the target A1C is generally 7% or lower.
Hypoglycemia, or low blood sugar, is a significant concern for people with diabetes. A blood sugar level below 70 mg/dL (3.9 mmol/L) is considered low and requires prompt attention. Levels below 54 mg/dL (3.0 mmol/L) are critically low and necessitate immediate action. Understanding the causes and symptoms of hypoglycemia, and how to prevent and treat it, is crucial for safe diabetes management.
Foot Care for People with Diabetes
Diabetes can damage nerves and blood vessels, particularly in the feet, making foot care extremely important. Nerve damage (neuropathy) can reduce sensation in your feet, so you might not feel injuries or pressure, while blood vessel damage can impair healing. This increases the risk of foot problems, infections, and ulcers.
To protect your feet:
- Quit smoking: Smoking further damages blood vessels and impairs circulation.
- Optimize blood sugar control: Good glucose management helps minimize nerve and blood vessel damage.
- Annual foot exams: Get a comprehensive foot exam by your provider at least once a year to assess for nerve damage and other foot issues.
- Daily foot checks: Inspect your feet daily for any cuts, blisters, redness, or swelling.
- Proper foot hygiene: Wash your feet daily, dry them thoroughly, especially between the toes, and use moisturizing lotion to prevent dry skin.
- Nail care: Keep nails trimmed straight across. If you have thick or difficult-to-cut nails, seek professional help from a podiatrist.
- Appropriate footwear: Wear well-fitting, supportive shoes to protect your feet from injury.
Preventing Diabetes Complications
Managing your blood sugar effectively significantly reduces the risk of long-term diabetes complications. Your healthcare provider may recommend medications or other treatments to further minimize your risk of:
- Eye disease (retinopathy)
- Kidney disease (nephropathy)
- Nerve damage (neuropathy)
- Heart disease and stroke
People with type 1 diabetes are also at increased risk for other conditions, such as hearing loss, gum disease, bone and joint problems, and yeast infections. Maintaining good blood sugar control is key to preventing or delaying these complications. Staying up-to-date on recommended vaccinations is also important for overall health.
Emotional Well-being and Diabetes
Living with diabetes can be emotionally challenging. The constant demands of self-management can feel overwhelming and lead to stress. However, taking care of your emotional health is just as vital as managing your physical health.
Stress management techniques can be helpful, such as:
- Relaxation techniques: Listening to music, meditation, and deep breathing exercises.
- Physical activities: Yoga, tai chi, or progressive relaxation.
It’s normal to experience occasional sadness or anxiety. However, if these feelings become persistent or interfere with your diabetes management, it’s important to reach out to your healthcare team. They can provide support and connect you with resources to improve your emotional well-being.
Managing type 1 diabetes is a lifelong journey that requires knowledge, dedication, and a strong support system. Understanding where insulin is produced, why it’s essential, and how to manage its replacement through therapy are fundamental steps towards living a healthy and fulfilling life with type 1 diabetes.
