Type 1 Diabetes: Recently Diagnosed

	Topic Overview
	Health Tools
	Cause
	Symptoms
	What Happens
	What Increases Your Risk
	When To Call a Doctor
	Exams and Tests
	Treatment Overview
	Prevention
	Home Treatment
	Medications
	Surgery
	Other Treatment
	Other Places To Get Help
	Related Information
	References
	Credits

Is this topic for you?

This topic provides information about type 1 diabetes for adults and parents of children who have been diagnosed with the disease in the past 6 weeks. If this topic doesn't answer your questions, one of the following topics may meet your needs.

• Type 1 Diabetes, if you want to learn about type 1 diabetes but do not have the disease
• Type 1 Diabetes: Living With the Disease, if you or your adolescent has type 1 diabetes. If you have not read the topic, Type 1 Diabetes: Recently Diagnosed, you may want to read it first.
• Type 1 Diabetes: Children Living With the Disease, if your child age 11 or younger has type 1 diabetes. If you have not read the topic Type 1 Diabetes: Recently Diagnosed, you may want to read it first.
• Type 1 Diabetes: Living With Complications, if you have complications—eye, kidney, heart, nerve, or blood vessel disease—caused by your diabetes

What is type 1 diabetes?

Type 1 diabetes mellitus is a lifelong disease that develops when the pancreas can no longer produce insulin. Insulin lets sugar (glucose) enter your body's cells, where it is used for energy. Without insulin, sugar builds up in your blood. The level rises above what is safe for your body. Over time, high blood sugar levels can damage blood vessels and nerves throughout your body and increase your risk of eye, heart, blood vessel, nerve, and kidney disease.

Type 1 diabetes can develop at any age; however, it usually develops in children and young adults. In the past, type 1 diabetes was called juvenile diabetes and insulin-dependent diabetes mellitus (IDDM).

What causes type 1 diabetes?

Insulin is made by certain cells (beta cells) in the pancreas. Type 1 diabetes develops because the body destroys the beta cells and therefore the pancreas's ability to produce insulin.

Some people inherit the risk for type 1 diabetes. However, even these people may not develop type 1 diabetes unless other factors, such as exposure to certain viral infections, are present. ¹

What are the symptoms of high and low blood sugar?

The main symptoms of high blood sugar from diabetes are:

• Increased thirst.
• Increased urination.
• Weight loss.
• Fatigue.
• Increased appetite.

These symptoms usually develop over a few days to weeks. Some people have these symptoms before they are diagnosed, but they do not realize the symptoms are caused by diabetes. They may believe the symptoms are caused by the flu or some other illness.

Sometimes blood sugar rises very high. If this happens, a life-threatening situation called diabetic ketoacidosis (DKA) can develop. DKA is an emergency. Symptoms include:

• Flushed, hot, dry skin.
• A strong, fruity breath odor (similar to nail polish remover or acetone).
• Restlessness, drowsiness, or difficulty waking up. Young children may lack interest in their normal activities.
• Rapid, deep breathing.
• Loss of appetite, abdominal pain, and vomiting.
• Confusion.

Severe diabetic ketoacidosis can cause difficulty breathing, brain swelling (cerebral edema), coma, or death. However, your blood sugar level usually rises slowly over hours or days. You can treat the high level before DKA develops.

You also need to watch for low blood sugar. Low blood sugar occurs when the sugar (glucose) level in your blood drops below what your body needs to function normally. Not eating enough food or skipping meals, taking too much medication (insulin), exercising more than usual, or taking certain medications that lower blood sugar can cause your blood sugar to drop rapidly. Symptoms include:

• Sweating (almost always present).
• Nervousness, shakiness, and weakness.
• Dizziness and headache.
• Confusion and irritability.
• Slurred speech.
• Personality changes, such as anger or crying.

If your blood sugar level drops very low (usually below 20 mg/dL), you may lose consciousness or have a seizure. Eating or drinking something that contains sugar usually can bring your blood sugar back up to a safe level. However, if you have symptoms of severe low blood sugar, you need medical care immediately.

What tests do I need for diabetes?

You need to test your blood sugar 3 or more times a day to make sure it falls within the target range you and your health professional set. You use a home glucose monitor to do these tests.

