Type 1 Diabetes

Type 1 diabetes is more common in children and adolescents. Previously, type 1 diabetes was known as ‘juvenile diabetes’. But a person can get this disease at any age.

Diabetes, as we commonly understand it, is basically type 2 diabetes. Only 5–10 percent of all diabetic patients suffer from type 1 diabetes.

Our body produces a hormone called ‘insulin’. Insulin regulates blood sugar levels. This hormone is not produced in sufficient quantity in the bodies of patients suffering from type 1 diabetes. As a result, the blood sugar level increases excessively.

Currently, there is no known way to prevent type 1 diabetes. However, the disease can be easily controlled by controlling blood sugar, living a healthy lifestyle, and having regular check-ups with the doctor.

Note that type 1 diabetes has nothing to do with age or being overweight. Researchers have linked these factors to type 2 diabetes. In many cases, following a healthy lifestyle alone can prevent type 2 diabetes, whereas type 1 diabetes patients require insulin in addition to a healthy lifestyle.

Symptoms of type 1 diabetes

The symptoms of type 1 diabetes appear relatively quickly. Especially in children, these symptoms appear very early. Symptoms include—

Excessive thirst
Urinating more often than usual, especially at night
Feeling overly tired
Weight loss without effort
Recurring fungal infections (thrush).
Blurred vision
Delayed healing of cuts or other wounds
Fruity odor on breath

Testing for type 1 diabetes

There are two types of tests to detect diabetes: blood tests and urine tests. These tests measure the amount of sugar in the urine or blood. Your doctor may recommend one or both of these tests to diagnose diabetes.

If the test detects diabetes, the doctor may administer additional tests to assess the condition of type 1 diabetes. For example-

Autoantibody test:

An autoantibody is a type of antibody produced in our body that attacks the body’s own cells. Autoantibodies typically exist in the blood of individuals with type 1 diabetes.

Ketone body test:

This test checks for the presence of chemicals called ketone bodies in the urine. The body forms ketone bodies by breaking down stored fat. The presence of ketone bodies in urine indicates type 1 diabetes.
Once diagnosed with type 1 diabetes, individuals should actively manage its control. For this, the blood sugar level should be measured regularly, and insulin should be taken accordingly. Find out more about this from the doctor.

What type 1 diabetes patients need to know

How many points is diabetes normal

The normal blood sugar level of a diabetic patient should be known by the doctor. Even if your blood sugar level is different from others, there is no reason to worry. In this case, it is enough to control the sugar level according to the doctor’s advice.

When measuring blood sugar with a glucometer, the following points are usually considered ideal: ‘Point’ refers to the unit of millimole/liter (mmol/l).

Before eating

4 to 7 points

2 hours after eating

8 to 9 points

Before sleep

6 to 10 points

Hyperglycemia occurs when the blood sugar level or diabetes level rises above the ideal point for the patient. If the blood sugar level falls below the ideal point determined for the patient, it is called hypoglycemia.

Several factors can affect your blood sugar levels. For example-

Stress
Illness or an infection
No physical exertion or excessive exercise
Different types of pain
Menstruation or period
Drinking alcohol

When to measure blood sugar

Measure blood sugar levels at the following times every day:

Before breakfast
2-3 hours after eating
Before exercise, during breaks in between, and after exercise
Before going to sleep.

By measuring blood sugar regularly in this way, it will be possible to understand how the sugar level fluctuates due to the influence of food and exercise. This will make it easier to control blood sugar by keeping it at a stable level.

However, if the diabetes is completely uncontrolled or the patient has another illness (e.g., fever, pneumonia, or diarrhea), more frequent blood sugar measurements may be necessary. Start treatment as soon as possible by measuring blood sugar, especially if there are any symptoms of hypoglycemia.

Methods of measuring blood sugar

You can determine blood sugar levels at home using a glucometer or diabetes testing kit. To puncture the tip of the finger, use a fine needle-like device. When the blood comes out, take a drop of blood on the testing strip and insert it into the meter to test the sugar.

