Type 1 diabetes (juvenile diabetes or insulin-dependent diabetes), is
a chronic disorder in which the pancreas produces little or no insulin. Insulin
is a hormone needed to convert sugar (glucose) into energy.
Type 1
diabetes can develop at any age, but is usually first seen in childhood or
adolescence. It is a very common illness in North America and estimates
indicate that one in 500 children born in the USA will develop type 1
diabetes. Overall it accounts
for at least 5-10% of all cases of diabetes.
There have been many hypotheses on what causes type 1 diabetes, but
so far nothing conclusive is known. Today,
we have no cure for the disease. However,
great advances have been made for the home monitoring and treatment of
diabetes.
To understand type 1 diabetes, one has to understand something about
glucose and its role in the body. Glucose
is a major source of energy and is used up by all the tissues of the body. For
all organs to survive, glucose must enter the cells. This requires a hormone called insulin. Insulin has the ability to drive glucose into cells and helps
process the glucose for energy.Therefore,
insulin also controls the glucose levels in the body.
Insulin is made in the pancreas and is released during times when
blood glucose levels are high. In
type 1 diabetes, the body fails to make insulin and thus the glucose levels
remain very high.Usually, the reason that the body does not make insulin is
because the diabetic�s immune system destroys the insulin producing cells,
though this is not a universal finding. In
others, the cause may be genetic or may be related to a viral infection. Although
the exact cause of type 1 diabetes is unknown, the risk of having the
disease is greatly increased if a child has a parent or sibling with the
same condition.
Symptoms of type 1 diabetes usually appear suddenly. The disease can first start with varied symptoms, so parents
need to be vigilant and knowledgeable of the disease to spot it early. The
diagnosis is easy if you know about the disease. The
symptoms may include:
-high sugar levels in the blood
-high levels of sugar in the urine
-extreme thirst
-frequent urination
-extreme hunger
-loss of weight
-blurred vision
-nausea and vomiting
-abdominal pain
-weakness and fatigue
-irritability and mood changes
The diagnosis of diabetes involves a few basic tests which include
randomly checking blood sugar and checking fasting blood sugar.Normally, a blood sample is taken randomly and blood sugar levels are
measured. If blood sugar levels
are greater than 200 mg/dl, regardless of the time of a meal, diabetes
should be suspected. If the
previous test is above 200 mg/dl, the blood sugar level is measured again
after an overnight fast. The
normal glucose level after fasting is between 70-100mg/dl. If
the level of glucose is greater than 126 mg/dl, then a diagnosis of diabetes
is made.Additional tests may
include the detection of antibodies towards insulin and the presence of
ketones in the urine.
To assess how well diabetes is controlled, a glycated hemoglobin
(HbA1c) test is done. If
glucose is present in the body for a long time, it will bind to hemoglobin
and measuring HbA1c lets the physician know well the disorder has been
controlled over the past few months. In most individuals the HbA1c levels
are less than 7%.
Current Treatments for Type 1 Diabetes
Uncontrolled
diabetes can lead to devastating complications including high blood sugar,low blood sugar, extreme thirst, frequent urination, nausea, blurred
vision, fatigue, diabetic
ketoacidosis (DKA), extreme lethargy, coma, seizures and even death.
Long-term complications of type 1 diabetes develop if the blood sugar
has not been controlled for long periods. The
complications are serious and are rarely reversible such as heart
disease, nerve damage,kidney
damage, eye damage
anddiabetic foot.
There is only one treatment for Type 1 diabetes and that is daily
insulin.
There
is absolutely no other substitute.Treatment
for type 1 diabetes is a lifelong commitment of monitoring blood sugar,
taking insulin, maintaining a healthy weight, eating healthy foods and
exercising regularly. The goal
is to maintain blood glucose within normal limits. Tighter
control of blood sugar levels can reduce the risk of diabetes-related heart
attacks and strokes by more than 50 percent.
No matter what type of insulin is used, monitoring of blood glucose
is essential. Careful monitoring is the only way to make sure that your
blood sugar level remains within your target range. Type 1 diabetes is a very fragile and unpredictable condition
and blood glucose levels can be affected by:
-
Food
-
Other medical illness
-
Exercise
-
Medications
-
Infections
-
Alcohol
-
Stress
-
Menstrual cycle
Insulin is life saving for type 1 diabetics. Today,
there are a variety of insulin products which have to be injected on a daily
basis. Many
types of insulin are available, including rapid-acting insulin, long-acting
insulin and intermediate options. Inhaled
insulin (Exubera) is now available as well and is rapidly acting. However,
caution should be exercised since recent studies do indicate that it may
cause low sugars in some patients.
Diabetes also profoundly affects the gut and causes slowing of the
bowels. Many diabetics complain
of constipation and feeling bloated. Thus,
some individuals may require medications (like Reglan) to help move the
bowels.
