Description

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic disease. In this condition, the pancreas produces little or no insulin. Insulin is a hormone that the body uses to allow sugar (glucose) to enter cells to produce energy.

Different factors, including genetics and some viruses, may cause type 1 diabetes. Although type 1 diabetes usually appears during childhood or adolescence, it can develop in adults.

Even after a lot of research, type 1 diabetes has no cure. The treatment is directed towards the management of the amount of blood sugar with insulin, diet and lifestyle to prevent complications.

Symptoms

Type 1 diabetes symptoms can appear suddenly and may include:

  • Feel more thirsty than usual
  • Urinate a lot
  • Bed-wetting in children who have never wet the bed during the night
  • Feeling very hungry
  • Losing weight without trying
  • Feeling irritable or having other mood changes
  • Feeling of tiredness and weakness
  • Have blurred vision

When to see a doctor

Talk with your health care provider if you notice any of the above symptoms in you or your child.

Causes

The exact cause of type 1 diabetes is unknown. Normally, the body's immune system, which normally fights harmful bacteria and viruses — destroys the insulin-producing (islet) cells in the pancreas. Other possible causes include:

  • Genetics
  • Exposure to viruses and other environmental factors

The role of insulin

Once a large number of islet cells are destroyed, the body produces little or no insulin. Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas).

  • The pancreas makes insulin in the bloodstream.
  • The insulin travels through the body, allowing sugar to enter cells.
  • Insulin reduces the amount of sugar in the bloodstream.
  • As the blood sugar level low, the pancreas makes less insulin in the bloodstream.

The role of glucose

Glucose — a sugar — is a major source of energy for the cells that make up muscles and other tissues.

  • Glucose comes from two major sources: food and your liver.
  • The sugar is absorbed into the bloodstream, where it enters cells with the help of insulin.
  • The liver stores glucose in the form of glycogen.
  • When glucose levels are low, such as when you haven't eaten in a while, the liver breaks down the stored glycogen into glucose. This keeps blood glucose levels within a normal range.

In type 1 diabetes there is no insulin to allow the glucose to the cells. Because of this, the sugar builds up in the bloodstream. This can cause life-threatening complications.

Risk factors

Some of the factors that may increase your risk for type 1 diabetes include:

  • The history of the family. Any person with a parent or sibling with type 1 diabetes has a slightly increased risk of developing the disease.
  • Genetics. Having certain genes increases the risk of developing type 1 diabetes.
  • Geography. The number of people who have type 1 diabetes tends to be higher as you move away from the equator.
  • Age. Type 1 diabetes can appear at any age, but appears in two notable peaks. The first peak occurs in children between the ages of 4 and 7 years of age. The second is in children between the ages of 10 and 14 years of age.

Complications

Over time, the type 1 of the complications of diabetes can affect major organs of the body. These organs include the heart, blood vessels, nerves, eyes and kidneys. With a normal level of sugar in the blood can reduce the risk of many complications.

The complications of Diabetes can lead to disability or even threaten your life.

  • Heart and blood vessels. Diabetes increases the risk of some problems with the heart and the blood vessels. These include coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of the arteries (atherosclerosis) and high blood pressure.
  • Damage to the nerves (neuropathy).The excess sugar in the blood can damage the walls of the small blood vessels (capillaries) that nourish the nerves. This is especially true in the legs. This can cause tingling, numbness, burning or pain. This usually begins at the tips of the toes or fingers and spreads upward. Poorly controlled blood sugar can cause you to lose all sense of feeling in the affected limbs over time. Damage to the nerves that affect the digestive system can cause problems with nausea, vomiting, diarrhea, or constipation. For men, erectile dysfunction can be a problem.
  • Kidney damage (nephropathy). The kidneys have millions of tiny blood vessels that keep debris from entering the blood. Diabetes can damage this system. Severe damage can lead to kidney failure or end-stage renal disease that can not be reversed. In the final stage of kidney disease should be treated with the mechanical filtration of the kidneys (dialysis) or a kidney transplant.
  • Damage to the eyes. Diabetes can damage the blood vessels in the retina (the part of the eye that senses light) (diabetic retinopathy). This could cause blindness. Diabetes 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 some complications in the feet. Left untreated, cuts and blisters can become serious infections. These infections may need to be treated with the toe, foot or leg removal (amputation).
  • Skin and mouth conditions. Diabetes may leave you more prone to infections of the skin and the mouth. These include bacterial and fungal infections. Gum disease and dry mouth were also more likely.
  • Complications in pregnancy. High levels of sugar in the blood can be dangerous for both the parent and the baby. The risk of spontaneous abortion, fetal death and birth defects increases when the diabetes is not well controlled. For the parents, diabetes increases the risk of diabetic ketoacidosis, diabetic retinopathy, eye problems (retinopathy), pregnancy-induced high blood pressure and preeclampsia.

