There is no cure for diabetes and it can only be managed. That is why it is important to undergo test to diagnose type 1 diabetes as early as possible so that early treatment can be started in order to prevent health complications developing later in life. The aim of treatment is to keep the blood sugar levels from either too high or too low. This can be achieved by:
- Taking insulin
- Frequent blood sugar monitoring
- Healthy diet
- Regular physical activity and exercise
- Preventing and treating short-term complications.
There are different types of insulin, each working differently. Some work quickly but do not last long, some work the whole day and some up to 8 hours. They also differ in strength, with U-100 being the most common and are given either by an injection-pen, or with the help of a syringe or a pump. Your doctor will work with you and check your blood sugar levels periodically to determine the number of injections needed per day, the dose and the timing.
The correct insulin dose is a deciding balancing act. If too much insulin is injected, the body burns too much glucose and the blood sugar can drop dramatically, leading to a life-threatening hypoglycemia. If too little insulin is injected, the body can again starve for energy and the blood sugar can rise to a dangerously high level, resulting in hyperglycemia and increasing the chances of long-term complications. That is why self-monitoring is important.
The American Diabetes Association recommends to control blood sugar at least 4 times per day: before meals and snacks, two hours after a meal, before excising or driving, before going to bed and if you suspect your blood sugar is low. Providing feedback to your doctor regarding effectiveness, will help to adjust the dose, diet and exercise regimens, as well as will help in detecting and preventing the asymptomatic hypoglycemia and hyperglycemia.
Pregnant women with Type 1 diabetes should especially keep a tight glycemic control. The most important time to check blood sugar during pregnancy is after meals, because it is the only time known for certain to provide readings that have a direct and proven effect on outcomes. This is particularly true during the first 8 weeks of pregnancy and is critical for both the mother and the child to avoid pregnancy complications and development of birth defects.
Although there is no specific diet for diabetics, it is important to achieve a balance between the consumed food and insulin. This means watching what you eat, when you eat and how much you eat to match dietary intake to insulin and physical activity. It is important to lower fat and refined carbohydrates intake, such as sweets and white bread, and increase fiber consumption, such as vegetables, fruit and whole grains. Eating a healthy diet helps to spread carbohydrates throughout the day, and ‘slow’ carbohydrates in the diet, like fruit or beans, take longer to be absorbed in the body. Learn from your dietitian how to count the amount of carbohydrates in your diet in order to take enough insulin to properly metabolize them.
Physical activity and aerobic exercise have shown to improve the body’s response to insulin. However, exercise can significantly lower blood sugar, sometimes making it difficult to control. Therefore, it is necessary to check blood sugar more frequently than usual when exercising, until you learn how that activity affects your sugar levels. It may be necessary to adjust your insulin dose or meal plan to compensate to the increased activity.
If a patient with type 1 diabetes, takes too much insulin, skips a meal or exercises heavily, the blood sugar can drop significantly, resulting in hypoglycemia. He may feel hunger, dizziness, headache, sweating and change in mood. This can be managed by a quick boost of sugar, like glucose tablets, candies, juice or other sources of quickly absorbed glucose, which then can be followed by something substantial, like fruit. It is essential to always have glucose tablets or candies at hand, just in case.
If severe hypoglycemia develops, resulting in confusion, drowsiness or even loss of consciousness, you may need an injection of glucagon. This is a sugar-release stimulating hormone, which should always be available wherever the person with type 1 diabetes may be.