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Guide to managing/living with type 1 diabetes

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Background: Type 1 diabetes is a condition where your body's pancreas no longer makes insulin on its own.  Because of this, your blood sugars will go up after eating carbohydrates/starches but will not come down on their own.  You will need to take insulin several times per day to keep your blood sugars down at a normal level.


Why should you care: If your blood sugar levels are high, this can damage different parts of the body including the heart, eyes, feet, and kidneys.  This damage is very UNLIKELY to happen if your blood sugars are mostly kept near a normal level.


How do you know if you have diabetes: Common symptoms for diabetes include losing weight unintentionally, urinating frequently/wetting the bed, eating uncontrollably (especially sweets), drinking large amounts of fluids.  Many people with type 1 diabetes do not know they have it until they end up in the hospital, usually for a condition called diabetic ketoacidosis.  If you have any concerns about having diabetes, please check with your doctor.  They will likely test your sugar with a blood or urine test.


What causes type 1 diabetes: It is important to note that for type 1 diabetes, it is not caused by anything you or your family did wrong.  It is NOT caused by lifestyle choices.  There seems to be some genetic and environmental factors that contribute, but as of now, we do not know any way to predict or prevent type 1 diabetes (although research is being done into this).


What are some tips for living with type 1 diabetes: The good news is that type 1 diabetes is becoming increasingly easier to live with and accepted by other people as time goes on.  More people are aware of diabetes every day and the needs for people with type 1 diabetes.  Here are some key pieces of advice for most people with type 1 diabetes:

- Check your blood sugar frequently during the day.  Most providers recommend testing at least 4 times daily (before each mealtime and at bedtime).  Some will recommend even more frequent testing.  It has been shown that the more people with diabetes test their blood sugar, the better their control is on average.  If you are testing 1-2 times per day, you will not have good blood sugars with type 1 diabetes.  There are now some continuous glucose meters such as the Freestyle Libre and Dexcom which can make testing easier.  However, you can have great diabetes control even with a standard glucometer.

- Take your insulin consistently and with each meal or snack as directed.  Any time you eat, you will need some insulin to prevent your blood sugar from going high.  It is much easier to prevent high blood sugar than to try to bring it back down after it has already gone high.

- Avoid ALL sugared drinks (unless your blood sugar is low).  This includes sweet tea (even watered down), fruit juice, regular soda, Gatorade/Powerade, ginger ale, lemonade, sugared coffees (most of what is at Starbucks).  Sugared drinks are better thought of as medicine for low blood sugar for people with type 1 diabetes.  They are crammed with sugar and since they are liquid they go into the bloodstream very quickly and spike blood sugar really fast.

- Try to meet regularly with a certified diabetes educator to learn about living with diabetes, testing blood sugar, taking insulin, and counting carbohydrates correctly.  This will make it much easier to learn the basics of diabetes and have good blood sugar control in the future.


What about insulin pumps/hybrid closed-loop pumps/"artificial pancreas": There are many insulin pumps now on the market and more research is being done each day into diabetes technology.  Insulin pumps can make living with diabetes easier.  However, despite tabloid headlines, there is NOT YET (as of late 2019) a true "artificial pancreas" to automate your life.  Whether you choose to use injections or a pump, it will require testing blood sugars, counting carbohydrates, and taking insulin regularly.  Some of the common insulin pumps are the t:slim pump (Tandem), Medtronic pumps (Medtronic), or Omnipod (Insulet).  Some of these can communicate with continuous glucose monitors and the companies are working on automating the insulin delivery process although these abilities are still limited.


Other things to know about type 1 diabetes:

- Develop good habits early in life.  The sooner you start to test blood sugars, take your insulin, and eat correctly the easier your life will be in the future.  Although diabetes care takes a LOT of time, it is easier if you make these things a habit such as brushing your teeth.

- If you are a kid, there are summer camps in many areas for children with diabetes.  This can be a great way to meet other children who have diabetes and see how they live their life.  These are usually supervised by physicians and adults with diabetes.

- Follow up regularly with your provider and keep in touch regarding your blood sugars and insulin doses.

- Some days will be better than others with your diabetes.  No matter how closely you watch your blood sugars and your food, you will have some high and low blood sugars that you cannot explain.  As long as these are uncommon, know you are doing well and know the next day should be better.

- People with type 1 diabetes can live normal lives with small adjustments if you develop good habits and skills early.  Diabetes does not dictate what you do or accomplish in life.  People with diabetes can be successful, famous, and happy just like anyone else.

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