Type 1 Diabetes - Pediatrics Introduction Type 1 diabetes prevents the body from removing sugar from the blood stream normally. Diabetes can lead to serious health problems if it is not treated. Currently there is no cure for diabetes but there are ways that you can control it. This reference summary helps adolescents with diabetes and parents of children with diabetes understand type 1 diabetes and how to control it. Diabetes Diabetes is diagnosed when your blood sugar is too high. The food we eat is turned into sugar, called glucose. The blood stream carries the glucose to the cells. For glucose to enter a cell, 2 conditions must be present: 1. The cell must have enough doors, called receptors. 2. A hormone called insulin unlocks the receptors. Insulin is a chemical hormone the pancreas makes. Insulin levels in the blood change depending on how much glucose is in the blood. In type 1 diabetes, the body does not make enough insulin. Therefore, people with type 1 diabetes must inject their insulin before a meal or snack in order to have a normal blood sugar. Type 1 diabetes tends to show up in children and young adults. Diabetes is NOT contagious. Symptoms of type 1 diabetes can show up very quickly, in a matter of hours or days. 1
Common signs and symptoms of diabetes include: Extreme thirst. Frequent urination. Excessive hunger. Weight loss. Feeling tired. Changes in vision. If left untreated, the level of glucose in the blood can become very high, causing coma and sometimes death. This can happen within hours or days of the symptoms beginning! Each person with diabetes will have differing signs and symptoms. Diabetes is found when your doctor or nurse finds a high level of sugar in your blood or urine. He or she may do a test if diabetes is suspected. The best time to check blood sugar level is before the person eats or drinks anything in the morning. This is called a fasting blood sugar. Treatment Options Diabetes cannot be cured. However, if blood sugar levels are kept within a normal range, diabetes can be controlled. You and your diabetes healthcare team will work together to make a treatment plan to control your blood sugar. Controlling Diabetes You can control diabetes with: Healthy diet. Exercise. Blood sugar checks. Insulin. Your dietitian or diabetes educator will tell you how to plan meals for your child or yourself. He or she can also answer any questions you may have. 2
The 3 goals of a healthy diet are: Weight control. Normal blood sugar level. Body fat reduction. A healthy diet includes: WHAT you eat. HOW MUCH you eat. HOW OFTEN you eat. You might be surprised by how many healthy and tasty food options you have. Exercise is an important part of managing your diabetes. Exercise lowers glucose levels, helps with weight-loss, keeps your heart healthy, and encourages healthy circulation. Your doctor will discuss your exercise plan with you. Always check with your doctor before starting a new exercise program. It is important to test blood sugar levels in order to make sure they are normal. If your blood sugar is too low or too high, your diabetes medication, diet, or exercise plan may need to change. Your doctor or nurse will let you know if a change is needed. Your blood sugar level is determined by testing a small drop of blood obtained from one of your fingers. This drop of blood is obtained by sticking your finger with a lancet, a small disposable needle. Blood sugar is usually checked 1 to 4 times each day, usually before meals and bedtimes. Most people with type 1 diabetes become very good at checking their own blood sugar. Your nurse or diabetes educator will teach you how to test your blood sugar correctly and will help you figure out the times of day to do the tests. He or she will also teach you how to make changes in insulin dose, diet, or exercise to help control your blood sugar. 3
There are many different insulin formulas. Your doctor or diabetes educator will teach you how to prepare the insulin syringe and how to give yourself an injection. You will have a schedule to follow. This schedule may need to be changed depending on your activity level and eating patterns. It will also need to change as you grow older and bigger. Hyperglycemia & Hypoglycemia Sometimes your blood sugar can become too high or too low when you are trying to control your diabetes. When too much sugar is in your blood, it is called hyperglycemia. Hyper is Greek and means more. Glycemia is also Greek and means sugar in the blood. Hyperglycemia can be caused by eating too much food or sugary foods, not taking your medication, or from being sick. If not treated, hyperglycemia could cause a coma. Signs of high blood sugar, or hyperglycemia, include: Dry mouth. Thirst. Frequent urination. Blurry vision. Fatigue or drowsiness. Weight loss. When you have high blood sugar, drink water or other sugar-free liquids. Check your blood sugar and stick to your diet plan. If your blood sugar stays too high, call your doctor. Your doctor will tell you what is too high for you. If your blood sugar is too high, you may need to go to the hospital. Hypoglycemia happens when there is too little sugar in your blood. Hypo is Greek and means less. Hypoglycemia usually happens in patients who take insulin or other medications. Taking too much insulin can cause it. Hypoglycemia is also known as insulin shock. Hypoglycemia can happen when you decrease your 4
food intake or skip a meal. It may also happen when you exercise more than usual. Signs of low blood sugar, or hypoglycemia, include: Sweating, shaking, nervousness, pounding heart. Hunger. Dizziness, faintness. Personality change, confused thinking, impatience, crankiness. Numbness of lips and tongue. Headache. Blurred vision. Slurred or slowed speech. If not treated, hypoglycemia can lead to fainting or seizures. People with type 1 diabetes experience different signs when their blood sugar is low. You should know how you feel when your blood sugar is too low. Some patients do not experience any signs when their blood sugar is low. These patients must test their blood sugar to find out i f they have hypoglycemia. If you have low blood sugar, immediately eat or drink something containing fast-acting sugar. Examples include: half a cup of fruit juice, regular soft drink, or 4 glucose tablets. If your symptoms do not disappear in 15 minutes or your blood sugar remains less than 80 mg/dl, take another dose of fast-acting sugar. Repeat every 10-15 minutes until your blood sugar is higher than 80. Do not subtract the snack from your next meal. Do not drive or get involved in potentially dangerous activities if you think your blood sugar is low. For example, if your blood sugar drops very low and you lose consciousness you could get hurt if you are doing wall climbing, riding bicycles, or swimming. 5
Tell your friends and family that you have diabetes. If they ever find you unconscious or have trouble understanding you, they should take you to a health care facility or call an emergency medical service right away. Complications When you control your blood sugar levels, the complications of diabetes happen less often. You will feel better and have more energy. If you do not follow your diet, exercise, and perform blood sugar level tests, serious complications could occur. Complications of diabetes include damage to the nerves and blood vessels of the body. These complications take years to occur. It is rare for them to affect people under 18 who have diabetes. However, good diabetes control during childhood helps prevent or delay these complications during adulthood. Controlling your diabetes can prevent nerve and blood vessel damage. Diabetes can be controlled with a diet plan, medication, exercise, blood sugar monitoring, and good hygiene. Conclusion You can successfully manage your diabetes with: Diet plan. Blood suger testing. Exercise. Prescribed medication. Good hygiene. Learning about diabetes. Your doctor, nurse, and dietitian will explain your specific diabetes control plan. By following your plan, you will have much less risk of diabetes complications. With a diabetes control plan, you can enjoy a healthier lifestyle while controlling diabetes! 6