Type 1 diabetes
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Type 1 diabetes is an autoimmune disease that, although it cannot be cured, can be maintained with appropriate lifestyle and treatment, its complications can be prevented or their onset can be postponed to a later age. That is why the use of appropriate therapy is critical. The disease is characterized by the immune system attacking the insulin-producing cells of the pancreas. As a result of the damage, the pancreas is no longer able to produce insulin, so patients need daily doses of insulin to survive. This can be done using injections or an insulin pump.
About 10% of adult diabetics belong to type 1. Type 1 diabetes can appear at any age, but in the vast majority of cases it begins before the age of 40. Its appearance in childhood (ages 9-14) is particularly common. The so-called late-onset autoimmune diabetes in adults (LADA - latent autoimmune diabetes of adults) is a rarer form of the disease, which is often - incorrectly - diagnosed as type 2 diabetes.
Insulin and its effects, symptoms of its deficiency
The symptoms of type 1 diabetes usually develop quickly, within days or weeks in the case of childhood onset, within a few months in the case of adult onset. At the time of discovery, other serious symptoms usually appear: strong vomiting may occur and continuous, very deep breathing is characteristic. This reflects a serious condition (diabetic ketoacidosis) that requires immediate hospital care. In the absence of proper diagnosis and treatment, serious health damage may occur, which may even end in a coma with a fatal outcome. This condition develops because, in the absence of insulin, fatty acids are released from the adipose tissue, which the liver converts into ketone bodies. These molecules are two-faced, since on the one hand they provide energy for starving cells, on the other hand, due to their acidic nature, they also push our blood in an acidic direction (this is called acidosis). In addition, severe dehydration is also a part of the condition.
Reasons
Type 1 diabetes is not related to lifestyle. Medical science has not yet revealed the exact cause and mechanism of damage to insulin-producing pancreatic cells, but we suspect that the body's immune system attacks and destroys these cells due to a genetically determined (i.e. inherited) error, which is presumably caused by an external trigger (e.g. virus infection). So the development of the disease is complex, the genetically determined abnormal functioning of the immune system and a trigger that initiates the disease (e.g. virus) play a role in it. Thus, if a close relative (parent, sibling) suffers from this disease, compared to the average population, you have a 12 times greater chance of also having type 1 diabetes.
Treatment
Type 1 diabetes is an incurable but treatable disease. The goal of the therapy is to constantly maintain normal blood sugar levels (normoglycemia) and thereby minimize the symptoms and organ damage caused by the disease.
If you are diagnosed with diabetes, your family doctor will refer you to a diabetologist who will help you understand the nature of the disease and possible ways to treat it. He monitors your condition during regular control examinations and monitors the development of complications caused by diabetes.
In type 1 diabetes, the body is unable to produce insulin, so its regular replacement is the therapy. There are many insulin preparations on the market, which have different absorption rates and duration of action. The correct dose and combination of these preparations is crucial, so it is worth entrusting their setting to a diabetologist. When insulin is administered orally, it breaks down quickly in the stomach and cannot enter the bloodstream in this form, so it must be delivered to the body in another way. An excellent solution for this is administration under the skin using an injection needle. The diabetologist specialist and the diabetologist specialist assistant will do their best to make it easier for you to get used to the above-mentioned intervention. You can get help learning how to inject yourself, how to store insulin and how to dispose of used needles. Most patients need insulin injections 2-4 times a day.
An insulin pump is another way to deliver insulin into the body. It is a small device about the size of a deck of cards, which is connected to a thin tube with a needle at the end, which is inserted under the skin. It is most often attached to the abdomen, but it can also be attached to the hip, arm, or buttocks. The dosage of insulin is thus continuous, and the amount can be adjusted by the user according to the blood sugar level. So you don't need to self-inject. Anyone can use an insulin pump, but it is usually recommended for type 1 diabetics who often experience low blood sugar levels (hypoglycemia) with traditional insulin dosing.
Other treatment methods
Diabetes increases the risk of developing cardiovascular diseases (ischemic heart disease, heart attack, cerebrovascular disease/stroke) and kidney disease. In order to reduce the risk, your doctor may prescribe the following medicines:
- blood pressure-lowering medicines (or antihypertensives), which lower blood pressure. ACE inhibitors (angiotensin-converting enzyme inhibitors), such as analapril, lisinopril, ramipril can be used if you have early symptoms of diabetic kidney disease, which can be diagnosed by albumin appearing in the urine. If caught and treated early, it can be reversible.
- statins, which reduce blood cholesterol and thus atherosclerosis
- low-dose aspirin treatment, which can help prevent heart attacks and strokes by inhibiting platelet aggregation
Self-monitoring of blood sugar levels
If you measure your blood sugar yourself, the measurement shows the current blood sugar level at the time of the check. You can check this several times a day, which helps you get an idea of how your meals, physical activity and diabetes medications affect your blood sugar level.
Record the values because the information is valuable to your doctor in optimizing your treatment. It raises the blood sugar level when the body is affected by some kind of stress (e.g. infection, fever). In addition, alcohol intake, taking other medications, and in the case of women, hormonal changes in the menstrual cycle can also result in changes in blood sugar levels.
The blood glucose measuring device is a small, portable device, which also comes with a finger prick device. The blood sugar level can be measured from the drop of blood that appears after pricking the fingertip. It doesn't matter where you stab: it's worth aiming for the edge of the fingertip and not the middle. With the help of this small device, both too low and too high blood sugar values can be measured. The machine displays the measured blood sugar level in units of millimol/liter (mmol/l). The normal value is between 4-6 mmol/l before a meal (preprandial) and below 8mmol/l two hours after a meal (postprandial), although these values can vary from person to person.
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