Damage to the nerves (neuropathy). The excess sugar in the blood can damage the walls of the small blood vessels (capillaries) that nourish the nerves. This is especially true in the legs. This can cause tingling, numbness, burning or pain. This usually begins at the tips of the toes or fingers and spreads upward. Poorly controlled blood sugar can cause you to lose all sense of feeling in the affected limbs over time.

Damage to the nerves that affect the digestive system can cause problems with nausea, vomiting, diarrhea, or constipation. For men, erectile dysfunction can be a problem.

Prevention

There is no known way to prevent type 1 diabetes. But researchers are working on the prevention of disease or damage of islet cells in people who are newly diagnosed.

Ask your doctor if you may be eligible for one of these clinical trials. It is important to carefully weigh the risks and benefits of any treatment in a trial.

Diagnosis

Diagnostic tests include:

  • The glycosylated hemoglobin (A1C) test. This blood test shows the average blood sugar level over the past 2 to 3 months. Measures the amount of sugar in the blood is attached to the oxygen-carrying protein in the red blood cells (hemoglobin). The higher the levels of sugar in the blood, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests means you have diabetes.

If the A1C test isn't available, or if you have certain conditions that can make the A1C test inaccurate-such as pregnancy or an uncommon form of hemoglobin (hemoglobin variant) — your provider may use the following tests:

  • Random blood sugar. A blood sample will be taken at a random time and can be confirmed by additional tests. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). No matter when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes.
  • The fasting blood sugar test. A blood sample will be taken after that you don't eat (fast) of the night to the morning. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is healthy. A level of blood sugar fasting glucose of 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.

If you are diagnosed with diabetes, your doctor may also run blood tests. These will check for autoantibodies that are common in type 1 diabetes. The tests help your provider decide between type 1 and type 2 diabetes when the diagnosis is not certain. The presence of ketones — byproducts of the breakdown of fat in the urine also suggests that the type 1 diabetes, rather than type 2.

After the diagnosis

You are going to regularly visit your doctor to discuss the management of your diabetes. During these visits, your doctor will monitor your A1C levels. Your target A1C goal may vary depending on your age and other factors. The American Diabetes Association recommends that A1C levels be below 7%, or an average glucose level of about 154 mg/dL (8.5 mmol/L).

The A1C test shows how the diabetes treatment plan is working better than daily blood sugar tests. A high level of A1C may mean that you need to change the amount of insulin, meal plan, or both.

Your provider will also take blood and urine samples. Going to use these examples to verify the levels of cholesterol, as well as the thyroid, liver and kidney function. Your doctor will also take your blood pressure and sites where you test your blood sugar and the supply of insulin.

Treatment

The treatment for type 1 diabetes includes:

  • Taking insulin
  • Count of carbohydrates, fats and proteins
  • Monitoring of blood sugar often
  • Eat healthy foods
  • Exercise regularly and maintain a healthy weight

The objective is to maintain the blood sugar level as close to normal as possible to delay or prevent complications. In general, the goal is to keep levels of blood sugar before meals, between 80 and 130 mg/dL (4.44 7,2 mmol/L). After the meal, the numbers should be no higher than 180 mg/dL (10 mmol/L) two hours after eating.

Insulin and other medications

Any person who has type 1 diabetes needs insulin therapy throughout his life.

