The symptoms were unpleasant enough – extreme thirst, constantly running to the bathroom, blurry vision, unexplained weight loss. Now, you have the diagnosis – type 1 diabetes. How did this happen? What’s the best type 1 diabetes treatment for women? Read on for answers from a top endocrinologist.
Type 1 diabetes can strike at any age. An auto-immune disease, it develops when the body stops producing insulin, a hormone needed to convert sugar, starches and other food into energy. If untreated, a type 1 diabetic’s body can develop all types of complications, even lapse into a life-threatening coma.
So far, there’s no magical type 1 diabetes treatment. But promising research – from pancreatic cell transplants to preventive vaccines – is moving science closer to a cure. Until then, there are ways to lead an active and productive life with type 1 diabetes. The key is to control blood sugar with levels as close to normal as possible.
“The good news for people with type 1 diabetes right now is that you can live a healthy and productive life once you get in a rhythm and are vigilant about keeping your average blood sugar in line,” says Raynald Samoa, M.D., clinical researcher and endocrinologist at the Los Angeles-based City of Hope Medical Center.
Read on for Samoa’s insights on type 1 diabetes treatment.
People think diabetes type 1 and 2 are the same disease. How are they different?
Let’s start with the underlying causes between diabetes type 1 and 2. Diabetes type 1 is an immune problem. It develops when the body attacks its own cells – in this case, the islet cells in the pancreas that produce insulin.
Without insulin, the body can’t move glucose (sugar) out of the bloodstream into cells, where it produces energy for normal body functions, especially the healthy development of muscles and body tissue. You need to supplement that insulin loss through injections or pumps.
Type 2 diabetes typically develops when a person’s pancreas wears down, thanks to age, heredity and lifestyle factors. Either the insulin produced isn’t enough or the body can’t use it efficiently. So the pancreas works harder to produce the extra insulin the body still needs. [Patients] can take pressure off the organ by losing weight, reducing carbohydrate intake, exercising and taking oral medications.
Type 1 diabetes patients are usually thin. Most are diagnosed at elementary or middle school age. Type 2 diabetics tend to be overweight and first get diagnosed in middle age. Fat cells may be more resistant to insulin than muscle cells.
A blood test will typically determine if someone has type 1 diabetes and the antibodies that attack cells. Type 2 diabetics don’t have these antibodies. But their average blood sugar is elevated.
The most critical difference may be the response time to the diagnosis. Without insulin, you can develop diabetic ketoacidosis, a life-threatening condition that requires medical attention. Untreated, the condition can lead to a diabetic coma. It’s one more reason to get checked by a medical professional at the first signs of increased thirst and frequent urination.
Why do people develop type 1?
Many theories exist. A virus may trigger the condition and start the autoimmune response. Women with hypothyroidism, or low thyroid, another autoimmune problem, seem to have a greater risk of developing type 1 diabetes as an adult.
Who should be treating my condition?
Because this condition often shows up in kids, pediatric endocrinologists are the best qualified physicians to treat children with type 1 diabetes. They’re trained to diagnose and manage hormone imbalances that relate to growth and development. However, once you outgrow pediatric care, find a doctor who understands the nuances of treating adult type 1.
How does an adult type 1 find a well-qualified physician?
Your current doctor or the American Diabetes Association can help you locate a nearby physician who specializes in type 1. Often this can be an internist, endocrinologist or family practitioner with special training. Your physician should help type 1 diabetics become students of their own bodies, learn to anticipate their insulin needs and lower the risk of complications, such as hypoglycemia, or low blood sugar, as part of their type 1 diabetes treatment.
Ideally, your type 1 physician frequently works with patients on insulin pumps, an option you might want to consider. Many type 1 patients find that pumps make life a lot easier. Also, be sure the physician is affiliated with a good hospital, in case a problem arises.
What are the advantages of an insulin pump?
No more shots. Patients still have to test blood sugar levels, but they no longer have to give themselves injections. The pump reads the blood sugar level and determines the amount of insulin to administer through a micro-thin plastic tube attached to the abdomen.