The only potential cure for type 1 diabetes is a pancreas transplant.
However, of all the organ
transplants, pancreas and islet cell transplants have had the least success.
And even after a successful
transplant, one has to take life-long immunosuppressive drugs that are
associated with numerous side effects which are worse than the diabetes
itself.
Recently stem cell transplants have been accomplished in a few
individuals and the short term results are excellent. However,
the procedure does involve taking some high risk drugs to suppress the
immune system to allow for acceptance of stem cells.
Nutritional Therapies for Type 1 Diabetes
Given
that diabetes is a disease of uncontrolled blood sugar, diabetics need to
pay careful attention to their diet.Medical
nutrition therapy is an integral component of diabetesmanagement
and of diabetes self-management education. Yet
manymisconceptions exist concerning nutrition and diabetes. Despite what everyone thinks there is no such thing as a
diabetic diet.
Diabetics should
reduce their intake of total fat, mainly saturated fat, which is known to
worsen diabetes and make the control of blood glucose difficult. Except
for the omega-3 fatty acids, most fats have an adverse effect on insulin
action. Some dieticians recommend that intake of unsaturated fatty
acids are beneficial in the long term management of diabetes.
Recent studies also indicate that there is a decreased risk of
diabeteswith increased intake of whole grains and dietary fiber.
Althoughfew
micronutrients may affect glucose and insulin metabolism,data to
document their role in the development of diabetes are lacking. In fact, a moderate amount of alcohol intake has recently been
shown to increase insulin sensitivity and improve glucose control. However,
recommending alcohol consumption as therapy may lead to worsening of the
social problems related to alcoholism, not to mention its damaging effects
on the liver.
The best way to control diabetes is by being smart and
selecting foods that will keep not only the sugar down, but will also help
to control weight gain and decrease cholesterol. This
can be achieved by changing to a diet with fewer calories and less fat; this
can be accomplished by eating more fresh fruit, vegetables, sea food and
legumes instead of red meat.
Diabetics should try to eat a healthy diet which derives at least 20%
of the daily calories from protein such as lean meats, 30% or less from fat
and the rest from carbohydrates. It
is best to become a label-based shopper, checking which foods are sugar and
fat free. Some labels even mention which foods are good for diabetics.
When it comes to alcohol consumption, there is no rule on how much
diabetics can drink. Alcohol is known to lower blood sugar, so it is advised that
if it is consumed that it is with meals. But
everything in moderation; diabetics should not treat the diabetes and at the
same time become alcoholic. Be
aware that brandy and some liqueurs have very high sugar content.
Because diabetes increases the risk of heart disease, diabetics
should make every attempt to control their cholesterol levels. There
are drugs to decrease cholesterol levels, but the best therapy is exercise.
All diabetics should have regular visits with a nutritionist or a
dietician. These individuals
can help you with developing a well balanced diet and can monitor your
progress. They can also teach
you about how the foods you eat affect your glucose levels and help you
coordinate your diabetes medications with meals. The
dietician will work with you to create a health eating plan what will
include all your favorite foods.
Diabetes does not mean not enjoying food. In
moderation, almost all types of food can be eaten by diabetics.Also, many diabetics try herbal remedies to try to control their
blood sugar, but nutritional therapies are often safer and easier to
understand, so some people are turning to mineral supplements instead of
herbs.
One
mineral that shows great promise for diabetics is chromium. For
years, research has revealed that chromium may in fact have some ability to
control blood glucose. Some
patients have benefited from chromium supplements, but it still is not the
magic pill. Current recommended dosages for chromium are 200 micrograms
taken three times daily.
Another element that has been postulated to lower blood sugar is
magnesium. Individuals in the nutrition business always believe that if
something is lower than normal in the body, then it must be the direct cause
of a disease. Low magnesium levels may have absolutely nothing to do with
diabetes and the levels may be low because of the excess urinary excretion.But it is not a bad idea to get adequate magnesium daily through a
supplement.
The best advice for all diabetic individuals is that there is little
evidence that most minerals or elements control diabetes. If
one eats a well-balanced diet with fruits and vegetables, no other
supplements may be necessary.
Lifestyle Changes for Type 1 Diabetes
Unfortunately, it is not yet known how type 1 diabetes can be
prevented or how it can be cured. It
is a serious chronic disease and the individual has to adapt to it. Diabetes
is relatively easy to control but the complications of diabetes are
devastating. To avoid the
complications, the following changes in lifestyle will make one�s life a
lot bearable and hassle free.
Despite
what everyone thinks there is no such thing as a diabetic diet � the only
criteria is to eat lots of fruits, vegetables and whole grains but limit the
calories, fat, and sugar content. Sugary
foods can be eaten but that makes control of blood sugar difficult. A
regular appointment with a dietician is highly recommended.