There are many types of insulin, including:

  • The short-acting insulin. It is sometimes called the regular insulin, this type starts to work about 30 minutes after the injection. It achieves the maximum effect in 90 to 120 minutes and lasts for about 4 to 6 hours. Examples are Humulin R, Novolin R, and Afrezza.
  • Rapid-acting insulin. This type of insulin starts to work within 15 minutes. You are reaching the maximum effect at 60 minutes and lasts about 4 hours. This type is often used for 15 to 20 minutes before meals. Examples are glulisine (Apidra), lispro (Humalog, Admelog, and Lyumjev) and aspart (Novolog and FiAsp).
  • Intermediate-acting insulin. Also called the NPH insulin, this insulin starts to work in about 1 to 3 hours. You are reaching the maximum effect at 6 to 8 hours and lasts 12 to 24 hours. Examples are insulin NPH (Novolin N, Humulin N).
  • Long and ultra-long-acting insulin. This type of insulin can provide coverage for as long as 14 to 40 hours. Examples are glargine (Lantus, Toujeo Solostar, Basaglar), detemir (Levemir) and degludec (Tresiba).

It is likely that you have several daily injections that include a combination of a long acting insulin and a rapid-acting insulin. These injections act more like the body's normal use of insulin regimens insulin that it only requires one or two shots a day. A combination of three or more injections of insulin a day has been shown to improve blood sugar levels.

The insulin delivery options

Insulin cannot be taken by mouth to reduce the sugar in the blood due to which the stomach enzymes break down insulin, avoiding work. You will need to receive vaccinations (shots), or use an insulin pump.

  • Injections.You can use a fine needle and syringe or an insulin pen to inject insulin under the skin. Feathers of insulin-like feathers of ink and are available in disposable or rechargeable varieties. If you choose to vaccinations (shots), it is likely that you will need a mixture of insulin types to use throughout the day and night.
  • An insulin pump.This is a small device worn on the outside of your body that you program to deliver specific amounts of insulin throughout the day and when you eat. A tube that is connected to a reservoir of insulin to a catheter that's inserted under the skin of your abdomen. There is also a tubeless pump option that involves the use of a sheath that contains the insulin in your body combined with a small catheter that is inserted under the skin.

Injections. You can use a fine needle and syringe or an insulin pen to inject insulin under the skin. Feathers of insulin-like feathers of ink and are available in disposable or rechargeable varieties.

If you choose to vaccinations (shots), it is likely that you will need a mixture of insulin types to use throughout the day and night.

An insulin pump. This is a small device worn on the outside of your body that you program to deliver specific amounts of insulin throughout the day and when you eat. A tube that is connected to a reservoir of insulin to a catheter that's inserted under the skin of your abdomen.

There is also a tubeless pump option that involves the use of a sheath that contains the insulin in your body combined with a small catheter that is inserted under the skin.

Glucose monitoring

Depending on the type of insulin therapy that you select or need, you have to check and record your blood sugar level at least four times a day.

The American Diabetes Association recommends that testing blood sugar levels before meals, before bed, before exercising or driving, and when you think that you have a low level of sugar in the blood. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. More frequent monitoring may reduce A1C levels.

Even if you take insulin and eat on a strict schedule, blood sugar levels can change. You'll learn how your blood sugar level changes in response to food, activity, illness, medications, stress, hormonal changes, and alcohol.

Continuous glucose monitoring

Continuous glucose monitoring (CGM) monitors the levels of sugar in the blood. It can be especially useful for the prevention of low blood sugar. These devices have been shown to reduce A1C .

Continuous glucose monitors are joined to the body with a fine needle under the skin. Check blood glucose levels every few minutes.

Closed loop system

A closed loop system is a device that is implanted in the body that links a continuous glucose monitor to an insulin pump. The monitor checks your blood sugar levels regularly. The device automatically provides the correct amount of insulin when the monitor shows that it is necessary.

The Food and Drug Administration has approved several hybrid closed loop systems for type 1 diabetes. Are the so-called "hybrid", because these systems require the user to enter something. For example, you may need to tell the device how many carbohydrates are eaten, or to confirm the levels of blood sugar once in a while.

A closed loop system that does not need any user input is not available yet. But most of these systems are currently in clinical trials.