Regular blood sugar measurements are very important for diabetic patients. Regular monitoring of sugar levels will help control diabetes. It is important to always keep a blood sugar meter handy to avoid various health complications from diabetes.

All you need to measure diabetes at home is:

1. Glucometer
2. Sterile small needle or lancet
3. Plastic needle insertion pen
4. Test strip
When buying a glucometer at the pharmacy, you can purchase these items together.

Here are 7 steps to measure blood sugar at home:

1. First, wash your hands thoroughly with soap or handwash and dry them. You can also disinfect your hands with alcohol pads or hand sanitizer instead of soap. But in that case, you have to wait until the fingers are completely dry.

2. Insert the test strip into the designated area of the glucometer. Strips also vary from model to model of glucometer, so select the correct strip according to the specific model. Also, check whether the strip is fake or expired.

3. Attach a lancet inside the plastic pen and remove the lancet cap. A new needle must be used every time you measure your blood sugar levels. Follow the instructions on the glucometer packaging or the leaflet inside the packet to know how to use the pen easily and correctly.

4. Now hold the pen on one side of the finger and pierce the tip of the finger with the needle. Holding the pen on one side of the finger will reduce the pain. Use a different finger each time you measure your blood sugar. A drop of spontaneous blood is enough to measure diabetes on a glucometer.

5. Now place a drop of blood onto the test strip that is attached to the glucometer. Hold the finger in a way that allows the drop of blood to fill the designated area of the test strip. If the blood level is too low, incorrect readings may occur, or the glucometer may show an error on the screen.

6. The glucometer screen will display the blood sugar or diabetes point within a few seconds. The glucometer screen usually displays calculations in mmol/l (millimol/liter) units. However, some glucometers may display readings in mg/dL (milligrams/deciliter) units.

Dividing the result in mg/dL units by 18 gives the result in mmol/l units. It is better to note down the results with date and time in a specific diary or book.

7. Finally, dispose of the used needle and strip in the waste basket.

Regularly take care of the glucometer and keep it clean as per instructions.

Treatment of type 1 diabetes

How to take insulin

You can take insulin injections at home in seven easy steps. The steps are:

1) Wash and dry your hands thoroughly.

2) Decide where to give the injection. The most suitable areas for insulin injections are fatty areas of the body, such as the abdomen (below the navel), thighs, or buttocks.

It is important to inject at a different place each time. The next injection should be at least 1 cm, or half an inch, away from where the insulin was taken. Repeated injections into the same area can harden and swell it, preventing proper absorption and functioning of insulin.

3) Open the outer and inner caps of the insulin pen and insert the needle into them. Turn the dial to 2 units. Then hold the pen straight.

Slowly push the plunger on the back of the pen until insulin is visible on the needle head. This process is known as ‘priming’. Any air in the needle, insulin vial, or cartridge can be expelled in this way, making dose control easier.

4) Now turn the dial and select the specific dose according to the doctor’s prescription. Make sure the injection site is clean and dry.

5) Insert the needle into the body at a right angle or vertically (90 degree angle). Before injecting, the skin can be gently lifted with tweezers. Press and hold the plunger until the dial returns to 0.

6) Count from 1 to 10 so that the insulin has enough time to enter the body before removing the needle. Remove it by pinching the skin.

7) Remove the needle and dispose of it in a safe place.

Symptoms of low blood sugar and what to do

Symptoms of low blood sugar and what to do:

‘Hypoglycemia’ is the term used when the amount of glucose or sugar in the blood falls below the minimum normal level. Hypoglycemia may occur frequently in patients with diabetes, especially those requiring insulin.

Symptoms of hypoglycemia:

The symptoms of hypoglycemia can vary from person to person. If you have a history of frequent low blood sugar, you may be able to tell if you have hypoglycemia by observing your own symptoms. However, your symptoms may vary over time.

Some of the symptoms of low blood sugar are early. Failure to initiate treatment promptly can lead to serious conditions such as seizures and loss of consciousness.

