A personal blog that aims to help demystify what Type 1 diabetes is.
I am by no means an expert, so this blog comes from my learning, understanding and personal experience of type 1 diabetes!
“Type 1 diabetes is a chronic autoimmune disease characterised by insulin deficiency and resultant hyperglycaemia”
In layman terms, this is when the body has stopped being able to produce insulin, a hormone we need to allow the energy from carbohydrates (glucose) to be released from our blood cells into the bodies cells.
So why is this a problem? If our bodies store glucose in our blood cells, our glucose levels start to rise. If this continues over a considerable period of time our bodies are not able to function correctly. This state of hyperglycaemia or diabetic ketoacidosis can damage nerves, blood vessels and vital organs.
Survival and day to day management have improved considerably due to the continued progress in medicine and technology, however, a cure for type 1 diabetes is yet to be found. Nevertheless, I should point out that there are still many in the UK and around the globe who can not access advanced diabetes treatments and management tools due to lack of availability and high costs.
How do you get Type 1 Diabetes?
This is all still a bit of a mystery, which is amazing, considering it’s believed that the history of the condition goes as far back as the Egyptians around 1550 BC! Unsurprisingly significant medical progress has been made since then and despite known genetic associations, most people who are diagnosed with type 1 diabetes do not have other cases in the family.
However we do know that you DO NOT get any form of diabetes from eating too much sugar! and an important difference when understanding type 1 is:
“There are no lifestyle changes you can make to lower your risk of type 1 diabetes” (NHS. UK).
How do you know you have Type 1 Diabetes?
Discovering you have the condition can hit you like a bolt out of the blue and getting to the point of diagnosis is not clear cut. In our case, we kept wondering why our daughter was losing weight and was more lethargic than normal. I still kick myself today as to why I waited so long to call the doctors when she was so poorly. But we just didn’t connect the dots and put it down to a growth spurt as she was entering her teens.
Diagnosis is not a sudden revelation. This is something that affects you gradually but there are some key signs to look out for (diabetes.or.uk):
- Going to the toilet a lot, especially at night.
- Being really thirsty.
- Feeling more tired than usual.
- Losing weight without trying to.
- Genital itching or thrush.
- Cuts and wounds take longer to heal.
- Blurred eyesight
- Increased hunger.
Different types of Diabetes
There are 12 different types of diabetes listed on Diabetes UK. These are:
- Type 1 Diabetes
- Type 2 Diabetes
- Gestational Diabetes
- Diabetes LADA
- Diabetes MODY
- Double Diabetes
- Type 3 Diabetes
- Steroid Induced Diabetes
- Brittle Diabetes
- Secondary Diabetes
- Diabetes Insipidus
- Juvenile Diabetes
The most common form of diabetes is type 2, affecting over 90% of diagnosed cases.
Now I hold my hands up that I do not know the ins and outs of type 2 diabetes, however, I do know that daily management is slightly different. This is because the body is still able to produce some insulin, just not enough. Therefore medication and sometimes insulin injections are required.
There is also evidence that in some cases type 2 diabetes can be reversed through lifestyle changes, whereas this is not the case for type 1.
Day to day management of Type 1 Diabetes
There are so many factors to consider when managing type 1 on a daily basis, in fact, there are over 40 things that can affect blood glucose levels from; food consumed, to activity, illness, hormones, stress and even the weather outside! Unsurprisingly this makes management tricky and sometimes we can get it wrong because we just don’t know what on earth is going on. But that’s OK.
However, in order to simplify this, the key measures that have to be monitored regularly throughout the day are:
- Blood Glucose Levels
- Insulin Levels
- Carbohydrate Counting
Blood Glucose Levels
It is essential that a person with diabetes measures and keeps track of their blood glucose levels. This can be done through a finger prick test or using a Continuous Glucose monitor (CGM) which is worn on the body.
In the UK, the NHS recommend that a person with type 1 diabetes keeps their blood sugars between 4-8 mmol/L. As a reference, a non-diabetic persons’ range is between 3.5 and 5.5 mmol/L)
So, not only are high blood glucose levels harmful (hyperglycaemia) but there are also low blood sugars (hypoglycaemia or hypos) to contend with as well. This is when BGL’s fall below 3.9 and will need to be treated with fast-acting carbohydrates like sweets, glucose tablets or a sugary drink. The risk, as with hyperglycaemia, if left untreated is a diabetic coma.
Keeping in range is really hard work and can be mentally exhausting.
Thankfully technology has come on leaps and bounds and weirdly I sometimes feel so fortunate that my daughter got her diagnosis last year and that we have been lucky enough to utilise all that’s available. This has made monitoring easier and less painful for my daughter’s fingers, however, it can be a double-edged sword in that it does become all-consuming.
A person with type 1 diabetes has to manually provide their body with insulin. This can be delivered through injections or via an insulin pump which is worn on the body.
How this is managed, quantities of insulin needed and delivered is totally unique to every type 1 individual.
In our case, my daughter has recently made the move from daily injections (which were around 7 to 8 a day) to an insulin pump that delivers the insulin requirements through a tube that is connected via a small cannula in her stomach. But there are quite a few different options out there and so for a person with type 1, it’s about figuring out what suits them best.
“Knowing how many carbs you’re eating and drinking helps you manage your blood glucose levels by matching your insulin dose to the amount of carbs in your meals and snacks.” (NHS.UK)
For those that follow me on Instagram, you will no doubt have read my comments on carb counting and this is why it’s there. In order to manage blood glucose levels and know how much insulin is required its important to carb count as accurately as possible.
carbohydrates are found in the following foods:
- Grains (breads, pasta, cereals)
- Root crops (potatoes, sweet potatoes, and yams)
- Most alcoholic drinks ( Beer, cider, lager, most cocktails)
- Desserts and sweets
- Most dairy products, except cheese,
- Sugars including sucrose, fructose, dextrose, maltose
So for a person with type 1 diabetes it’s all about the carbs!
Whether that is choosing a low carb diet, making some changes that will reduce the carb content of a meal or just eating carbs as and when you want. Again it’s about learning what works best for each individual.
Diabetes is an invisible condition that can take up a lot of headspace, management, organisation and time. How a person with type 1 chooses to manage their condition is totally individual, it’s not a one size fits all. Type 1 is not reversible and is not caused by diet or lifestyle choices (or eating sugar!)
As with many conditions and illnesses, a person with type 1 can also feel frustration, guilt, exhaustion and embarrassment to name but a few. So next time you are aware of an invisible condition maybe simply show love, ask what they need and don’t be embarrassed to ask your questions.
I really hope this was helpful and gave some insight into type 1 diabetes. But if there are any other topics or questions you have then write in the comments below and I will do my best to answer or point you in the right direction.
Thank you for reading
DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018). Type 1 diabetes. The Lancet, 391(10138), 2449–2462. doi:10.1016/s0140-6736(18)31320-5
Type 1 Diabetes in children, adolescents and young adults, 7th edition by Dr Ragnar Hanas