Other medications

Other medications may also be prescribed for people with type 1 diabetes, such as:

  • High blood pressure medications. Your doctor may prescribe angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (arbs) to help keep the kidneys healthy. These medications are recommended for people with diabetes who have blood pressure over 140/90 millimeters of mercury (mm of Hg).
  • The aspirin. Your healthcare provider may recommend that you take the baby or regular aspirin every day to protect your heart. Your doctor may think that you have a higher risk of a cardiovascular event. Your doctor will explain the risk of bleeding if you take aspirin.
  • Medications to reduce cholesterol.The cholesterol guidelines stricter for people with diabetes, because of their increased risk of heart disease. The American Diabetes Association recommends that the low-density lipoprotein (LDL or "bad") cholesterol less than 100 mg/dL (2.6 mmol/L). The high-density lipoprotein (HDL or "good cholesterol") are recommended more than 50 mg/dL (1.3 mmol/L) in women and greater than 40 mg/dL (1 mmol/L) in men. Triglycerides, another type of fat in the blood, should be less than 150 mg/dL (1.7 mmol/L).

Medications to reduce cholesterol. The cholesterol guidelines stricter for people with diabetes, because of their increased risk of heart disease.

The American Diabetes Association recommends that the low-density lipoprotein (LDL or "bad") cholesterol less than 100 mg/dL (2.6 mmol/L). The high-density lipoprotein (HDL or "good cholesterol") are recommended more than 50 mg/dL (1.3 mmol/L) in women and greater than 40 mg/dL (1 mmol/L) in men. Triglycerides, another type of fat in the blood, should be less than 150 mg/dL (1.7 mmol/L).

Eating healthy and monitoring of carbohydrates

There is No such thing as a diabetes diet. However, it is important that the center of their diet with nutritious foods, low-fat, fiber-rich foods, such as:

  • Fruits
  • Vegetables
  • Whole grains

Your dietitian will recommend that you eat fewer animal products and refined carbohydrates, like white bread and sweets. This healthy eating plan is recommended even for people without diabetes.

You will have to learn how to count the amount of carbohydrates in the food that you eat. By doing so, you can give yourself enough insulin. This will allow your body to properly use the carbohydrates. A registered dietitian can help you create a meal plan that fits your needs.

Physical activity

Everyone needs regular aerobic exercise, including the people who have type 1 diabetes. In the first place, to get your provider to ACCEPT for the exercise. Then choose activities you enjoy, such as walking or swimming, and do every day when you can. Try to at least 150 minutes of moderate aerobic exercise a week, with no more than two days without any type of exercise.

Remember that physical activity reduced the sugar in the blood. If you begin a new activity, check your blood sugar more often than usual until you know that the activity affects your blood sugar levels. You may need to adjust your meal plan or the dose of insulin due to the increased activity.

Activities of interest

Certain activities of life can be a cause of concern for the people who have type 1 diabetes.

  • Driving. Low blood sugar can occur at any time. It is a good idea to check your blood sugar at any time in which we get behind the wheel. If it is below 70 mg/dL (3.9 mmol/L), have a snack with 15 grams of carbohydrates. Re-test again in 15 minutes to ensure that it has risen to a safe level before start driving.
  • Of work. Type 1 diabetes can pose some challenges in the workplace. For example, if you work in a job that involves driving or operating heavy machinery, low blood sugar could result in a serious risk to you and those around you. You may have to work with your provider and your employer to ensure that some adjustments are made. You may need additional breaks for blood sugar testing, and fast access to the food and drink. There are federal and state laws require employers to provide these settings for people with diabetes.
  • The fact of being pregnant.The risk of complications during pregnancy is higher in people with type 1 diabetes. Experts recommend that you consult with your doctor before you become pregnant.A1Creadings must be less than 6.5% before trying to get pregnant. The risk of diseases present at birth (congenital disease) is higher in people with type 1 diabetes. The risk is greater when the diabetes is poorly controlled for the first 6 to 8 weeks of pregnancy. Careful with the management of your diabetes during pregnancy can reduce the risk of complications.
  • Older or have other conditions. For those who are sick or weak, or have difficulty thinking clearly, the strict control of blood sugar may not be practical. It may also increase the risk of low levels of sugar in the blood. For many people with type 1 diabetes, a less stringent A1C goal of less than 8% may be appropriate.

The fact of being pregnant. The risk of complications during pregnancy is higher in people with type 1 diabetes. Experts recommend that you consult with your doctor before you become pregnant. The A1C test should be less than 6.5% before trying to get pregnant.

The risk of diseases present at birth (congenital disease) is higher in people with type 1 diabetes. The risk is greater when the diabetes is poorly controlled for the first 6 to 8 weeks of pregnancy. Careful with the management of your diabetes during pregnancy can reduce the risk of complications.

