Dr. M.J. Bazos, MD
Patient Handout
TYPE I
DIABETES
About Your
Diagnosis
Type I diabetes is a disease of the
insulin-producing cells of the pancreas that results in the inability of the
body to metabolize nutrients normally. Type I diabetes is caused by a lack of
insulin. Insulin is a hormone produced by special cells in the pancreas called
beta cells. In most individuals with type I diabetes, beta cells are destroyed
by the body’s own natural defense system, the immune system. Researchers
do not know what causes the body to attack its own beta cells. Without insulin,
the body is unable to normally use carbohydrates from the diet for energy. The
result is a buildup of sugars in the bloodstream called glucose. Type I iabetes
may develop in other patients as a result of certain diseases, such as cystic
fibrosis or hemochromatosis Type I diabetes may also result from surgical
removal of the pancreas or severe inflammation of the pancreas. Type I diabetes
is slightly more common in men than women and has a peak age of onset at
12–15 years. Most cases are diagnosed before 30 years of age. It is more
common in Caucasians of European descent than in other ethnic groups. There are
currently more than 300,000 individuals in the United States with type I
diabetes. There currently is no cure for diabetes, except under special
circumstances, in which patients receive a pancreas transplant operation. It is
generally reserved for only those few patients with
advanced
kidney disease, who are receiving
a simultaneous kidney
transplant.
Living With Your
Diagnosis
Symptoms of type I diabetes
include frequent urination (especially at night), excessive thirst, increased
hunger, rapid weight loss, and extreme fatigue. Blurry vision, slow-healing
sores in the skin, or numbness in the hands or feet may develop. Type I diabetes
may lead to decreased vision and blindness. Kidney failure requiring dialysis
may occur. Nerve damage may also occur. These complications generally happen
after many years of type I diabetes, especially if poorly controlled. Patients
with type I diabetes are also at increased risk of coronary heart disease and
peripheral vascular
disease.
Treatment
The
best treatment for type I diabetes involves a team approach of medical
professionals who specialize in the care of diabetes, including a registered
dietician, a certified diabetes educator, and a physician. The dietician will
establish a meal plan with predictable quantities of carbohydrates and calories
eaten at specific times of the day. The diabetes educator will teach insulin
administration techniques, home blood glucose monitoring, and the treatment of
high and low blood sugars. The physician will take a complete medical history,
perform a physical examination, and prescribe insulin. Longterm studies have
proven that individuals who undergo intensive insulin therapy using multiple
injections of insulin a day, or an insulin pump, are able to achieve better
control of their blood sugar levels and have fewer complications from their
diabetes. Additional members of the health care team that may be consulted
include an exercise physiologist, a psychologist, a podiatrist, a nephrologist,
and an ophthalmologist.Hypoglycemia, or low blood sugar, is the most common side
effect of diabetes treatment. Occasionally a severe hypoglycemic reaction may
occur in which the patient becomes unconscious or has a seizure. Other possible
side effects from treatment include fat atrophy at the insulin injection site,
leading to poor insulin absorption over time. Very rarely an allergic reaction
to insulin may occur.
The
DOs
• Follow your diet, eating
regular meals at regular times.
•
Learn how exercise and food affects your blood sugar
levels.
• Take your insulin as
prescribed & Monitor your blood sugar levels at
home.
• Obtain an annual eye
examination by an ophthalmologist if you have had type I diabetes for more than
5 years.
• Obtain annual urine
testing for protein.
• Obtain a
hemoglobin A1c blood test every 3–6 months as an indicator of your
long-term blood sugar control.
•
Instruct family members in the use of glucagons administration in the case of
low blood sugar emergencies.
The
DON’Ts
• Don’t skip
doses of your insulin, especially when you are
sick.
• Don’t run out of your
insulin.
• Don’t drink
excessive amounts of alcohol because this may lead to unpredictable low blood
sugar reactions.
• Don’t forget
that exercise will lower your blood sugar
level.
When to Call Your
Doctor
• If you have a fever or
nausea and vomiting and are unable to keep down any solids or
liquids.
• You are having high or low
blood sugars that you cannot
explain.
• You are overdue for your
eye examination or urine protein
test.
Websites:
American
Diabetes
Association
http:\\www.diabetes.org
National
Institute of Diabetes and Digestive and Kidney
Diseases
http:\\www.niddk.nih.gov.