Diabetes type I

Type 1 diabetes was formerly called "juvenile onset diabetes" or insulin dependent diabetes. Type 1 diabetes can occur at any age, but is most common in children and adults less than 30 years old. Until recently, when children had diabetes, it was type 1. But type 2 has become more common in recent years with the increase of obesity in adolescents.

Normally, the food we eat is broken down into sugar or glucose. The blood carries the sugar to the cells for energy. The pancreas gland makes insulin, which helps move the sugar from the bloodstream into the cells. When the body does not make enough insulin, sugar builds up in the blood. This build up of sugar and lack of insulin is known as Type 1 diabetes.

The disease process for type 1 can take years to develop. Yet, the symptoms may develop very quickly, sometimes within days. Blood sugar levels may be very high before diabetic symptoms occur or diabetes is diagnosed. High blood sugar is called hyperglycemia. Some of the symptoms are:

• increased thirst and hunger
• frequent or increased urination
• fatigue or weakness
• blurry vision or
• unplanned weight loss

If hyperglycemia (high blood sugar) is not treated, diabetic ketoacidosis can occur. This condition is also known as DKA or diabetic coma. It is an acute, major, life-threatening complication that usually occurs in people with type 1 diabetes. Ketoacidosis is a result of having very high levels of ketones in the blood. These are acids that are present in urine when the body does not have enough insulin. They are a warning sign that your diabetes is out of control.

A person with diabetes will usually seek treatment for some of the symptoms of hyperglycemia before ketoacidosis happens. If not, treatment is needed immediately because ketoacidosis is an emergency. If any of the following occur, call your healthcare provider immediately or have someone take you to the nearest emergency department:

• shortness of breath (slow, deep breathing with a fruity odor to the breath is a key sign since this characteristic odor is caused by ketones)
• ketones in the urine (urine checks are useful in determining the level of acidosis)
• dry or flushed skin
• nausea, vomiting, or abdominal pain, especially vomiting more than twice in 4 hours with high ketones in the urine and
• confusion with eventual loss of consciousness

Treatment is usually done in a hospital. It may require the administration of IV fluids, insulin, glucose, and changes in diet.

Diabetes is a lifelong disease. It must be continually controlled to delay or prevent problems. Some of the problems caused by diabetes are:

• heart and kidney disease
• blindness
• nerve damage leading to amputations
• high blood pressure
• stroke and
• blood flow problems and poor wound healing

It is very important for people with diabetes to work with their provider to keep their diabetes under control. The long-term effects of uncontrolled diabetes are permanent and may be disabling. Type 1 diabetes is always treated with insulin. But diet and exercise are also important parts of keeping the blood sugar level in a normal range.

The provider will recommend a diet. At times, a registered dietician will be asked to help work out a specific meal-planning guide. The major goal of diabetes treatment is to bring the blood sugar levels as close to normal as possible. This helps the person with diabetes feel better. It also helps prevent or delay the start of diabetes complications. Blood sugar testing is an important part of the control of diabetes. Often people with diabetes need to test their blood 4 times a day or more. Usually blood sugar is tested before meals and at bedtime. There are many different types of machines that can be used to test blood at home. When ill, the blood sugar needs to be tested more often. The provider will recommend how often blood sugar should be checked. Sometimes it is necessary to check the urine for ketones.

Blood glucose monitoring keeps track of blood sugar results each day. But there is another blood test that should also be used. It is called the glycated hemoglobin test or you may also hear it called A1C or HbA1C. This blood test is drawn in the provider's office. The A1C gives the average blood sugar control for the past 2 to 3 months. It helps you know how well your treatment plan is working. The American Diabetes Association recommends keeping the A1C below 7 percent.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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