Potential future treatments

  • The pancreas transplant. With a successful pancreas transplant, you no longer need insulin. But pancreas transplants-not always with success — and the procedure poses serious risks. Because of these risks can be more dangerous than the own diabetes, pancreas transplants are usually used for those that are very difficult to control the diabetes. They can also be used for people who also need a kidney transplant.
  • The transplantation of islet cells. Researchers are experimenting with the transplantation of islet cells. This provides new insulin-producing cells from a donor pancreas. This experimental procedure had some problems in the past. But the new techniques and better drugs to prevent the cells of the islets of rejection, you can improve your chances of becoming a success in the treatment.

Signs of problems

Despite their best efforts, sometimes, the problems that is going to happen. Certain short-term complications of type 1 diabetes, such as low sugar in the blood, in need of immediate attention.

Low blood sugar (hypoglycemia)

Hypoglycemia diabetic occurs when a person with diabetes does not have enough sugar (glucose) in the blood. Ask your provider what is considered a low sugar level in blood for you. Blood sugar levels can drop for many reasons, such as to skip a meal, eat less carbs ringing in your meal plan, do more physical exercise than normal, or inject too much insulin.

Learn about the symptoms of hypoglycemia. Test your blood sugar if you think that your levels are low. In case of doubt, always test your blood sugar. The first symptoms of low blood sugar include:

  • Paleness of the skin (pallor)
  • Tremors
  • Dizziness or lightheadedness
  • Sweating
  • Hunger or nausea
  • An irregular or fast heartbeat
  • Difficulty concentrating
  • Feeling of weakness and lack of energy (fatigue)
  • Irritability or anxiety
  • Headache
  • Tingling or numbness of the lips, tongue, or cheek

Nighttime hypoglycemia can cause you to wake up with the sweat-soaked pajamas or a headache. Nocturnal hypoglycaemia can sometimes cause an unusually high blood sugar reading first thing in the morning.

If the hypoglycemia diabetic untreated, the symptoms of hypoglycemia worsen and may include:

  • Confusion, unusual behavior, or both, such as the inability to complete routine tasks
  • Loss of coordination
  • Difficulty speaking or slurred speech
  • Blurred or tunnel vision
  • Inability to eat or drink
  • Muscle weakness
  • Drowsiness

Severe hypoglycemia can cause:

  • Convulsions or seizures
  • Unconsciousness
  • Death, rarely

You can increase your blood sugar quickly by eating or drinking a simple source of sugar, such as glucose tablets, hard candy or fruit juice. Tell your family and friends what symptoms to look for and what to do if you are not able to treat the condition yourself.

If a blood glucose meter is not readily available, the treatment for low blood sugar, anyway if you have symptoms of hypoglycemia, and after the test as soon as possible.

Let the people you trust about hypoglycemia. If others know what symptoms to look for, you may be able to alert you to the first symptoms. It is important that family members and close friends know where it is saved glucagon, and how to give to a potentially serious situation can be more easily managed in a secure way. Glucagon is a hormone that stimulates the release of sugar in the blood.

Here's a little bit of emergency information to give to others. If you're with someone that is not responding (lose consciousness) or is unable to swallow due to the low blood sugar:

  • Do not self-inject insulin, as this will cause blood sugar levels to fall even more
  • Do not give liquids or foods, as these may cause choking
  • Give glucagon by injection or nasal spray
  • Call 911 or emergency services in your area for the immediate treatment if glucagon is not in the hand, you don't know how to use it, or the person is not responding

Hypoglycemia unawareness

Some people can lose the ability to feel their blood sugar levels are low. This is called hypoglycemia unawareness. The body no longer reacts to a low level of sugar in the blood with symptoms such as dizziness or headaches. The lower of blood sugar, the more likely you are to develop hypoglycemia unawareness.

If you can avoid having an episode of hypoglycemia during several weeks, you can start to become more aware of reach to minimum. Sometimes the increase of sugar in the blood to target (for example, 80 to 120 mg/DL 100 to 140 mg/DL) at least for a short time can also help to improve low sugar in the blood of consciousness.

High blood sugar (hyperglycemia)

Blood sugar can rise for many reasons. For example, it may increase due to overeat, eat the wrong types of foods, not taking enough insulin or the fight against a disease.