You need to see your health professional about every 3 to 4 months for exams and tests to monitor your condition and adjust your treatment. About every 3 months—or whenever your health professional recommends—you will have a hemoglobin A_1c test to estimate your average blood sugar level over the previous 2 to 3 months.

You also need to have regular tests to check your blood pressure and cholesterol levels; high levels increase your risk of diabetes complications.

How is it treated?

You will take insulin injections daily or use an insulin pump. Treatment for type 1 diabetes focuses on keeping your blood sugar levels as close to normal as possible. This is called tight control. It is the best way to reduce your risk of diabetes complications. However, some people—such as those whose blood sugar drops too low with tight control—may need to set a different target range with their health professional.

A normal to near-normal blood sugar level is 90 mg/dL to 130 mg/dL before eating or less than 180 mg/dL 1 to 2 hours after eating. It also may be measured as a hemoglobin A_1c of 6% or less (normal) to 7% (near normal). This is a test of your blood sugar control for the past 2 to 3 months. If you do not have problems with low blood sugar, you may be able to tightly control your blood sugar to an A_1c of 6% or less.

You also need to eat a healthful diet that spreads carbohydrate throughout the day, check your blood sugar 3 or more times a day, and get regular exercise. Because you have diabetes, you are at higher-than-average risk of a heart attack and stroke. You may take medication to keep your blood pressure and cholesterol in the normal ranges. If you are 30 or older, you also may take aspirin.

Your treatment plan may change based on your blood sugar levels and other test results reviewed in your doctor's office.

If your child has type 1 diabetes, treatment involves the same actions but also allows for normal growth and development.

You may find that soon after you are diagnosed with type 1 diabetes, your blood sugar levels return to normal. You are in what is called the "honeymoon period." The remaining insulin-producing cells in your pancreas are working harder to supply enough insulin for your body. You may take little or no insulin; however, this does not mean that the disease is gone. After the remaining insulin-producing cells are destroyed, the honeymoon period ends, and you will need to take insulin for the rest of your life.

How will diabetes affect my life?

You can live a long, healthy life if you keep your blood sugar levels as close to normal as possible. This requires the right combination of food, physical activity, and insulin every day. If your young child has diabetes, you assume the responsibility for balancing these factors. As your child grows, he or she will take over more responsibility for his or her care.

Many people are afraid of giving themselves shots every day. With practice, it will become routine. Figuring out how to mix diet, insulin, and exercise in your daily life takes time. Don't get discouraged. Seek out help from your health professionals if some part of diabetes care gives you trouble.

As you adjust to having diabetes, you will learn how to monitor your blood sugar level at home, give yourself insulin injections, recognize high and low blood sugar symptoms, count carbohydrate in your diet, and take precautions when you are sick. Diabetes care will become an important part of your life, but it doesn't have to take over your life.

Frequently Asked Questions

Health tools help you make wise health decisions or take action to improve your health.

	Actionsets are designed to help people take an active role in managing a health condition.
	Carbohydrate counting for people who use insulin
	Dealing with low blood sugar from insulin for diabetes
	Dealing with low blood sugar when your child takes insulin
	Giving an insulin injection to a child with diabetes
	Giving an insulin injection to an adult with diabetes
	Home blood sugar monitoring
	Home blood sugar monitoring for children with diabetes
	Preventing high blood sugar emergencies from diabetes
	Preventing high blood sugar emergencies in children with diabetes

Type 1 diabetes develops because the body's defense system (immune system) tells the body to destroy the beta cells in the pancreas that make insulin. It's not known what causes this immune response. Some people inherit the risk for type 1 diabetes. However, even these people may not develop type 1 diabetes unless other factors, such as exposure to certain viral infections, are present.

• In infants and children, the beta cells usually are destroyed rapidly, resulting in a sudden rise in blood sugar level and a sudden onset of diabetes symptoms.
• In adults, the cells often are destroyed more slowly, resulting in a slower rise in blood sugar level and a slower onset of diabetes symptoms.

Certain genes make a person more susceptible while other genes seem to protect the person from the disease. A complex interaction between a person's genes and some environmental factors, such as having enteroviral infections—especially Coxsackie B infections—may increase the risk of developing the disease, but it does not mean that the person will definitely develop the disease.

