What is type 1 diabetes mellitus?

Type 1 diabetes is a disorder that occurs when your body produces little or no insulin.

Insulin is a hormone made by the pancreas. (The pancreas is a large gland that lies behind the stomach.) When you digest food, your body breaks down much of the food into sugar (glucose). Your blood carries the sugar to the cells of your body. The cells use the sugar for energy. Insulin helps the sugar leave the blood stream and enter the cells which lowers the level of sugar in your blood.

When your body does not make enough insulin, your cells do not absorb enough sugar from your blood. This leads to high blood sugar levels and diabetes. High blood sugar can cause many problems that can be life-threatening if they are not treated. However, with treatment, your blood sugar level can stay close to the normal range.

Type 1 diabetes is used to be called insulin-dependent diabetes. This type of diabetes usually develops in childhood or early adulthood.

How does it occur?

Type 1 diabetes occurs when most of the cells in the pancreas that make insulin have been destroyed. Usually the cause of this type of diabetes is not known. Sometimes diabetes is the result of a viral infection or injury of the pancreas. It may also be an immune system disorder.

What are the symptoms?

Symptoms usually develop suddenly over days to weeks. Symptoms vary widely from person to person. Common symptoms include:

• increased urination
• excessive thirst, dry mouth, and drinking a lot of fluids
• increased appetite (or loss of appetite)
• weight loss
• muscle wasting
• loss of fat
• fruity odor to breath
• tiredness
• dry skin.

If diabetes is not treated, you can become seriously ill.

How is it diagnosed?

With a blood sugar (glucose) test. A fasting blood sugar of more than 126 mg/cl.

How is it treated?

Insulin is the primary treatment for type 1 diabetes. In addition you will learn how to balance the insulin dose with your food and activity.

• Insulin therapy

  You will begin to take insulin as soon as the diagnosis is confirmed. You will also learn to check your blood sugar level at home. Your blood sugar tests give information about how well your insulin dose, meal plan, and activity are balanced.

  High or low blood sugars can be caused by:

  • a change in your work habits or level of activity
  • another medical problem, such as infection
  • a change in eating habits or meal times
  • outdated insulin that has become frozen or overheated (above 80 degrees)
  • a different injection site or improperly given insulin
  • stress
  • other medications.

• Meal Plan

  You can use a meal plan to help keep your blood sugar levels near the normal range. Your insulin dose and timing will be planned to balance with your food.

  Ask your doctor to refer you to a dietitian for help with meal planning and management. A dietitian can help you create a meal plan that has foods you like and fits your lifestyle and insulin.

• Activity

  Exercise lowers blood sugar. Regular exercise and activity can help keep your blood sugar level near the normal range. Talk to your doctor about an activity plan that is safe for you.

• Education

  You make decisions each day that affect your blood sugar and your health. You can attend diabetes classes or talk to your doctor or nurse about how you can learn what you need to know. Check with your doctor, the local American Diabetes Association, hospital, or health department about classes in your area.

How long will it last?

Type 1 diabetes is a lifelong condition.

How can I take care of myself?

Learn all that you can about diabetes. Many hospitals have diabetes educators and dietitians who can help you. Ask your doctor for a referral.

Taking care of yourself can lower your risk for possible complications from diabetes including heart disease, stroke, blindness, and kidney failure. Keeping your blood sugar as close to normal as is safe for you greatly lowers your risk and can delay and possibly prevent these complications.

Guidelines for insulin:

• Take your insulin to balance your food and scheduled activities..
• Learn your symptoms for low blood sugar and carry a some form of sugar at all times, so you can treat low blood sugar quickly.
• Learn when and how to check your blood.
• Learn to use the results of these blood tests to adjust your insulin dosage.

Guidelines for meal plans:

• Time your meals to balance with insulin effects and scheduled activities.
• When you increase your activity, eat more or decrease your insulin dose to prevent low blood sugar.

Guidelines for seeing your doctor:

• Follow your doctor's recommendations for follow-up visits until your blood sugar is in your target range.
• When your blood sugar is in range, see your doctor every 3 to 6 months.
• Ask your doctor for a dilated eye exam every year.

Other guidelines for managing diabetes:

• Ask your doctor or nurse for information on how to manage your diabetes when you are ill, are travelling, or for other special situations.
• Exercise regularly. Exercise helps lower your blood sugar.
• Carry identification (such as a card or bracelet) that says you have diabetes, in case of an emergency.
• Learn how to care for your feet.

Can I help prevent type 1 diabetes?

Type 1 diabetes cannot be prevented. However, your risk for the long-term problems of diabetes can be reduced.

• Keep your blood sugar as close to normal as possible.
• Learn how to test your blood sugar and what the numbers mean.
• Know when and how to adjust your insulin.
• Ask your doctor for help to stop smoking.
• Take care of any medical problems, especially high blood pressure.
• Keep your doctor's appointments.
• Call your doctor if you have any questions or changes in your blood sugar levels.

You can get written information about diabetes from:

The American Diabetes Association
1701 Beauregard
Alexandria, VA 22311

1-800-DIABETES

http://www.diabetes.org

Information provided (reviewed) by Martha Funnell, MS, RN, CDE, Michigan Diabetes Research and Training Center, October, 2002.