Overview:
What is Insulin-dependent Diabetes Mellitus? What is Type 1 diabetes?
Insulin dependent diabetes mellitus, known as Type 1 diabetes is a type of diabetes resulting from the inability of the pancreas to produce insulin. Diabetes is a chronic health problem that is characterised by elevated blood glucose levels.
Type-1 diabetes is seen in children and so it was also known as juvenile diabetes. Although it can occur in all ages and adults too, the children are more commonly seen affected with it.
In Type-1 diabetes, the pancreatic insufficiency causes low or no production of insulin, which is a hormone necessary for transport of glucose in the cells. This inhibits the insulin-mediated glucose uptake and the levels of sugars or glucose rise in the blood. Glucose is a source of energy for the cells in the body.
Elevated levels of blood sugars is termed as hyperglycemia. Due to hyperglycemia, the body may suffer from various symptoms and complications.
Diabetes cannot be cured but it can be treated with proper medical regime and home care.
Type-2 or Non-insulin dependent diabetes is more common than the Type-1 or Insulin dependent diabetes mellitus . It is more commonly seen in adults. In this case the Insulin production is normal but still the body cannot process the glucose and result into high blood glucose levels.
What is pancreas? What is the role of pancreas? How is it related to diabetes?
- Pancreas is a part of the digestive system located in the upper abdomen. It is a gland with both exocrine and endocrine functions.
- As an exocrine gland it helps in the digestion process by secreting the pancreatic enzymes
- As an endocrine gland it releases the hormone named Insulin in the blood stream to facilitate the uptake of glucose into the cells to produce energy.
- Pancreas is made up of three parts: Head, body and tail.
- The pancreas has islets of Langerhans which has cells called alpha, beta,delta cells, etc. The beta cells produce insulin which decreases the glucose level. Alpha cells produce glucagon which increases glucose level.
- Any damage or destruction of the beta cells of the islets of Langerhan's may result into little or low or no production of insulin. Thus causing the disorder called diabetes Type-1.
What is Insulin? What is the role of Insulin? How it is related to the diabetes.
- Insulin is a hormone produced by the beta-cells of the Islets of Langerhans in the pancreas.
- Role of Insulin:
- Insulin regulates the blood sugar levels.
- Insulin is needed for the transport of glucose to the cells. When the level of glucose increases in the blood, the pancreas releases insulin hormone in the bloodstream. Insulin carries the glucose molecules and transport them into the cells to produce energy.
- Glucose is utilised to produce energy which is then stored in the liver as glycogen.
- The hormone Insulin comes to action every time the glucose or sugar levels in the blood rise.
- In diabetes type 1, there is no or very less production of insulin and this results into the increase of blood sugar levels.
What are the signs and symptoms of Diabetes Mellitus Type 1?
The signs and symptoms of Type 1 diabetes in children are:
- Elevated blood sugar levels or hyperglycemia
- Loss of weight despite full or large meals
- Increased hunger
- Increased thirst
- Frequency of urination increases
- Enuresis or bedwetting in children
- Irritability
- Diminished or blurred vision
- Easily tired or fatigued on exertion.
What are the causes of Diabetes Type 1?
The causes of diabetes Type 1 are not known exactly.
- Autoimmune response of the body that destroys the cells that produce insulin in pancreas
- Infections
- Environmental factors such as cold climate and viral diseases.
What are the risk factors of type 1 diabetes?
The risk factors of diabetes type 1 are:
- Age: It is more commonly found in the children than adults.
- Family history of diabetes: a person who has a family member, mostly a sibling is at more risk of having type 1 diabetes mellitus
- Genetics: It is believed that some changes in the genetic composition may be a risk factor causing diabetes.
- Injury to pancreas or any surgery of pancreas may be a risk factor.
What diagnostic tests confirm the diagnosis of Insulin dependent diabetes mellitus or Type 1 diabetes?
- Blood tests for checking sugar levels are done to rule out hyperglycemia.
- It includes the fasting blood sugar, random blood sugar and postprandeal blood sugar.
- Fasting blood sugar is the test done in the morning on empty stomach. It ranges normal below 100mg/dL (70-100mg/dL). Blood sugar higher than 100 mg/dL may suspect a prediabetes condition. Tests showing 126 mg/dL or higher levels on two consecutive tests may confirm diabetes.
- Random blood sugar is the test done at random time during the day. It should be below 200 mg/dL. Levels higher than 200 mg/dL may confirm diabetes.
- HbA1c or Glycated hemoglobin is done to assess the glucose levels in the blood for last 2-3 months on an average. It detects the amount of the glucose attached to the hemoglobin pigment in the blood. The value of HbA1c higher than 6.5% on two different tests may confirm the presence of diabetes.
