Thank you to Jessica from www.ViveHealth.com for our article about type one diabetes. Many individuals (including nurses) don't know the difference between type one and type two diabetes. Most of the adult patients we come across are managing type two diabetes. So what makes type one diabetes different?
Type I Diabetes
Also known as juvenile diabetes, Type I Diabetes is an autoimmune disease that affects both children and adults alike. Roughly 1.25M people in the U.S. (200,000 kids under 20 years of age and over 1,000,000 adults over 20) currently live with and manage the chronic condition according to the Juvenile Diabetes Research Foundation.
Causes of Type I Diabetes
Type I Diabetes occurs when the body’s pancreas doesn’t produce enough insulin (or in some cases, no insulin at all). Different from Type 2 Diabetes where the body develops a chronic resistance to insulin overtime or simply becomes unable to produce enough insulin to keep up with sugar levels in the blood, Type I Diabetes is a currently incurable autoimmune response caused by genetics or in some case, a virus.
Insulin is a critical hormone produced by the pancreas, the large gland that sits behind the stomach, that aids cells in converting glucose into energy. Plainly put, when you eat a meal or drink a beverage, the carbohydrates are broken up in your body and the sugar (glucose) is released into the bloodstream. Beta cells in your pancreas than secrete insulin which attaches to cells in your bloodstream and cues them to absorb the glucose for energy.
Insulin regulates blood sugar levels further by making sure that excess glucose is stored in the liver for later use when more energy is required, i.e. with physical activity. The more your blood sugar levels rise, the more insulin your pancreas produces.
In addition to genetics, other known risk factors for Type I Diabetes include having a family history of it, where you live (cases of Type I Diabetes grow the further you get away from the equator), and age. Most diagnoses of Type I Diabetes are made in kids between the ages of 4 and 7 and then between the ages of 10 and 14.
Symptoms of High Blood Sugar
Patients with Type I Diabetes unfortunately have damaged or destroyed beta cells, thus limiting the ability for their pancreas to produce insulin. Without treatment and insulin regulation, blood sugar levels can skyrocket. This is referred to as hyperglycemia and can result in:
Wetting the bed (for children without a bedwetting history)
Unintended weight loss
Heavy or labored breathing
Fruity odor on breath
Sugar in urine
Recurring high blood sugar levels (over 180mg/dL) can lead to buildup of acids in the bloodstream (ketoacidosis), as well as organ failure, damage to blood vessels and nerves, infections, intestinal problems, vision loss, and other serious conditions.
Diagnosis of Type I Diabetes
When evaluating a patient for Type I Diabetes, a series of tests will help medical providers formulate a diagnosis. An A1C (glycated hemoglobin) test looks at the oxygen-carrying protein in your red blood cells (hemoglobin) and what percentage of it has sugar attached to it. This diagnostic test paints a picture of your average blood sugar levels over the past two to three months. A1C levels over 6.5% on at least 2 separate tests can help doctors diagnose diabetes.
Blood sugar tests, where you prick a clean finger and fill a strip inserted into a monitor with a drop of blood, can also equip healthcare providers with data to make an informed diagnosis. A ‘random’ blood sugar test can be taken at any time whether a patient has eaten or not, while a ‘fasting’ blood sugar test is taken the morning after an overnight fast.
Blood sugar levels are measured as milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Chronically high readings of a blood sugar over 200mg/dL, or a fasting blood sugar over 126mg/dL on at least two separate tests, indicates diabetes, especially when coupled with some of the symptoms listed above.
Treatment of Type I Diabetes
As the pancreas does not properly induce insulin production in a patient with Type I Diabetes, synthetic insulin is needed to be able to help cells get the energy they need and prevent sugar from building up in the bloodstream. A handful of different types of insulin are utilized by diabetes patients depending on their diet and activity levels.
Long-acting insulin begins to work several hours post-injection, and lasts for up to 24 hours
Intermediate-acting insulin begins to work 2 to 4 hours post-injection, and continues to work for 12 to 18 hours
Short-acting insulin begins to work roughly 30 minutes post-injection, and continues working for 3 to 6 hours
Rapid-acting insulin takes effect within 15 minutes and works for about 2 to four hours
Short and rapid-acting insulin are typically taken before meals in combination with longer acting insulin dosages during the day to help regulate blood sugar levels specifically when food is being converted into glucose in the body. Insulin is administered via syringe injection, injection pen, or an insulin pump (which provides a continuous stream of insulin throughout the day).
Patients with Type I Diabetes are vigilant monitors of their condition, consistently checking their blood sugar levels throughout the day, managing insulin injections, watching diet and counting carbs, and being extra aware of symptoms of high and low blood sugars. There is no cure for Type I Diabetes, and even continuous stellar care might not stave off some of the effects of the disease including blood pressure and heart problems, kidney failure, loss of vision, diabetic neuropathy, and more.
The good news is that advancements in medical technology, and more and more research into the causes of Type I Diabetes, are paving a bright future for patients managing the disease and looking for a cure.
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Jessica Hegg is the content manager at ViveHealth.com. Avid gym-rat and nutrition enthusiast, she’s interested in all things related to staying active and living healthy lifestyle. Through her writing she works to share valuable information aimed at overcoming obstacles and improving the quality of life for others.