Diabetes Mellitus Type 1 In Adults

What is diabetes mellitus type 1?

Diabetes mellitus is a disease that affects how your body makes insulin and how it uses glucose (sugar). Insulin is a hormone that helps your body use sugar by allowing the sugar to enter body cells. With type 1 diabetes, your body makes little or no insulin, causing high blood sugar levels. Type 1 diabetes is also called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. It is more common in children or young adults, but it can occur at any age.

What causes diabetes mellitus type 1?

Type 1 diabetes may be an autoimmune disease. An autoimmune disease is a condition where your body's immune system (defense system) attacks your body's cells. Normally, when blood glucose level increases, the pancreas (an organ that lies behind the stomach) makes insulin. In type 1 diabetes, the cells in the pancreas that make insulin are destroyed.

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

You may have any of the following:

• More thirsty than usual
  
  
• Frequent urination
  
  
• Losing weight without trying
  
  
• Blurred vision
  
  
• Hungry most of the time

How is diabetes mellitus type 1 diagnosed?

If you have signs or symptoms of type 1 diabetes, blood tests are done to diagnose the disease. You may need any of the following blood tests:

• Blood glucose: A sample of your blood is collected, and the amount of sugar in the blood is checked.
  
  
• Fasting plasma glucose: After you have fasted (no food or liquid) for 8 hours, your blood sugar is checked.
  
  
• Oral glucose tolerance test (OGTT): Your blood will be drawn 2 or more times during this test. After fasting, the first sample of blood will be taken. You will then be given a glucose drink. Two hours after drinking the liquid, the second sample of blood will be taken.
  
  
• Hemoglobin A1C (HbA1C) test: This blood test shows the average amount of sugar in your blood over the past 2 to 3 months.

How is diabetes mellitus type 1 treated?

Type 1 diabetes can be treated and controlled most of the time. The goal is to keep your blood sugar at normal levels. This can be done by correctly taking insulin. Insulin can be taken by injections (shots), or continuous subcutaneous insulin infusion (CSII) using an insulin pump. Ask your caregiver what method is best for you. Meal and activity planning are also very important in diabetes management.

How do I check my blood sugar levels?

You may have to check your blood sugar level at least 3 times each day. You will be taught how to check your blood sugar level at home using a glucose monitor. This is a small device that shows how much sugar is in your blood. The monitor uses a small drop of blood from a prick on your finger. Ask your caregiver what your blood sugar levels should be before and after you eat a meal. Ask them when you must check your blood sugar level. Write down your blood sugar results each time you check them and show the results to your caregiver. Ask your caregiver how to use the results of blood tests to change your diet, exercise plan, and medicine, if changes are needed.

What other health problems can diabetes mellitus type 1 cause?

You may need tests to check for eye or thyroid disorders and other diseases that can occur when you have diabetes. Ask your caregiver what tests you may need and how often you may need them. Uncontrolled high blood sugar levels may damage other body tissues and organs over time. You may be at risk of having 1 or more of the following if your blood sugar levels are always high:

• Heart attack, stroke, and other problems due to poor circulation
  
  
• Kidney damage that may cause kidney failure
  
  
• Nerve damage that may cause numbness and an increased risk of having foot ulcers
  
  
• Eye problems that may cause blurred vision or even blindness

What should I know about diet with type 1 diabetes mellitus?

A dietitian will help you make a meal plan to keep your blood sugar level under control. He may suggest the following:

• Keep track of how many carbohydrates you eat. Too many carbohydrates at one time can cause your blood sugar to rise very high. Carbohydrates are found in bread, cereal, starchy vegetables, beans, fruit, milk, and yogurt. Candy, desserts, and regular soda also contain carbohydrates.
  
  
• Never skip a meal.
  
  
• Choose foods that are low in fat, saturated fat, and cholesterol. Examples of low-fat foods are lean cuts of meat, fish, skinless chicken and turkey, and low-fat milk.
  
