Diabetes mellitus type 1, normally known as Type 1 Diabetes, is a type of diabetes that is caused by the lack of insulin as a result of the destruction of insulin-producing cells. Since insulin regulates the amount of glucose in the body, the destruction of the insulin-producing cells subsequently leads to high levels of glucose in blood and urine. As a result, Type 1 Diabetes is normally associated with frequent urination, increased thirst and hunger, and drastic weight loss in case of a poor lifestyle management. Type 1 Diabetes is less common as compared to Type 2 Diabetes and is normally referred to as juvenile diabetes as it mainly affects children and young adults (Diabetes UK, 2011). In contrast, Type 2 Diabetes is caused when the insulin is produced but the body does not use it efficiently, leading to high glucose levels. The body responds by producing more and more insulin, eventually exhausting the cell producing them and making them to fail, marking the onset of Type 2 Diabetes. This form of diabetes is the most common, accounting for more than 80% of all cases of diabetes in the UK. Its cause is mainly attributed to obesity (WebMD, 2011).
Living with Type 1 Diabetes
Type 1 Diabetes can be fatal if it is not managed well. One of the most common methods of managing the disease is through the administration of insulin shots. Insulin is administered through injections or inhalation. Having Type 1 Diabetes does not necessarily lead to poor health and a diabetic persons can still live to their full potential. The following list outlines how patients can manage their lifestyles to reduce the risk of long-term health complications.
Seeking to learn more about the disease
When it is first diagnosed, most people always have little insight into the disease and try to have access to any information that can create awareness. Consequently, the patients experience a steep learning curve as they try to comprehend all the information obtained from various media. Unfortunately, most people stop learning just after a few months assuming they know enough (WebMD, 2011). This is a mistake as learning should be a continuous but steady process. Knowing more about the condition increases the confidence on the ability to manage it. Besides, through learning, a patient is able get tips from professionals and persons that have diabetes themselves on ways of managing the side effects of the symptoms of Type 1 Diabetes (WebMD, 2011). There are a number of materials that offer simplified information on how the disease can be managed and these should be read occasionally.
Daily management of Diabetes
There are four main pillars for managing Type 1 Diabetes Mellitus (T1DM). The pillars are insulin, food, exercise and blood glucose level testing. Eating a well balanced diet is the first step to managing the disease as it helps to control the amounts of blood glucose, blood fats, and blood pressure.
Since T1DM is caused by a deficiency of insulin in the blood, its introduction is vital towards reducing blood glucose levels. The main purpose for administration of insulin in the body is to lower blood glucose and hence avoid long-term health complications that affect the nervous system (e.g. poor cognition abilities, loss of conscience etc) and the cardiovascular system (e.g. heart attack and loss of sight). Insulin administration is achieved through injection or inhalation of insulin that is manufactured artificially. Continuous glucose monitors can be used to alert patients of severely high or low glucose levels. Persons that have the disease for a long time will know when their blood glucose levels have fluctuated as it affects various physiological processes and patients learn to associate these processes with low blood glucose (BG) levels, such as thirst or fatigue (Silverstein et al. 2005, pp. 199). However, testing the blood is the surest way of knowing BG levels and there are simple kits that can be used to carry out a home blood sugar test (WebMD, 2011).
A balanced diet also helps to regulate body weight and hence reducing the risks of heart attack. It is important to find a balance between the quantity of carbohydrates and fats in any diet or food material (Silverstein et al. 2005, pp. 189). Patients should consume less fats, especially animal fats as this could lead to heart conditions. Monosaturated fats such as olive oil and rapeseed oil are encouraged. Oily fish should be consumed at least twice a week as they contain monosaturated fats. Other low-fat foods include eggs, lean mea and pulses (such as lentils). Regular meals should contain more carbohydrates and starch (Silverstein et al. 2005, pp. 200). Such foods include bread, pasta, chapattis, potatoes, noodles, low fat fruit yoghurt, baked beans, rice and cereals (Gillespie et al, 1998, pp. 901). Meals should be accompanied with adequate amounts of fresh fruits and vegetables (WebMD, 2011).
