Munson Health
 
Type 1 Diabetes

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by Wood D

(Insulin Dependent Diabetes Mellitus; Juvenile-Onset Diabetes; Ketosis-Prone Diabetes; "Brittle" Diabetes; Diabetes Mellitus Type 1; Diabetes, Type 1)

 

Treatment

Diabetes treatment goal is to maintain blood sugar at levels as close to normal as possible. Regular medical care is important for preventing or delaying complications.
While diabetes makes blood glucose levels too high, treatment can make blood glucose levels go too low. This is called hypoglycemia. It can cause confusion, shakiness, anxiety, heart palpitations and more. If the levels fall too low it can cause seizures and loss of consciousness. You and your doctor will plan and adjust your medication and diet to keep the risk of hypoglycemia low.

Insulin

Insulin injections replace the insulin you are missing. The amount given is based on your individual need and a blood glucose test you take before and after meals and at bedtime. You will need to have insulin shots two or more times daily.
You may also have an insulin pump that automatically gives you small amounts of insulin through the day.

Pramlintide

Amylin is made in the pancreas along with insulin. In people with type 1 diabetes, this hormone like insulin is missing. The missing amylin may be responsible for the blood glucose rise after a meal in people with diabetes. The drug pramlintide may be used when insulin therapy is not enough to control blood sugar.

Glucagon

Glucagon can be injected to quickly increase blood glucose level. People with type 1 diabetes should always have an emergency supply available in case of hypoglycemia.
If you are diagnosed with type 1 diabetes consider getting a medical alert ID. It will let others know you have diabetes in case you are unable to communicate.

Diet

If you have type 1 diabetes, you should meet often with a registered dietitian. Generally speaking, it is best to:
  • Follow a well-balanced meal plan with a variety of food groups.
  • Eat at regular times each day. Include a bedtime snack in your meal plans. Do not skip meals
  • Avoid highly refined carbohydrates. This includes sugar or high fructose products like soda.

Exercise

Exercise is encouraged as long as blood glucose levels are under control. Follow your doctor's advice on activity levels and changes you may need to make.
You may need to adjust your insulin dose or diet if you are having low glucose levels after exercise.

Blood Sugar Testing

Regular blood glucose checks throughout the day will help you manage your diabetes. Testing is often done with a blood glucose monitor. You can also ask your doctor about continuous monitoring systems that you wear all day.
Keep a record of the results to show your doctor. Your treatment plan may change based on your test results. The HbA1c blood test is also used by your doctor to assess your overall glucose control.

Pancreatic Islet Cell Transplant

This is a procedure that is still being investigated. It involves transplanting islet cells from a donor to a person with type 1 diabetes. After the transplant, these new cells are able to produce insulin. In some cases, people who receive these transplants may no longer need insulin injections.

Closed-Loop Artificial Pancreas

This device is still being studied and developed. It is a continuous glucose monitoring system (CGMS). This system can automatically checks glucose levels through the day. Insulin is then delivered as needed through the day and night. The monitoring system will allow you to keep your blood sugar levels within the normal range without daily testing or injections.

Pancreatic Transplant

A pancreatic transplant may be recommended if you have:
  • Severe kidney disease that requires a kidney transplant
  • Acute diabetic complications or emergencies that can not be prevented by insulin
  • Severe problems due to injecting large amounts of insulin
  • Severe and frequent complications related to diabetes such as severe recurrent hypoglycemia
Follow your doctor's instructions for best results.
Follow your doctor's instructions for best results.
 

RESOURCES

American Diabetes Association
http://www.diabetes.org/

National Diabetes Information Clearinghouse
http://diabetes.niddk.nih.gov/

 

CANADIAN RESOURCES

Canadian Diabetes Association
http://www.diabetes.ca/

Team Diabetes Canada
Canadian Diabetes Association
http://www.diabetes.ca/

 

References


American Association of Clinical Endocrinologists. American College of Endocrinology. Medical guidelines for the clinical practice for the management of diabetes mellitus. Endocrine Pract . 2007;13(suppl 1)3-68.


American Association of Clinical Endocrinologists. American College of Endocrinology. Medical guidelines for the management of diabetes mellitus: the AACE system of intensive diabetes self-management. 2002 update. Endocrine Pract . 2002;8(suppl 1)S40-82.


The DCCT/Epidemiology of Diabetes Interventions and Complications Research Group. Retinopathy and nephropathy in patients with type 2 diabetes four years after a trial of intensive therapy. N Engl J Med . 2000;342:381-389.


Diabetes. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nccdphp/publications/aag/ddt.htm . Updated February 14, 2008. Accessed July 21, 2008.


Diabetes causes. National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/causes/index.aspx . Accessed December 31, 2012.


Diabetes type 1. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated December 28, 2012. Accessed December 31, 2012.


Paviakis M, Khwaja K. Pancrease and islet cell transplantation in diabetes. Curr Opin Endocrinol Diabetes Obes . 2007;14:146-150.


Physical activity/exercise and diabetes. Diabetes Care . 2004;27(suppl 1)S58-62.


Traina AN, Kane MP. Primer on pramlintide, an amylin analog. Diabetes Educ. 2011;37(3):426-431.


Type 1 diabetes. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/type-1/?loc=DropDownDB-type1 . Accessed December 31, 2012.


9/23/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med. 2008 Sep 8. [Epub ahead of print]


3/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Cardwell CR, Stene LC, Joner G, et al. Birthweight and the risk of childhood-onset type 1 diabetes: a meta-analysis of observational studies using individual patient data. Diabetologia. 2010 Jan 10. [Epub ahead of print]


4/1/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Verbeeten KC, Elks CE, Daneman D, Ong KK. Association between childhood obesity and subsequent Type 1 diabetes: a systematic review and meta-analysis. Diabet Med. 2011;28(1):10-18.

 

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