- Urine tests are done to test the presence of sugar and ketone bodies in the urine.
What is the treatment of diabetes mellitus type 1?
- The treatment is to provide insulin to the body to regulate the glucose levels in the blood.
- Take healthy diet, limiting carbs and sugars: avoiding white bread, white rice and sugar meals.
- Monitoring glucose levels: Glucose monitoring is an essential aspect of diabetes care. You may have to put on an insulin pump to get track of your glucose levels. The insulin pump is a device with a insulin depot attached via a small catheter or tube beneath your skin. This monitors the blood sugar at regular set intervals and if it records elevation of glucose, it releases insulin to bring it under control. In this way it works automatically. Your doctor may advice you regarding the care associated with the use of insulin pump.
- Insulin injections are to be taken daily before food as recommended by the doctor. Insulin can be administered by insulin syringe,or specialised insulin pens. Insulin pumps are also used for monitoring and regulating blood glucose levels.
- Insulin used for the treatment can be short-acting, intermediate-acting, ultra or long-acting and rapid-acting insulin.
- Talk to your doctor and discuss the glucose levels and take your insulin as taught.
- You may need supervision initially but it can be learned with practice.
- Skipping meals can be dangerous especially with diabetes. Never skip your meals when you are on sugar medications or insulin. This may rapidly bring down the sugar level making you hypoglcemic.
- Continue medications, if any: Your doctor may prescribe some oral medications along with the insulin therapy. Take medicines regularly as ordered.
- Exercise regularly to maintain health: Exercising heavily can cause complication if you are living with diabetes. Get medical advice before resuming any exercise. Aerobic exercises help a lot to keep yourself healthy. Keep record of your glucose levels before you exercise and if you feel sick then consult your doctor right away to get advice on exercise duration and types.
What changes are to be made in lifestyle when you have type 1 diabetes ?
Diabetes is a chronic condition and it needs a lot of patience and care. It is good to incorporate some lifestyle changes to maintain optimum health while living with diabetes type 1.
Lifestyle changes with type 1 diabetes
Activity changes: Avoid a sedentary lifestyle. Be an active person, who keeps oneself fit and healthy.
Take brief sessions of breaks while you work. It prevents you from sudden fatigue.
Exercise: Exercise plays an important role to let your body function actively. Aerobic exercise, swimming and walking can be resumed on your doctor's advice. Strenuous exercising on empty stomachs should be avoided.
Diet changes: Changes in the diet must be done to regulate the blood glucose levels. Get the help of a certified dietitian to help you with healthy diet regime that manages your sugar effectively.
- Diet must contain whole cereals, fresh fruits and veggies, less fatty foods, brown rice, etc.
- Avoid high-carb diet and white sugars. Eat whole wheat bread instead of white bread.
- Having a glass of bottle gourd juice on empty stomach in the morning helps in controlling the cholesterol and sugar.
- Having a glass of bitter gourd juice on empty stomach in the morning helps control your blood sugar levels effectively.
- Before diet take your medicines or insulin injections without fail.
- Never skip meals.
- Eat small portions of your meal rather than binging on a large amount.
Skin care: Diabetes may cause more urination and this may increase your urine output and may result into dehydration. It makes your skin dry and rough then.
- Drink enough water to maintain hydration of your skin. Use of moisturisers help to prevent dryness or any break in the skin.
- The injection site also gets damaged due to the punctures, clean the part and dry it and apply antiseptic lotion to prevent any infection.
- Pay special attention to the toes and fingers as elevated blood levels may cause fungal infections.
- Clean and dry the area between your fingers and toes.
- Use size larger footwear to prevent any injury to the toes or foot. The injured foot does not heal faster due to the neuropathy or less sensation in the foot.
Meditation: Meditation helps bring balance between your mind and body. Living with diabetes may leave you stressed at times. Try out relaxation techniques and meditation to find peace and reduce your stress levels.
What are the complications of diabetes?
The two common complications are hypoglycemia which means the blood glucose levels decrease, and ketoacidosis or the breakdown of fat which results in the formation of ketone bodies in the blood.
Other complications are:
- Increased risk to the heart ( chances of heart attack),
- Damage to the kidneys(nephropathy) and brain (neuropathy)
- Damage to the eyes(retinopathy)
- Damage to the nerves in the body, (Peripheral neuropathy)
- Skin changes: The skin is more prone to get fungal and bacterial infections. See: Impetigo skin infection.
- Increased risk of infections in mouth and foot.
- Gestational diabetes may have pregnancy related complications such as increased risk of miscarriage or still birth and neonatal birth deformities. It may also cause pre-eclampsia and pregnancy induced hypertension.
Note: This post is for informational and educational purpose only, It is not a substitute to any medical or professional advice or treatment. See your doctor in any case.
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