Exercise is very important in the management of T1DM since it increases glucose absorption by the body tissues and hence reduces insulin requirements. With adequate exercise, the amount of insulin administered into the body can be lowered significantly. Besides, there are numerous health-related benefits related to exercise, such as lowering blood pressure, managing body weight, and helping in lipid metabolism. Children with Type 1 Diabetes should exercise at least three to four times a week for about 20-60 minutes. A physician should provide advice on the best activities to partake in during exercise (Silverstein et al. 2005, pp. 208). However, activities such as running, walking, cycling, swimming, dancing or gardening are recommended.
Stressful conditions cause the body to react as if it is under attack by releasing hormones and sugars into the blood stream. This can elevate BG levels within a short time and cause serious health complications (WebMD, 2011). Any signs of stress (such as difficulty in concentrating and difficulty falling or asleep) should be handled in a relaxed manner, such as breathing deeply or exercising.
Persons with T1DM can benefit immensely by partaking in diabetes support groups and other diabetes events such as the Diabetes UK event. Assistance can also be sought from family members and friends. One should not be ashamed of telling others about their diabetic condition as there are more than 2.5 million people living with the condition in the UK (Diabetes UK, 2011). Therefore, by telling others about the condition not only helps the person, but also encourages others to open up (BBC, 2011).
National service framework standards for diabetes
Despite being the fourth leading killer in the UK, response to the disease has been slow and studies show that 50% of older persons with diabetes remain undiagnosed, and many of those diagnosed have normally had the disease for many years prior to the diagnosis (Harris et al, 1992, pp. 817). In order to improve the national management of diabetes, the National Service Framework (NSF) set up 12 standards with an aim of preventing diabetes, to identify persons wit diabetes, and ensure that diabetic persons are given high-quality, evidenced-based care. The 12 standards are outlined below:
Standard 1. Prevention of Type 2 diabetes mellitus (T2DM)
The NSF will develop, execute and monitor policies to reduce the risk of developing T2DM in the whole of the UK and reduce the inequalities in the risk of developing T2DM. Under this standard, the NSF aims to increase awareness of the causative factors of T2DM, such as obesity. The NSF will also inform people of strategies that can be used to lower the risks of developing the disease, such as education to promote healthy eating and exercise, assisting persons to lose weight and maintain the weight loss (Nazarko, L. 2003).
Standard II: Identification of persons with diabetes
A large number of persons remain undiagnosed with T2DM for many tears. During those years, complications arising from the disease normally develop. This standard aims to identify persons suffering fro the disease at an earlier phase (Nazarko, L. 2003). The government undertakes regular screenings with assistance from the National Screening Committee to help identify these people and place them on diabetes management programs.
Standard 3: Empowering people with diabetes
All children, young persons and adults with diabetes will receive a service that promotes partnership in decision-making, supports them in diabetes management and assist them in adopting and maintaining a lifestyle that does not place their lives at risk. Generally, persons with diabetes (and not necessarily professionals) are given the freedom to exercise personal control over their lives in the day-to-day management of the condition.
Standard 4: Clinical care of adults with diabetes
All diabetic adults will be given high-quality care throughout their lifetime. This care will include support to ensure that they exercise adequate control of their BG levels, blood pressure, and other risk factors in the management of diabetes. This standard aims to get experts work together with persons with diabetes to assist them in weight control, increase activity levels and firmly control the BG and cholesterol levels and hypertension (Nazarko, L. 2003).
Standard 5 & 6: Clinical care of children and young people with diabetes
All children and young persons with diabetes will always be given high-quality care and, together with their families and others taking part in their routine care, will receive assistance to optimize the control of their BG and their physical, psychological, intellectual, educational and social development. All children and young adults with diabetes will have a smooth transition of care from paediatric diabetes management to adult diabetes services in any healthcare institution where the patient is based. The transition will arranged in consultation with each patient at an appropriate age.