  
• Choose foods that are low in sodium and use less table salt. Limit foods that are high in sodium, such as soy sauce, lunch meats, hot dogs, crackers, potato chips, and soup.
  
  
• Choose foods that are good sources of fiber, such as vegetables and whole grain breads and cereals. Beans and lentils are also good fiber sources.
  
  
• Limit the amount of alcohol you drink. Alcohol affects your blood sugar and can make it harder to manage your diabetes. Too much alcohol can also damage your brain, heart, and liver. The risk of getting high blood pressure and certain types of cancer are greater for people who drink too much alcohol. Drinking too much alcohol also increases the risk of having a stroke. Women should have no more than 1 drink a day. Men should have no more than 2 drinks a day. A drink of alcohol is 12 ounces of beer, or 5 ounces of wine. One and one-half ounces of liquor, such as whiskey, is 1 drink of alcohol.

What should I know about exercise with type 1 diabetes mellitus?

Regular exercise helps your blood sugar level stay in the best range, and decreases your risk of getting heart disease. It can also help you lose weight, and improve how you feel. Do at least 30 minutes of moderate exercise that increases your heart rate 5 days a week. Work with your caregiver to plan the best exercise program for you.

• Check your blood sugar before and after exercise to learn how your blood sugar responds to exercise. Caregivers may tell you to change the amount of insulin you take or food you eat. Do not exercise if your blood sugar is elevated and you have ketones in your urine, or if your blood sugar is less than 100 mg/dL.
  
  
• If your blood sugar is less than 100 mg/dL, eat or drink a carbohydrate snack before exercising. This will help to avoid low blood sugar. Examples of carbohydrate snacks are 4 to 6 crackers, 1/2 banana, 8 ounces (1 cup) of milk, or 4 ounces (1/2 cup) of juice.
  
  
• Have a carbohydrate snack available during and after exercise, and drink liquids before, during, and after exercise.
  
  
• Check your feet daily for foot injuries or open sores. Do non-weight-bearing activity, such as riding a bicycle, if you have a foot injury or open sore.

What else can I do to help manage type 1 diabetes mellitus?

• Medicines: Take your medicines as ordered by your caregiver. Ask for more information about the medicines that you need.
  
  
• Influenza vaccine: This vaccine helps prevent influenza (flu). Everyone older than age 6 months should get a yearly influenza vaccine. Get the vaccine as soon as it is available, usually in October or November each year.
  
  
• Keep all follow up appointments: Remember to wear your medical alert jewelry or carry a card that says you have diabetes. Ask your caregiver where to get these items. Your caregiver may want you to have additional tests to check for:
  
  
  • Heart health: Ask your caregiver about tests to monitor your blood pressure and cholesterol (amount of fat in your blood).
    
    
  • Blood glucose control: Ask your caregiver how often you should have the hemoglobin A1C (HbA1C) test.
  
  
• Weight loss: Ask caregivers if you need to lose weight, and how much weight you need to lose. Ask them to help you with a weight loss program.
  
  
• Quit smoking: It is never too late to quit smoking. Smoking can worsen the problems that can occur with diabetes, such as poor blood flow to your feet. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Your health and the health of those around you will improve if you quit smoking. Ask your caregiver for information about how to stop smoking if you are having trouble quitting.

Where can I find support and more information?

Diabetes is a life-changing disease for you and your family. It may be hard to accept that you have diabetes. You may want to see a mental health worker (talk therapist). This caregiver can help you take an active role in managing your diabetes. Contact the following for more information:

• American Diabetes Association
  1701 North Beauregard Street
  Alexandria , VA 22311
  Phone: 1- 800 - 342-2383
  Web Address: http://www.diabetes.org
  

When should I contact my caregiver?

Call your caregiver if:

• You feel very weak or very tired.
  
  
• You feel dizzy or have headaches.
  
  
• You are vomiting or have an upset stomach.
  
  
• You have questions or concerns about your disease, medicine, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• 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.

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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.

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