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Diabetes Mellitus Type 1 In Adults

What is diabetes mellitus type 1?

Diabetes mellitus type 1 is a disease that affects how your body makes insulin and uses glucose (sugar). Insulin helps move sugar out of the blood so it can be used for energy.

What causes diabetes mellitus type 1?

Normally, when the blood sugar level increases, the pancreas makes more insulin. Type 1 diabetes develops because the immune system destroys pancreas cells that make insulin. The pancreas cannot make enough insulin, so the blood sugar level continues to rise. A family history of type 1 diabetes may increase your risk for diabetes.

What are the signs and symptoms of diabetes mellitus type 1?

  • More thirst than usual

  • Frequent urination

  • Hunger most of the time

  • Weight loss without trying

  • Blurred vision

How is diabetes mellitus type 1 diagnosed?

  • Blood glucose test: A sample of your blood is tested for the amount of sugar it contains.

  • Fasting plasma glucose test: After you have fasted for 8 hours, your blood sugar level is tested.

  • Oral glucose tolerance test: After you have fasted for 8 hours, your blood sugar level is tested. You are then given a glucose drink. Your blood sugar level is checked after 1 hour, and again after 2 hours. Healthcare providers look at how much your blood sugar level increases from the first check.

  • A1c test: This blood test shows the average amount of sugar in your blood over the past 2 to 3 months. Your healthcare provider will tell you the A1c level that is right for you. He can help you make changes if a check shows the A1c is too high.

  • Antibody test: This blood test may be done to check for signs that your immune system is attacking your pancreas.

How is diabetes mellitus type 1 treated?

Type 1 diabetes cannot be cured, but it can be controlled. The goal is to keep your blood sugar at a normal level.

  • You will need at least 1 dose of insulin each day. Insulin can be injected or given through an insulin pump. Ask your healthcare provider which method is best for you. You or a family member will be taught how to give insulin injections if this is the best method for you. Your family member can give you the injections if you are not able. Take your insulin as directed. Too much insulin may cause your blood sugar level to go too low.

  • You will be taught how to adjust each insulin dose you take with meals. Always check your blood sugar level before the meal. The dose will be based on your blood sugar level, carbohydrates in the meal, and activity after the meal.

How do I check my blood sugar level?

You will be taught how to check a small drop of blood with a glucose monitor. You will need to check your blood sugar level at least 3 times each day. Ask your healthcare provider when and how often to check during the day. If you check your blood sugar level before a meal , it should be between 70 and 130 mg/dL. If you check your blood sugar level 1 to 2 hours after a meal , it should be less than 180 mg/dL. Ask your healthcare provider if these are good goals for you. You may need to check for ketones in your urine or blood if your level is higher than directed. Write down your results and show them to your healthcare provider. He may use the results to make changes to your medicine, food, or exercise schedules.

What should I do if my blood sugar level is too low?

Your blood sugar level is too low if it goes below 70 mg/dL. Eat or drink a small amount of fast-acting carbohydrate, or take 4 glucose tablets (15 to 20 grams of glucose). Check the level again 15 minutes later. If it is above 70 mg/dL, eat a small snack. If it is still below 70 mg/dL, eat a small amount of fast-acting carbohydrate, or take 4 glucose tablets. Your healthcare provider or dietitian can tell you which fast-acting carbohydrates to eat, and how much is safe for you. Ask your healthcare provider for more information on diabetic hypoglycemia (low blood sugar level).

What do I need to know about nutrition?

A dietitian will help you make a meal plan to keep your blood sugar level steady. Do not skip meals. Your blood sugar level may drop too low if you have taken insulin and do not eat.

  • Keep track of carbohydrates (sugar and starchy foods): Your blood sugar level can get too high if you eat too many carbohydrates. Your dietitian will help you plan meals and snacks that have the right amount of carbohydrates.

  • Eat low-fat foods: Some examples are skinless chicken and low-fat milk.

  • Eat less sodium (salt): Some examples of high-sodium foods to limit are soy sauce, potato chips, and soup. Do not add salt to food you cook. Limit your use of table salt.

  • Eat high-fiber foods: Foods that are a good source of fiber include vegetables, whole grain bread, and beans.

  • Limit alcohol: Alcohol affects your blood sugar level and can make it harder to manage your diabetes. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

How much exercise do I need?

Exercise can help keep your blood sugar level steady, decrease your risk of heart disease, and help you lose weight. Exercise for at least 30 minutes, 5 days a week. Work with your healthcare provider to create an exercise plan.

  • Check your feet for open sores before you exercise. Ask your healthcare provider for activities you can do if you have an open sore. You will need to exercise carefully so that you do not make the sore worse.

  • Check your blood sugar level before and after exercise. Healthcare providers may tell you to change the amount of insulin you take or food you eat. If your blood sugar level is high, check your blood or urine for ketones before you exercise. Do not exercise if your blood sugar level is high and you have ketones in your urine or blood.

  • If your blood sugar level is less than 100 mg/dL, have a carbohydrate snack before you exercise. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice.

  • Drink liquids that do not contain sugar before, during, and after exercise. Ask your dietitian or healthcare provider which liquids you should drink when you exercise.

What else can I do to manage my diabetes?

  • Keep all follow-up appointments: Your healthcare provider will want to monitor your blood sugar level. He may want you to have your A1c checked every 3 months. Most people should keep their A1c below 7.5%. You will need to return at least once each year to have your feet checked. You will also need urine tests every year to check for kidney problems. Have your eyes checked for retinopathy every 2 years.

  • Ask about your weight: Ask healthcare providers if you need to lose weight, and how much to lose. Ask them to help you with a weight loss program. Even a 10 to 15 pound weight loss can help you manage your blood sugar level.

  • Quit smoking: If you smoke, it is never too late to quit. Smoking can worsen the problems that can occur with diabetes. Ask your healthcare provider for information about how to stop smoking if you are having trouble quitting.

  • Carry medical alert identification: Wear medical alert jewelry or carry a card that says you have diabetes. Ask your healthcare provider where to get these items.
    Medical alert ID bracelet

  • Ask about vaccines: Diabetes puts you at risk of serious illness if you get the flu, pneumonia, or hepatitis. Ask your healthcare provider if you should get a flu, pneumonia, or hepatitis B vaccine, and when to get the vaccine.

What are the risks of diabetes mellitus type 1?

Uncontrolled diabetes can damage your nerves, veins, and arteries. Long-term high blood sugar levels can damage your eyes and kidneys. Damage to arteries increases your risk of heart attack and stroke. Nerve damage may also lead to other heart, stomach, and nerve problems. Diabetes is life-threatening if it is not controlled.

When should I contact my healthcare provider?

  • You are vomiting or have diarrhea.

  • You have an upset stomach and cannot eat the foods on your meal plan.

  • You feel weak or more tired than usual.

  • You feel dizzy or have headaches.

  • Your skin is red, dry, warm, or swollen.

  • You have a wound that does not heal.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • Your blood sugar level is lower than directed and does not improve with treatment.

  • You are having trouble staying awake or focusing.

  • You are shaking or sweating.

  • You have blurred or double vision.

  • Your breath has a fruity, sweet smell, or your breathing is shallow.

  • Your heartbeat is fast and weak.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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