Type 1 diabetes

Causes

Type 1 diabetes can occur at any age. However, it is most often diagnosed in children, adolescents, or young adults.Insulin is a hormone produced by special cells, called beta cells, in the pancreas. The pancreas is found behind your stomach. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. In type 1 diabetes, beta cells produce little or no insulin.Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to the symptoms of type 1 diabetes.The exact cause of type 1 diabetes is unknown. Most likely it is an autoimmune disorder. An infection or some other trigger causes the body to mistakenly attack the cells in the pancreas that make insulin. This kind of disorder can be passed down through families.

Exams and Tests

Diabetes is diagnosed with the following blood tests:

• Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL two times
• Random (nonfasting) blood glucose level -- you may have diabetes if it is higher than 200 mg/dL, and you have symptoms such as increased thirst, urination, and fatigue (this must be confirmed with a fasting test)
• Oral glucose tolerance test -- diabetes is diagnosed if the glucose level is higher than 200 mg/dL after 2 hours
• Hemoglobin A1c test

Normal: Less than 5.7%

Pre-diabetes: Between 5.7% and 6.4%

Diabetes: 6.5% or higher

Ketone testing is also sometimes used. The ketone test is done using a urine sample or blood sample. Ketone testing may be done:

• When the blood sugar is higher than 240 mg/dL
• During an illness such as pneumonia, heart attack, or stroke
• When nausea or vomiting occur
• During pregnancy

The following tests or exams will help you and your doctor monitor your diabetes and prevent problems caused by diabetes:

• Check the skin and bones on your feet and legs.
• Check to see if your feet are getting numb.
• Have your blood pressure checked at least every year (blood pressure goal should be 130/80 mm/Hg or lower).
• Have your hemoglobin A1c test (HbA1c) done every 6 months if your diabetes is well controlled; otherwise, every 3 months.
• Have your cholesterol and triglyceride levels checked yearly (aim for LDL cholesterol levels below 70-100 mg/dL).
• Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
• Visit your eye doctor at least once a year, or more often if you have signs of diabetic eye disease.
• See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.

DIET AND EXERCISE

People with type 1 diabetes should eat at about the same times each day and try to eat the same kinds of foods. This helps to prevent blood sugar from becoming too high or low. See also:

Diabetes diet

Snacking when you have diabetes

The American Diabetes Association and the American Dietetic Association have information for planning healthy, balanced meals. It can help to talk with a registered dietitian or nutrition counselor.

Regular exercise helps control the amount of sugar in the blood. It also helps burn extra calories and fat to reach a healthy weight.

Ask your health care provider before starting any exercise program. People with type 1 diabetes must take special steps before, during, and after intense physical activity or exercise. See also: Diabetes and exercise

MANAGING YOUR BLOOD SUGAR

Checking your blood sugar levels at home and writing down the results will tell you how well you are managing your diabetes. Talk to your doctor and diabetes educator about how often to check.

A device called a glucometer can read blood sugar levels. There are different types of devices. Usually, you prick your finger with a small needle called a lancet to get a tiny drop of blood. You place the blood on a test strip and put the strip into the device. You should have results in 30 - 45 seconds.

Keep a record of your blood sugar for yourself and your doctor or nurse. This will help if you have problems managing your diabetes. You and your doctor should set a target goal for your blood sugar levels at different times during the day. You should also plan what to do when your blood sugar is too low or high.