Observe:

  • Frequent need to urinate
  • Increased thirst
  • Blurred vision
  • Fatigue
  • Headache
  • Irritability

If you think you have high blood sugar, check your blood sugar. If it is higher than the target range, it is likely that you will need to manage a "correction". A correction is an additional dose of insulin administered to bring your blood sugar back to normal. High levels of blood sugar does not come down as quickly as it rises. Ask your doctor how long you should wait until you are back to review. If you use an insulin pump, a random high blood sugar readings may mean that you need to change the place where you put the bomb in his body.

If you have a blood sugar reading above 240 mg/dL (13.3 mmol/L), a test for blood ketones using a urine test stick. Do not exercise if your blood sugar is over 240 mg/dL or if there is a presence of ketones. If only a trace or small amounts of ketones are present, drinking more noncalorie liquid to remove the ketones.

If your blood sugar is persistently above 300 mg/dL (16.7 mmol/L), or if your level of ketones in urine remains high, despite taking the correction of the insulin dose, call your healthcare provider or seek emergency care.

Increase the presence of ketones in the urine (diabetic ketoacidosis)

If your cells are deprived of energy, the body may start to break down the fat. This produces toxic acids known as ketones. Diabetic ketoacidosis is a life-threatening emergency.

The symptoms of this serious disease, which include:

  • Nausea
  • Vomiting
  • Abdominal Pain
  • A sweet, fruity smell on the breath
  • Shortness of breath
  • Dry mouth
  • Weakness
  • The confusion
  • Comma

If you suspect ketoacidosis, check the urine for excess ketones with an over-the-counter ketones test kit. If you have large amounts of ketones in your urine, call your doctor immediately or seek emergency care. Also, call your doctor if you have vomited more than once, and you have ketones in the urine.

Lifestyle and home remedies

Careful management of type 1 diabetes can reduce your risk of serious — even fatal — complications. Keep these tips in mind:

  • Make a commitment to managing your diabetes. Take your medications as recommended. Learn all you can about type 1 diabetes. Make healthy eating and physical activity part of your daily routine. Establishing a relationship with a diabetes educator. Ask your health care team for help.
  • Identify. Wear a tag or bracelet that says you are living with diabetes. Keep a kit of glucagon nearby in case of a low blood sugar emergency. Make sure your friends and loved ones know how to use the kit.
  • Schedule a yearly physical and regular eye exams. Your regular diabetes checkups aren't meant to replace yearly medical examinations or routine eye exams. During the physical, your doctor will look for any diabetes-related complications. Your healthcare provider will also look for other medical problems. Your eye doctor will check for signs of eye complications, such as damage to the retina, cataracts, and glaucoma.
  • Keep your vaccinations up to date.High blood sugar can weaken the immune system. Get vaccinated against the flu every year. Your healthcare provider will probably recommend the pneumonia vaccine, as well. They can also recommend getting the COVID-19 vaccine. The Centers for Disease Control and Prevention (CDC) recommends vaccination against hepatitis B if you have not had before and you are an adult between the ages of 19 and 59 years of age with type 1 diabetes or type 2 diabetes. TheCDCrecommends of vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older and have diabetes and have not received the vaccine, talk with your doctor about if it is right for you.
  • Pay attention to your feet. Wash your feet daily with warm water. Dry carefully, especially between the toes of the feet. Moisturize your feet with lotion. Check your feet every day for blisters, cuts, blisters, redness, or swelling. Consult your doctor if you have pain or other foot problem that does not heal.
  • Keep your blood pressure and cholesterol under control. Eating healthy foods and exercising regularly can help to control high blood pressure and cholesterol. The medication may also be necessary.
  • If you smoke or use other forms of tobacco, ask your doctor for help to quit smoking. Smoking increases your risk of diabetes complications. These include heart attack, stroke, nerve damage and kidney disease. Talk with your doctor about how to stop smoking or to stop using other types of tobacco.
  • If you drink alcohol, do so responsibly. Alcohol can cause either high or low sugar in the blood. Depends on how much you drink and if you eat at the same time. If you choose to drink, do so in moderation and always with a meal. Check your blood sugar levels before going to sleep.
  • Take stress seriously. The hormones that the body produces when it is under long-term stress may prevent insulin to work properly. This can stress and frustrate you even more. Take a step back and set some boundaries. Prioritize your tasks. Learn ways to relax. Get enough sleep.