Early symptoms are:

Excessive sweating
Feeling tired
Head-turning
Feeling hungry
Pins and needles around the lips
Trembling in the body
Chest palpitations
Being easily upset, tearful, agitated, or cranky
Turning pale

Home remedies for low blood sugar:

If your blood sugar drops below 4 points or you have symptoms of hypoglycemia, do the following:

Step 1: Eat sugary foods or drinks.

Have a small glass of soft drink or fruit juice. Alternatively, you can eat a small handful of sweets or four to five dextrose tablets.

Step 2: Measure your blood sugar after 10 to 15 minutes.

If it is 4 points or above and you feel better than before, go to step 3.

If blood sugar is still below 4 points, go back to step 1 and eat sugary drinks or foods. Check the sugar again after 10–15 minutes.

Step 3: If it’s time to eat, eat a sugary meal or a sugary snack. Breakfast can be a piece of toast, a few biscuits, or a glass of milk.

If you feel well or have a few symptoms of hypoglycemia, there is no need to go to the hospital. But if you have repeated hypoglycemia or you have no symptoms even after your blood sugar has dropped, you should contact your doctor.

Special Precautions for Diabetic Driving:

If a diabetic patient has to drive a vehicle (e.g., a CNG, automobile, pickup, bus, or truck) for professional reasons or for daily commuting, then the following 3 things should be ensured:

Measure the blood sugar level within 2 hours before driving.
Measure blood sugar level after 2 hours after driving for a long time.
Carry sugary snacks and sugary foods like bananas or flour bread when starting the journey.

If it seems that the sugar level has reduced to ‘hypo’ while moving, then-

Stop the car at a safe place.
Remove the key and shut off the car.
Get out of the driver’s seat.
The blood sugar level should be measured. If hypoglycemia occurs, seek immediate medical attention.
Do not drive for at least 45 minutes after feeling normal.

Regular checkups and tests

After a diabetes diagnosis, individuals should regularly follow up with their doctor. If there is any question, it should be known to the doctor without hesitation.

A diabetes checkup includes some tests that need to be done every 6 months. There are some tests that are done only once a year.

Examination every 6 months

These tests include blood and urine tests. These tests are recommended to determine how well diabetes is under control.

Typically, healthcare professionals recommend these tests every 6 months, but individuals with newly diagnosed type 1 diabetes may require more frequent testing. These tests include:

HbA1C Test: The test is done to find out how the blood sugar level has been controlled in the last 2–3 months.
Cholesterol test: This test is done to determine the amount of fat in the blood.
Kidney Function Tests: These tests determine if the kidneys function properly.
Urinary Albumin: The test measures the amount of albumin, a protein, in the urine.

In addition, the doctor also checks the patient’s weight and blood pressure. You can also discuss with the doctor the sugar level measured by the glucometer at home and have the opportunity to show the test report.

Annual Examination

Eye Exam:

It is important to have an eye exam once a year. This test will take a picture of the back of the eye and check for any changes in the eye caused by diabetes.

This is different than a simple vision test. This test does not check whether you need glasses or not.

Foot exam:

The points to be noted in this case are:

Are the legs getting numb or not?
Are the legs getting stiff again?
Whether there is a new infection or a sore in any part of the foot.

If any of these problems occur, consult a doctor immediately.

Changes in treatment

When diagnosing type 1 diabetes, doctors usually advise patients to eat meals at specific times. Along with that, you have to take insulin at a certain dose at a certain time.

Over time, some may develop better control of diabetes. In that case, some changes in treatment can be made in accordance with one’s own lifestyle. As a result, the patient can eat at his own convenience and take insulin accordingly. However, the patient should consult the doctor before making any changes in treatment.

Honeymoon period

The body may produce insulin for up to a year after diabetes is diagnosed. This period is called the ‘honeymoon period’. After this period, blood sugar can become difficult to control. So, if there is a problem with keeping diabetes under control, one should consult a doctor.