What is type 1 diabetes?

Type 1 diabetes is a disease that affects how your body makes insulin and uses glucose (sugar). Normally, when the blood sugar level increases, the pancreas makes more insulin. Insulin helps move sugar out of the blood so it can be used for energy. Type 1 diabetes develops because the immune system destroys cells in the pancreas that make insulin. The pancreas cannot make enough insulin, so the blood sugar level continues to rise. A family history of type 1 diabetes may increase your risk for diabetes.

What are the signs and symptoms of type 1 diabetes?

• More thirst than usual

• Frequent urination

• Hunger most of the time

• Weight loss without trying

• Blurred vision

How is type 1 diabetes diagnosed?

• An A1c test shows the average amount of sugar in your blood over the past 2 to 3 months. Your healthcare provider will tell you the A1c level that is right for you. Your provider can help you make changes if your A1c is too high

• A fasting plasma glucose test is when your blood sugar level is tested after you have not eaten for 8 hours

• A 2-hour plasma glucose test starts with a blood sugar level check after you have not eaten for 8 hours. You are then given a glucose drink. Your blood sugar level is checked after 2 hours

• A random glucose test may be done any time of day, no matter how long ago you ate

• An antibody test may show that your immune system is attacking your pancreas

How is type 1 diabetes treated?

Type 1 diabetes cannot be cured, but it can be controlled. The goal is to keep your blood sugar at a normal level.

• You will need insulin each day. Insulin may be injected or given through an insulin pump. Ask your healthcare provider which method is best for you. You or a family member will be taught how to give insulin injections if this is the best method for you. Your family member can give you the injections if you are not able. Take your insulin as directed. Too much insulin may cause your blood sugar level to go too low

• You will be taught how to adjust each insulin dose you take with meals. Always check your blood sugar level before the meal. The dose will be based on your blood sugar level, carbohydrates in the meal, and activity after the meal

How do I check my blood sugar level?

You will be taught how to check a small drop of blood with a glucose monitor. You will need to check your blood sugar level at least 3 times each day. Your healthcare provider will tell you when and how often to check during the day. If you check your blood sugar level before a meal, it should be between 80 and 130 mg/dL. If you check your blood sugar level 1 to 2 hours after a meal, it should be less than 180 mg/dL. Ask your healthcare provider if these are good goals for you. You may need to check for ketones in your urine or blood if your level is higher than directed. Write down your results and show them to your healthcare provider. Your provider may use the results to make changes to your medicine, food, or exercise schedules.

What should I do if my blood sugar level is too low?

Your blood sugar level is too low if it goes below 70 mg/dL. If the level is too low, eat or drink 15 grams of fast-acting carbohydrate. These are found naturally in fruits. Fast-acting carbohydrates will raise your blood sugar level quickly. Examples of 15 grams of fast-acting carbohydrate are 4 ounces (½ cup) of fruit juice or 4 ounces of regular soda. Other examples are 2 tablespoons of raisins or 3 to 4 glucose tablets. Check your blood sugar level 15 minutes later. If the level is still low (less than 100 mg/dL), eat another 15 grams of carbohydrate. When the level returns to 100 mg/dL, eat a snack or meal that contains carbohydrates. This will help prevent another drop in blood sugar. Always carefully follow your healthcare provider's instructions on how to treat low blood sugar levels.

What do I need to know about nutrition?

A dietitian will help you make a meal plan to keep your blood sugar level steady. Do not skip meals. Your blood sugar level may drop too low if you have taken diabetes medicine and do not eat.

• Keep track of carbohydrates (sugar and starchy foods). Your blood sugar level can get too high if you eat too many carbohydrates. Your dietitian will help you plan meals and snacks that have the right amount of carbohydrates

• Eat low-fat foods, such as skinless chicken and low-fat milk

• Eat less sodium (salt). Limit high-sodium foods, such as soy sauce, potato chips, and soup. Do not add salt to food you cook. Limit your use of table salt

• Eat high-fiber foods, such as vegetables, whole-grain breads, and beans

• Limit alcohol. Alcohol affects your blood sugar level and can make it harder to manage your diabetes. Limit alcohol to 1 drink a day if you are a woman. Limit alcohol to 2 drinks a day if you are a man. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor

How much exercise do I need?

Exercise can help keep your blood sugar level steady, decrease your risk of heart disease, and help you lose weight. Stretch before and after you exercise. Exercise for at least 150 minutes every week. Spread this amount of exercise over at least 3 days a week. Do not skip exercise more than 2 days in a row. Include muscle strengthening activities 2 to 3 days each week. Older adults should include balance training 2 to 3 times each week. Activities that help increase balance include yoga and tai chi. Work with your healthcare provider to create an exercise plan.

• Check your blood sugar level before and after exercise. Healthcare providers may tell you to change the amount of insulin you take or food you eat. If your blood sugar level is high, check your blood or urine for ketones before you exercise. Do not exercise if your blood sugar level is high and you have ketones

• If your blood sugar level is less than 100 mg/dL, have a carbohydrate snack before you exercise. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice. Drink water or liquids that do not contain sugar before, during, and after exercise. Ask your dietitian or healthcare provider which liquids you should drink when you exercise

• Do not sit for longer than 30 minutes. If you cannot walk around, at least stand up. This will help you stay active and keep your blood circulating

What else can I do to manage type 1 diabetes?

• Check your feet each day for sores. Wear shoes and socks that fit correctly. Ask your healthcare provider for more information about foot care

• Maintain a healthy weight. Ask your healthcare provider how much you should weigh. A healthy weight can help you control your diabetes. Ask your provider to help you create a weight loss plan if you are overweight. Together you can set manageable weight loss goals

• Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage and make it more difficult to manage your diabetes. Ask your healthcare provider for information if you currently smoke and need help to quit. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine

• Check your blood pressure as directed. Ask your healthcare provider what your blood pressure should be. Most adults with diabetes and high blood pressure should have a systolic blood pressure (first number) less than 140. Your diastolic blood pressure (second number) should be less than 90

• Wear medical alert identification. Wear medical alert jewelry or carry a card that says you have diabetes. Ask your healthcare provider where to get these items

• Ask about vaccines. You have a higher risk for serious illness if you get the flu, pneumonia, or hepatitis. Ask your healthcare provider if you should get a flu, pneumonia, or hepatitis B vaccine, and when to get the vaccine

What are the risks of type 1 diabetes?

Uncontrolled diabetes can damage your nerves, veins, and arteries. Long-term high blood sugar levels can damage your eyes and kidneys. Damage to arteries increases your risk of heart attack and stroke. Nerve damage may also lead to other heart, stomach, and nerve problems. Diabetes is life-threatening if it is not controlled. Control your blood glucose levels to reduce your risk for health problems.

Call 120 if:

• You have chest pain or shortness of breath

When should I seek immediate care?

• You have a low blood sugar level and it does not improve with treatment

• Your blood sugar level is above 240 mg/dL and does not come down after you take a dose of insulin

• You have ketones

• You have a fever

• You have nausea or are vomiting and cannot keep any food or liquid down

• You have blurred or double vision

• Your breath has a fruity, sweet smell, or your breathing is shallow

• You have symptoms of a low blood sugar level, such as trouble thinking, sweating, or a pounding heartbeat

When should I contact my healthcare provider?

• Your blood sugar levels are higher than your target goals

• You often have low blood sugar levels

• Your skin is red, dry, warm, or swollen

• You have a wound that does not heal

• You have trouble coping with your illness, or you feel anxious or depressed

• You have questions or concerns about your condition or care

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2017 Truven Health Analytics LLC All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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