Like
everyone, type 1 diabetics should also exercise. The
exercise will prevent weight gain and help control the blood sugar. For
those diabetics who start to exercise, glucose levels should be measured
more frequently to ensure that low blood sugar does not occur.
Learn
as much as you can about your disease.Being knowledgeable can help a diabetic understand and appreciate the
disorder and adjust accordingly. One
should regularly see an endocrinologist and a nutritionist. Wear
an identification bracelet so emergency personnel know you are diabetic. This important tag will ensure that all health care workers
know your condition and will immediately identify any treat any serious
complications that may arise.
Keep
a glucagon kit nearby in case of a low blood sugar emergency. Make sure
those around you know how to use it.It is very important to see a physician regularly because of the
multitude of complications that can occur. Both the kidney and eyes should be frequently checked. Keep
up-to-date on immunizations because the high blood sugar can weaken your
immune system. The high blood sugar also makes one more prone to numerous
infections.
The
high blood sugar can destroy your gums and teeth through recurrent
infections. Brush your teeth daily, and get regular dental exams.There is no other more devastating complication than the diabetic
foot. When diabetes is not controlled, the majority of individuals
will eventually end up with amputations of their toes or their legs. One
should avoid all trauma to the feet and wear proper protective shoes. All
injury or infection of the feet must be immediately seen by a physician.
Most
diabetics develop a high blood pressure because of the stiffening of their
blood vessels. Their blood
pressure must be maintained within normal limits and routine checks up are a
must.Because
diabetes increases the risk of heart disease, one should make every attempt
to control cholesterol levels. The
combination of cholesterol and diabetes is bad news.
This
social habit worsens and increases the risk of every type of diabetic
complication. In simple,
diabetics should not smoke. The
majority who do smoke will have their feet/legs amputated or die from a
heart attack.Stress
is bad for all disorders and diabetes is no exception. Stress
can worsen high blood sugar and make it difficult to control. Relax, sleep well and live an active life.
Type 1 diabetes is devastating when it occurs in a young child. The
child usually does not understand this life-long ailment and frequently
fails to understand the need for frequent glucose monitoring and daily
insulin injections. The
majority of children with type 1 diabetes go on to develop some type of
mental anguish including:
-hostility
-fear of death
-guilty
-loneliness
-depression
-isolation
The best thing for the parent is to not be over protective as this
will just feed into the mental anguish. Encouragement,
teaching and improving self-esteem and independence of the child are key to
coping with the illness.
Type 1 diabetes is a difficult illness and controlling it requires a
lot of don�ts and patience. The
outcome is good for those who control their blood sugar, and for those who
do not, life can be very unpleasant � one can end up losing their limbs,
eyes, kidneys and even life.
Herbal Treatments for Diabetes
There is only one treatment for type 1 diabetes and that is insulin. There
is no other agent, chemical, nutrient, element or mineral that is a
replacement for insulin.Many
individuals with type 1 diabetes have died as a result of stopping insulin. Herbs
may be taken as an additional supplement but these natural plants and
minerals play more of a role in type 2 diabetes.
Sweet
Eze is a combination of herbs and is a self-rescribed nutrient. Reports
from diabetics indicate that they were off the diabetic medications after
taking Sweet Eze. However,
recent data from the FDA indicate that there are other chemicals in Sweet
Eze which are not listed on the product label and there are no controlled
studies which have shown its benefits. Caution
is advised.There
are a lot of reports on Fenugreek and its ability to lower blood sugar. Some studies have confirmed this finding but little is known
how it controls diabetes.
Toronto,
the home of the discovery of insulin, has been a Mecca for herbs and
nutrients in the treatment of diabetes. Research indicates that ginseng did
lower blood glucose in type 2 diabetes over a prolonged period. However,
despite these encouraging results, the researchers caution that it is too
early for diabetic patients to rely only on ginseng. They note that that there was a wide difference in the effect
seen depending on where the ginseng was bought. Because of the lack of standardization of most herbs, it is
difficult to know for certain what one is buying and impossible to ensure
consistent dosages. In
addition, all the active ingredients in ginseng have not been identified.
At
present, be aware that there is no substitute for insulin in the treatment
of type 1 diabetes. For type 2 diabetes, some herbs may have a role but because of
the lack of standardization and absolutely no quality control, the ADA has
steered patients away from herbal therapies. Recently
Chinese herbs were found to contain prescription diabetic medications as a
fraudulent attempt to trick patients.
If one does decide to try herbs or minerals, discuss this with your
doctor and herbalist so they may adjust your medications appropriately. Many
individuals have lost their lives when relying on unfounded therapies. Diabetes
is a disorder with very high mortality when not treated appropriately.
Note: Some statements in this article may not be approved by the FDA. This article is for informational purposes only and should not be taken as professional medical advice.