Diabetes type 1
Diabetes type 1
Diabetes mellitus (sugar diabetes) is a long-term condition where the body cannot control the amount of glucose in the blood properly. It develops when there is an insufficient amount of the natural hormone insulin. If untreated, the symptoms include excessive thirst, lots of trips to the toilet to pass urine and weight loss. Poorly controlled blood sugar can also be a major threat to health, including increased risk of heart disease and strokes, nerve damage and blindness.
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Glucose, a simple form of sugar, enters the blood from the intestines, where is absorbed from food and sugary drink as a natural part of digestion. It is also produced by the liver, which acts as a store of energy.
One of the many functions of the blood is to carry glucose around the body. When it reaches the various body tissues, such as the muscle cells, it is converted into energy. The precise concentration of glucose in the blood is automatically regulated. Crucial to this is the hormone insulin, which is secreted into the blood by the pancreas – a gland found behind and below the stomach.
Insulin is required for the conversion of glucose into energy. With the digestive system and liver working normally, a shortage of insulin causes glucose to build up in the blood, leading to the symptoms of diabetes.
There are two main types of diabetes – Type 1 and Type 2.
- Type 1 typically occurs in people under 40 and is also known as insulin dependent diabetes.. The person affected does not produce any of their own insulin and need to take it by injection every day. Once developed it is a life-long disease.
- Type 2 diabetes occurs later in life and is sometimes known as late-onset diabetes or non-insulin dependent diabetes.
Diabetes affects almost 10% of our Hong Kong population. Of these, over 95% are Type 2 Diabetes and 5% are Type 1 Diabetes.
Type 1 diabetes is caused by the destruction of insulin-producing cells called the islets of Langerhans within the pancreas – a gland found behind and just below the stomach. The destruction of these cells is generally agreed to be caused by the body's own immune system. Consequently, diabetes is known as an autoimmune disorder.
Type 1 diabetes takes only a few weeks to develop. The initial symptoms are:
- Increased production of urine (because the body tries to get rid of the excess glucose in the urine, diluting with water)
- Unusual thirst
- Fatigue (because the glucose is not being converted into energy)
- Loss of weight
- Increased appetite
- Feeling sick
- Blurred vision
- Infections such as thrush or irritation of the genitals
If Type1 diabetes is not treated at this stage, the body begins to produce chemicals called ketones to build up in the blood. This condition – diabetic ketoacidosis – causes additional symptoms:
- Stomach pain
- Rapid breathing
- Increased pulse rate
Without treatment, diabetic ketoacidosis can lead to coma or death.
Type 1 diabetes can be picked-up with a blood test to measure the level of glucose in the blood. It may be necessary to fast for eight hours before the blood sample is taken.
Type 1 diabetes cannot be cured, but it can be controlled by insulin injections. Insulin cannot be taken in tablet form because it is destroyed by the acids in the stomach. Insulin injections are usually self-administered to the skin of the abdomen two or four times a day, using either a traditional hypodermic needle or a pen type syringe with refillable cartridges. There are different kinds of insulin that work at different rates and for different lengths of time.
Controlling blood sugar
Careful control of blood sugar is the key to maintaining good health.
Hypoglycaemia –blood glucose that is too low– and hyperglycaemia – blood sugar that is too high, are the result of poor control.
An inadequate amount of blood glucose – from either not eating enough or from taking too much insulin – results in hypoglycaemia. This can cause symptoms of faintness, sweating and a pounding heart, and if not treated by eating or drinking something sugary, can lead to collapse and coma. People with diabetes will probably experience a hypo, or near-hypo, from time to time, and should make sure they always have some sugary food or glucose tablets close at hand to control it.
A high level of glucose in the blood is harmful. Even if the symptoms are not immediately severe (see above), uncontrolled high blood sugar can over time lead to a number of complications including irreversible damages to the eyes, kidney and nerves. Uncontrolled diabetes also increases the risk of cardiovascular diseases such as heart attack and stroke and, because it damages the circulation, it can lead to foot ulcers and gangrene.
Monitoring blood sugar
People with diabetes regularly use blood sugar monitors. This involves taking a pin-prick of blood and analysing it with either colour-coded strips of paper (which give a blood sugar reading based on the colour they turn) or an electronic monitor. Diet and insulin can be adjusted to keep the level within the normal range.
Hospital clinics, run by diabetologists (doctors with a special interest in the disease) and specialist nurses are available to provide the necessary guidance and support for this self-management.
In addition to controlling blood pressure, lifestyle is a key part of ensuring diabetes has the minimum impact on health.
A healthy diet is essential. This is the same as the normal, balanced diet recommended for good health – low in fat, sugar and salt; high in fibre, vegetables and fruit. Special diabetic foods are not necessary, but its important to eat regularly and keep weight under control.
Physical activity, which promotes a healthy circulation and helps to maintain a healthy weight, is recommended. Many successful sports people have diabetes: well-controlled diabetes need not prevent an active life.
Alcohol should be consumed only in moderation and with food.
Smoking damages the circulation and, like diabetes, increases the risk of cardiovascular disease. It is extremely important for smokers with Type 1 diabetes to quit smoking.
American Diabetes Association
National Institute of Diabetes and Digestive and Kidney Diseases
The Hormone Foundation
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