Standard 7: Management of diabetic emergencies
The NSF will develop, implement, and supervise common protocols for speedy and effectual treatment of diabetic emergencies by using expert care professionals. Protocols include the management of serious complications and procedures to alleviate the risk of recurrence.
Standard 8: Care of people with diabetes during admission to hospital
All children, young persons and adults with diabetes and are admitted to hospital, for whatever reason, will be given appropriate care as pertaining to their condition. Where possible, the patients will continue to get involved in choices regarding the management of their diabetes (Nazarko, L. 2003).
Standard 9: Diabetes and Pregnancy
The NHS will develop, implement and monitor strategies with the hope of empowering and supporting women with diabetes to ensure the pregnancy is not affected by the diabetes.
Standard 10, 11 AND 12: Discovery and management of long-term complications
All children, young persons and adults with diabetes will be monitored regularly to manage the long term complications of the disease.
The National Health Service (NHS) will develop, implement and monitor approved protocols and systems of care to ensure that persons who develop long-term complications are given immediate, appropriate and effective monitoring and treatment to lower risks of disability and early death (Nazarko, L. 2003).
All persons with diabetes and requiring multi-agency support will receive integrated support and care.
Near future issues for children with diabetes
As children with diabetes grow into their teenage years and youth, their insulin requirements may change over time and this will change their diabetes management plan. Over the years, their insulin requirements will increase and this may lead to a shift in the daily meal plans. Besides, the way they administer insulin (using shots or an insulin pump) may change too. Generally, as children grow up, they must continue controlling the levels of BG levels and carefully monitor their lifestyle to reduce the likelihood of developing acute complications. Exercises will be lengthier to manage the surge in BG levels. Due to increased metabolic processes and physical activity, children growing up may have to increase the monitoring of their BG levels. Besides, a change in the meal plan will pay back for increased physical activity.
Although there are specific types of meals recommended for persons with diabetes, this does not necessarily mean that the children will be restricted to a lifetime of similar food materials. Instead, the children can consume a variety of meals as long they are high in nutrition and low in fats and calories. Fruits, vegetables, and whole grains are highly recommended while animal products and sugary foods will be minimized. The quantity of carbohydrates in any meal must be monitored since this is the main determinant of BG levels. Sugary foods such as sweets, fruit juices, and soft drinks should be used in moderation.
As years go by, lifestyle will be very important in managing BG levels. Activities such as smoking and drinking can create complications for persons suffering from Type 1 diabetes. While smoking increases the chances of getting diabetes, it also makes the management of diabetes difficult for persons who have the condition already. Smoking also creates other complications such as heart disease, renal diseases, vascular disease, increased blood pressure, and so on. Diabetics should take alcohol in moderation since alcoholic substances contain calories and carbohydrates that may complicate BG level management. Some alcoholic products can cause low blood sugars. Drugs use can cause fluctuations in BG levels besides creating serious health complications since some drugs can become harmful when they come into contact with the various medications used to manage diabetes.
Over the years, people with diabetes may require additional treatments to supplement the insulin administration and a healthy lifestyle to manage T1DM. These treatments can be in the form of tablets. However, they can only be used upon advice by a healthcare professional (BBC, 2011). Finding out the best treatment options is vital towards the management of diabetes.
BBC. (2011). Diet and Diabetes. BBC Health. Web.
Diabetes UK. (2011). Children’s support holidays. Web.
Gillespie S. J., Kulkarni K. D., Daly A. E. (1998). Using carbohydrate counting in diabetes clinical practice. Journal of the American Dietetic Association, Vol. 98 (8):897-905
Harris, M.I., Klein, R., Welborn, T.A., Knuiman, M.W. (1992). Onset of non-insulin dependent diabetes occurs at least 4-7 years before clinical diagnosis. Diabetes Care, 15: 815-819.
Nazarko, L. (2003). Meeting the national service framework standards for diabetes. Web.
Silverstein J. et al. (2005). Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care, Vol. 28 (1): 186-212.
WebMD. (2011). Type 1 Diabetes: Children Living With the Disease – Topic Overview. Web.