Diabetes mellitus type 1 can occur at any age but usually develops during childhood and adolescence. About 5% of the diabetics have this type of diabetes. The treatment for diabetes type 1 does not cure the diabetes. There is no cure for diabetes type 1 and treatment has to be taken lifelong. The solution for diabetes type 1 control lies in keeping the blood sugar level within normal limits.
Type 1 diabetes develops because the pancreas does not produce insulin or produces very little insulin. This happens because the autoimmune system of the body mistakenly destroys the beta cells in the pancreas. These are the cells of the pancreas that produce insulin, which keeps the blood glucose level under control.
Treatment and management guidelines of diabetes type 1 in children and adults:
1. Medicines for diabetes type 1, which primarily include insulin injection or an insulin pump
2. Proper diabetes diet, which includes healthy foods and counting your carbohydrate intake.
3. Exercise – aerobic exercises, which can include walking, cycling, swimming, etc.
4. Checking blood sugar levels several times a day
Treating type 1 diabetes or juvenile onset diabetes, as it was formerly called, is not just about medicines. Proper diet and an exercise plan are equally important as the diabetes medication, which your doctor will prescribe to you. Parents of children with juvenile onset diabetes have a major role to play in monitoring the child’s diabetes and making sure, he follows the treatment guidelines properly.
The aim of these four guidelines is to keep your blood sugar levels within normal limits. Fasting blood glucose should be between 70 to 120 mg/dl and in the sample two hours after food, below 180 mg/dl.
About 5% of diabetes patients suffer from diabetes type 1. The symptoms of this diabetes onset suddenly. It doesn’t take long for your doctor to diagnose you from the symptoms. He will request for laboratory blood investigations, which will confirm the diagnosis of type 1 diabetes. Your doctor will advise you on the foods to eat and the daily exercise routine you will have to follow. He will then start you on the treatment, which has to be lifelong.
If you follow the treatment program and keep your blood glucose within normal limits, you don’t have a thing to worry about. You will live a normal life doing all activities as a non-diabetic does and shall probably live longer because of the disciplined living.
Medicines for treatment of type 1 diabetes
Anyone diagnosed with this type of diabetes has to check his blood glucose level each week to know if the blood glucose level is within normal limit.
Insulin is the main medicine used and it is given by subcutaneous route (injected just under the skin). There is no treatment of type 1 diabetes without insulin. Oral insulin pills don’t work, because the digestive juices in the stomach break down the insulin.
Types of insulin
There are different types of insulin and they are classified according to their onset of action.
Rapid-acting insulin begins to act about 15 minutes after administration, its action peaks in one hour and lasts for about 2 to 4 hours.
Short-acting insulin begins to act within 30 minutes after injection, its action peaks between 2 to 3 hours and lasts for anywhere between 3 to 6 hours.
Intermediate-acting insulin begins to act in about 2 to 4 hours, peaks 4 to 12 hours after injection and is effective for about 12 to 18 hours.
Long-acting insulin starts to act several hours after it is injected and its action lasts for 24 hours.
Insulin is administered by a disposable insulin syringe and needle, an insulin pen or an insulin pump. Depending on what is best for you, your doctor may put you on a mixture of the types of insulin – rapid acting insulin with a long acting one to be taken during the 24 hours. Again, you may have to take insulin injections multiple times – three to four times a day..
The insulin pump is the size of a cell phone and contains the insulin reservoir, which is connected by a tube to small catheter that is injected just under the skin. It is programmed to inject specific amounts of rapid-acting insulin into the body several times during the day at the prescribed time. This is the basal rate, which indicates the steady dose of insulin.
- Medications for high blood pressure are prescribed if your blood pressure is above 140/80 mm of Hg.
- Your doctor may prescribe cholesterol-lowering medicines because diabetes and high cholesterol often coexist and due to the high risk of heart disease.
- For the same reason you may be asked to take aspirin on a daily basis.
Monitoring blood sugar guidelines
Continuous glucose monitoring (CGM) is advised to maintain optimal blood glucose levels. Patients having type 1 diabetes mellitus must learn to self-monitor blood levels at home using a glucose meter.
The American Diabetes Association recommends testing for glucose levels before meals and snacks, sometimes after meals, before exercising, before driving and before bed. This testing is not just to check high sugar levels but also to watch for low sugar levels. Dose for insulin is accordingly regulated.
All insulin-dependent diabetes patients must strictly check their blood sugar levels as recommended above.
Patients with type 1 diabetes should also test urine for ketones especially if they have any of the following symptoms.
- Symptoms of cold or flu
- Nausea or vomiting
- Abdominal pain
- Excessive thirst or urination
- An unexpected high glucose level
- Persistent fluctuation in plasma glucose levels
New treatments for diabetes type 1
- Pancreas transplant has been successful in some cases but can pose more problems that the diabetes itself. Even if the transplant is successful, you would need immunosuppressant drugs to prevent organ rejection. These drugs have serious side effects, which can be more serious than your diabetes. If safe immunosuppressant drugs become available, many diabetics will have less to worry about this new treatment.
- Pancreatic islet transplantation transfers some insulin producing cells from the healthy non-diabetic donor pancreas to the recipient. The new cells then start making insulin. This procedure still exists in the experimental stage. The body’s autoimmune system destroys these new cells as it had destroyed its own cells.
- Stem cell transplant has shown great potential and one day scientists hope that this can rid the diabetes type 1 patients of the suffering of taking insulin shots daily. They have been successful in transforming human embryonic stem cells into fully functioning beta cells capable of producing insulin. So far, they have developed millions of insulin producing cells through the stem cell technology. Stem cell transplant involves shutting down the immune system and then building it up again so that it will not destroy the beta cells of the pancreas that produce insulin.
To sum up management and treatment of diabetes type 1
There is no cure for diabetes mellitus type 1. Treatment and management guidelines of diabetes type 1 in children and adults have to be followed throughout life.
- Take your diabetes medicines regularly
- Continuously monitor blood glucose levels
- Follow the exercise plan daily without any holidays
- Stick to the diabetes diet
- Avoid alcohol. However, two pegs (60 ml) for men and one peg for women can be taken after permission from your doctor.
- Avoid smoking