Keep your vaccinations up to date. High blood sugar can weaken the immune system. Get vaccinated against the flu every year. Your healthcare provider will probably recommend the pneumonia vaccine, as well. They can also recommend getting the COVID-19 vaccine.

The Centers for Disease Control and Prevention (CDC) recommends vaccination against hepatitis B if you have not had before and you are an adult between the ages of 19 and 59 years of age with type 1 diabetes or type 2 diabetes. The CDC recommends vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older and have diabetes and have not received the vaccine, talk with your doctor about if it is right for you.

Coping and support

Diabetes can affect the emotions, both directly and indirectly. The poor control of blood sugar can affect directly to the emotions causing changes in behavior, such as irritability. There may be times when you resent your diabetes.

People living with diabetes have a higher risk of depression and diabetes-related distress. Many diabetes specialists regularly include a social worker or a psychologist as part of your diabetes care team.

You may find it helpful to talk with other people with type 1 diabetes. Online and in-person support groups are available. Group members often know about the latest treatments. They can also share their own experiences or useful information. For example, you can share where to find carbohydrate counts for your favorite takeout restaurant.

If you are interested in a support group, your healthcare provider may be able to recommend one in your area. Or you can visit the web sites of the American Diabetes Association (ADA) or the Juvenile Diabetes Research Foundation (JDRF). These sites to the list of information about local support groups and activities for people with type 1 diabetes. You can also reach the ADA 800-DIABETES ( 800-342-2383 ) or JDRF in 800-533-CURE ( 800-533-2873 ).

Preparing for your appointment

If you think that you or your child has type 1 diabetes, consult your dealer immediately. A simple blood test can show if you need more evaluation and treatment.

After diagnosis, you will need close medical follow-up until your blood sugar is stable. A provider who specializes in hormonal disorders (endocrinologist) usually works with other specialists in the care of diabetes. Your health care team will probably include:

  • Certified diabetes educator
  • Registered dietitian
  • Social worker or mental health professional
  • Pharmacist
  • Dentist
  • Certified diabetes educator
  • A doctor who specializes in the care of the eyes (eye doctor)
  • A doctor who specializes in the health of the feet (podiatrist)

Once you have learned how to manage type 1 diabetes, your doctor will likely recommend tests every few months. A thorough annual examination and regular foot and eye exams also are important. This is especially true if you're having a difficult time managing your diabetes, if you have high blood pressure or kidney disease, or if you are pregnant.

These tips can help you prepare for your appointment. It can also let you know what to expect from your doctor.

What you can do

  • Write down any questions you may have. Once you start treatment with insulin, the early symptoms of diabetes should go away. However, you may have new problems that need to be addressed. These include having low blood sugar that happens often, or finding ways to control high blood sugar after eating certain foods.
  • Write down key personal information, including any of the main sources of stress or recent changes in your life. Many factors can affect the control of diabetes, including the stress.
  • Make a list of all the medicines, vitamins, and supplements you are taking.
  • For their regular checkups, keep records of your blood glucose levels or from your meter to your appointments.
  • Write questions to ask their provider.

Prepare a list of questions can help you make the most of your time with your service provider, and the rest of your health care team. Things that you want to discuss with your doctor, dietitian, or diabetes educator include:

  • When and how often you should monitor your blood glucose
  • The therapy of insulin — types of insulin, the time of dosing, dosage amount
  • The administration of insulin — shooting in front of a pump
  • Low blood sugar — how to recognize and treat
  • High blood sugar — how to recognize and treat
  • Ketone — testing and treatment
  • Nutrition — types of food and its effect on the blood sugar
  • Carbohydrate counting
  • Exercise — the adjustment of the insulin and food intake for the activity
  • Medical management — how often to visit your service provider, and other members of the care team diabetes
  • Sick day management

What to expect from your doctor

Your healthcare provider will probably ask a lot of questions, including:

  • How comfortable you are managing your diabetes?
  • How frequent are your low blood sugar episodes?
  • Do you know when your blood sugar is low?
  • What is a typical day in the diet?
  • Are you exercising? If so, how often?
  • On average, the amount of insulin you are using daily?

What you can do in the meantime

If you are having trouble controlling your blood sugar or have questions, please contact with your team of health care in between appointments.

Symptoms and treatment of Type 1 diabetes