Type 1 Diabetes Mellitus
What is type 1 diabetes mellitus?
Type 1 diabetes is a disorder that
occurs when your body produces little or no insulin.
Insulin is a hormone produced by the
pancreas. (The pancreas is the large gland that lies behind the
stomach.) When you digest food, your body breaks down much of the
food into sugar (glucose). Your blood carries the sugar to the cells
of your body for energy. Insulin helps the sugar leave the
bloodstream and enter the cells. This is how insulin lowers the
level of sugar in your blood.
When your body does not have enough
insulin, the cells of your body do not absorb enough sugar from your
blood. As a result, you have high levels of sugar in your blood.
When you have too much sugar in your blood, many problems begin to
occur. These problems can be life-threatening if they are not
treated. However, proper treatment can control your blood-sugar
Type 1 diabetes is also called
insulin-dependent diabetes. This type of diabetes usually develops
in childhood or early adulthood.
How does it occur?
Type 1 diabetes occurs when most of
the insulin-producing cells in the pancreas have been destroyed.
Usually the cause of this type of diabetes is not known. Sometimes
the diabetes is the result of a viral infection or injury of the
pancreas. It may also result from an immune system disorder.
What are the symptoms?
Symptoms may develop suddenly. Or
they may develop gradually over days to weeks. Symptoms vary widely
from person to person. Common symptoms include:
thirst, dry mouth, and the drinking of a lot of fluids
appetite or loss of appetite
weight loss from loss of body fluids
- loss of fat
feelings of prickling, burning, or itching of the skin, usually
on the hands or feet
How is it diagnosed?
Your health care provider will ask
about your medical history and your symptoms and examine you. He or
she will test the level of sugar in your blood. If your morning
fasting blood sugar (before breakfast) is above 126 milligrams per
deciliter (mg/dL), you are diabetic.
Sometimes another test called a
glucose tolerance test is done. For this test a sample of your blood
is taken when you have not eaten anything since the night before.
Then you drink a sugar drink and your blood is tested 2 hours later.
If after 2 hours your blood sugar level is over 200 mg/dL, you are
How is it treated?
Giving your body more insulin is the
primary treatment for type 1 diabetes. In addition you will learn
how to control your blood sugar through diet and exercise. The goal
is for you to be able to lead as normal a life as possible.
You will start having insulin
shots as soon as the diagnosis is confirmed. (You will begin to
regulate your diet at the same time.) At first you must check
your blood-sugar level several times a day to make sure you are
getting the right dosage of insulin. If you have too much or too
little sugar in your blood, you will need to change your diet or
the amount of insulin you are taking to keep your blood sugar at
a normal, healthy level.
You will learn how to measure
your insulin dose, clean your skin, and give yourself shots.
If the insulin doesn't seem to be
working, your health care provider will check for the following:
change in your work habits or level of exercise
another medical problem, such as infection
improper technique of insulin injection
improperly stored insulin
failure to follow your diet plan
interaction of the insulin with another medication you
The insulin pump is a new way of
giving the body insulin. A tube connected to the pump is
inserted under the skin. The device is worn like a pager. As
your blood sugar level changes, you can adjust the amount of
insulin pumped through the tube.
The main goal of your diet plan
is to maintain a normal blood-sugar level. You will be given
guidelines about which foods you should eat and how many
calories you should eat each day. The number of calories you are
allowed is determined by whether you need to maintain, lose, or
gain weight. You will also learn how to space your meals so you
avoid going too long without food.
Your health care provider may
refer you to a dietitian for help with diet planning and meal
management. A dietitian can help you design a meal plan that
fits your lifestyle. Your prescribed diet will include a lot of
lean protein, complex carbohydrates (such as pasta, breads, and
cereals), and foods with high fiber. Your diet should not
include sugar-rich food such as soft drinks, candy, and
Exercise is very important. A
good activity plan can help control your blood-sugar level. Talk
to your health care provider about making an activity plan for
There is a lot you will need to
learn. You should attend diabetes classes or talk to your health
care provider about how you can learn all you need to know. You
can also check with the local American Diabetes Association
chapter, hospital, or health department about classes in your
How long will the effects last?
Type 1 diabetes is a lifelong
condition. Its symptoms increase or decrease depending on your
response to the insulin and your new diet and on how well you are
able to control your blood-sugar level.
How can I take care of myself?
Taking good care of yourself to avoid
complications is especially important with diabetes. Possible
diabetic complications include heart disease, stroke, blindness,
kidney failure, and nerve damage, especially to your feet and legs.
Carefully controlling your blood sugar will delay or prevent these
Guidelines for eating:
foods with lean protein, complex carbohydrates, and lots of
fiber. Choose foods low in saturated fats. Read labels
Distribute your total calories evenly throughout the day
your meals to balance peak insulin effects and scheduled
activities. Try to always have your meals and snacks at the
same time each day
you increase your activity, eat more or decrease the insulin
you are taking. This will help prevent low blood sugar
how to make proper food choices when you eat out
- Ask for
diabetic meals when you travel (for example, in hotels and
on planes). Order your meals ahead of time
Guidelines for managing calories:
water or other noncaloric drinks when you feel an urge to
eat between meals
the amount of alcohol you drink
only the types of food allowed by your diet plan
- Eat on
a regular schedule
slowly and chew food thoroughly
Guidelines for managing insulin:
your health care provider's instructions for giving yourself
your health care provider what causes low blood sugar and
what to do when you have low blood sugar
when and how to test your blood
your health care provider's instructions for adjusting your
insulin dosage according to the results of blood tests
some form of sugar at all times, so you can treat low blood
- Carry a
protein snack, such as cheese and crackers, to make sure you
eat as often as you should
Guidelines for seeing your health
your health care provider's recommendations for frequent
follow-up visits until your diabetes is under good control
your diabetes is under control, see your health care
provider every 3 to 6 months
- Be sure
to have an eye exam every year
Other guidelines for managing
how to do proper skin and foot care every day. Wear
comfortable, well-fitting shoes to help prevent foot injury.
Break in new shoes gradually
Exercise regularly according to your health care provider's
advice. Exercise helps the insulin do its job better
identification (such as a card or bracelet) that says you
have diabetes, in case of an emergency
Learn about diabetes and its
complications so you can make the correct decisions to control your
blood-sugar levels. Many hospitals have diabetes educators and
dietitians who can help you. Ask your health care provider to refer
you to these people.
You can get diabetic cookbooks and
written information about diabetes from:
The American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 800-DIABETES (800-342-2383)
How can I help prevent type 1
Type 1 diabetes cannot be prevented.
However, many of the problems associated with the disease can be
eliminated or reduced if you:
- Follow the
guidelines your health care provider gives you
- Maintain a
normal blood-sugar level
- Learn how
to inject insulin correctly, including where to inject it
- Learn how
to test your blood sugar
- Know when
to adjust your medication
- Have other
medical problems treated, especially high blood pressure
- Keep your
appointments with your health care provider
- Call your
health care provider if you have any questions
Phyllis G. Cooper, R.N., M.N., and Clinical Reference Systems.
Published by Clinical Reference Systems, a division of HBO &
Copyright © 1998 Clinical Reference Systems
content provided by iMcKesson, LLC
Reviewed for medical accuracy by physicians of the VeriMed