What are the main treatment differences between diabetes type 1 and 2?
With type 1, taking insulin is the only option. Weight management, diet and oral medications typically treat type 2.
A type 1 diabetes treatment program should focus on delivering insulin in a way that mimics what the pancreas would normally do.
What is a normal or average blood sugar level?
Ideally, your blood sugar should hover between 90 Mg/dl (number of milligrams of glucose [or sugar] per deciliter of blood) and 110MG/dl, depending on when you’ve eaten. An A1C blood test reflects your average blood sugar over the past 90 days, which helps indicate how well your long-term type 1 diabetes treatment plan is working.
Besides getting the dosing of insulin down to a science, what else helps?
Consistent meal times and sleep patterns are helpful, but insulin needs still can vary widely from day to day.
Once you get spikes in your blood sugar levels stabilized, you may need to check blood sugar only once before each meal and at bedtime.
Can a woman with type 1 diabetes get pregnant? What does she need to know once she gets pregnant?
Women with type 1 can have safe and healthy pregnancies. The chances of having a baby who will develop type 1 diabetes aren't high enough to discourage pregnancy.
What’s critical is controlling blood sugar when you’re pregnant. High blood sugar levels increase the risk for pregnancy complications and having a baby with a congenital birth defect. A pregnant type 1 diabetic should try to keep blood sugar levels close to normal, between 65Mg/dl and 95Mg/dl before meals, and under 120Mg/dl two hours after eating.
What other ages and stages of a type 1 diabetic’s life pose challenges?
Changing hormones in teenagers can play havoc with their insulin levels, as can poor sleeping and eating patterns. Teens seem to have trouble accepting a diagnosis and may ignore advice regarding type 1 diabetes treatment and care.
Teens who don’t keep their diabetes under control could face a future on dialysis due to kidney failure and lose their vision as early as age 30. Once they get that message and put a plan and support network in place, they do really well.
It helps to remind them that many famous athletes, actors, politicians, doctors, lawyers and top executives have type 1 diabetes and do fine.
Young mothers can also pose challenges because they tend to put the care of their children ahead of their own health.
How is the condition different in girls and women?
Fluctuating hormones make control trickier in girls after puberty. Once young women learn their bodies’ rhythms, they are often better at adjusting their insulin doses to accommodate their needs.
Most of my patients on insulin pumps are women. It may be a more practical solution for those with young children or women undergoing menopause, who may need more insulin but don’t want to stop to give themselves injections. They’d rather let the pump take care of that.
What role does a diabetic diet play in type 1?
Weight control is typically not a big issue for type 1s. Eating balanced meals consistently and not skipping meals is more important.
A type 1 diabetic should avoid sugar and simple carbohydrates, such as breads and baked goods made of refined flour. Both sugar and carbohydrates turn to sugar in the blood. Complex carbohydrates, such as whole grains, also raise blood sugar, but more slowly, making the rise in blood sugar easier to manage.
An average-sized adult female should keep carbohydrate consumption to 180 grams or less a day.
And exercise?
Exercise is hugely important. It keeps muscles sensitive to insulin – the more you exercise the less insulin you need. Even after exercise, your muscles are active and burn more glycogen, which is blood sugar. When glycogen consumption is revved up, you need less insulin to keep blood sugar down.
Is there any good news?
New tools and technologies, such as the insulin pump, make managing diabetes much easier. Smaller sticks for pricking fingers make checking blood levels virtually painless.
One promising type 1 diabetes treatment is islet cell transplants from donors. Another is the possibility of a vaccine that will delay the onset of diabetes. Efforts are underway to predict who will get type 1 using insulin to delay onset.
For more information, visit our Type 1 Diabetes Health Center.
Myth vs. Fact: How Much Do You Know About Diabetes?
In the United States alone, 23.6 million people have diabetes. And 5.6 million of them don’t even know it. Unfortunately, misinformation about diabetes is rampant – and mixing up the facts about this disease can have dire consequences.
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