In the past, experts thought that vaccines (particularly whooping cough and Haemophilus influenza B, or HIB) may cause diabetes; however, studies have found no relationship between these vaccinations and developing type 1 diabetes.²

Your (or your child's) symptoms of type 1 diabetes probably developed quickly, over a few days to weeks. These symptoms are caused by blood sugar levels rising above the normal range (hyperglycemia) and include:

• Frequent urination, which may be more noticeable at night. If your child has already learned to use the toilet, he or she may have started wetting the bed during naps or at night.
• Extreme thirst and a dry mouth.
• Weight loss.
• Increased hunger.
• Blurred vision.
• Fatigue.

If your blood sugar rose to very high levels, you may have received treatment in a hospital for diabetic ketoacidosis, which is an emergency.

What symptoms might I have now?

Now that you are taking insulin injections, watch for signs of either high or low blood sugar. High blood sugar (hyperglycemia) usually develops slowly over a few days or weeks; on the other hand, low blood sugar (hypoglycemia) can develop within 10 to 15 minutes. Children, especially very young children, are at greater risk for harm caused by very low blood sugar levels.

Watch for the following symptoms of high or low blood sugar. You (or your child) may not have the same symptoms every time, and you may have symptoms that are not listed.

• Symptoms of low blood sugar include sweating, weakness, and inability to concentrate. Severe low blood sugar can cause loss of consciousness and seizures.
• Symptoms of high blood sugar include increased thirst and increased urination.
• Signs of high or low blood sugar in young children can be confusing but may include paleness and a sudden change in emotion.

You may find that soon after you are diagnosed with type 1 diabetes your blood sugar levels return to normal. You are in what is called the "honeymoon period." The remaining insulin-producing cells in your pancreas are working harder to supply enough insulin for your body. You may take little or no insulin; however, this does not mean that the disease is gone. After the remaining insulin-producing cells are destroyed, the honeymoon period ends, and you will need to take insulin for the rest of your life.

Treatment for your diabetes includes following a diet that spreads carbohydrate throughout the day, getting regular physical activity, monitoring your blood sugar levels (using a home blood sugar meter), and taking insulin. By working closely with your doctor and following your prescribed treatment, you will feel better and have more control of your life. If your child has type 1 diabetes, treatment involves the same tasks but allows for normal growth and development.

Before diagnosis, your blood sugar level may have risen high enough to cause severe symptoms, such as confusion or even coma. This condition is called diabetic ketoacidosis and often requires treatment in a hospital. During your hospital stay, your blood sugar level is lowered with insulin injections, and your condition is monitored closely. You are still at risk for this emergency in the future if your blood sugar rises very high and your body produces ketones.

If you have persistent high blood sugar levels over a long period of time, diabetes can damage your:

• Eyes (diabetic retinopathy).
• Kidneys (diabetic nephropathy).
• Nerves (diabetic neuropathy).
• Heart (leading to heart attacks).
• Blood vessels (leading to strokes and poor circulation in your legs).

If you keep your blood sugar level within a normal to near-normal range, you may prevent, or at least delay, these complications. Children seem protected from developing these complications during childhood; however, when they become adolescents, their risk begins to increase. Keeping your child's blood sugar levels as close to normal as possible will help prevent these complications from developing in young adulthood.³

Risk factors for developing type 1 diabetes include:²

• Family history of type 1 diabetes. Having a family history of the disease increases the chance that you will develop antibodies to the insulin-making cells in the pancreas. But it does not mean that you will develop diabetes. Only about 10% to 15% of people with type 1 diabetes have a family history of the disease.
  • If the father has the disease, a child has a 6% risk of developing it.
  • If a sibling has the disease, a child has a 5% risk of developing it.
  • If the mother has the disease, a child has a 2% risk of developing it.
  • If an identical twin has the disease, the other twin has a 30% to 50% risk of developing it.
  • If a parent and one sibling have the disease, a child has a 30% risk of developing it.
• Race. White people have a greater risk for developing type 1 diabetes than blacks, Asians, or Hispanics.
• Presence of islet cell antibodies in the blood. People who have both a family history of type 1 diabetes and islet cell antibodies in their blood are likely to develop the disease.
• Certain viral infections during childhood. A child who has enterovirus infections, particularly Coxsackie B infections, has a risk almost 6 times greater than other children for developing type 1 diabetes. However, this does not mean that the child will definitely develop the disease. In fact, doctors are uncertain whether these infections actually play a role in developing diabetes.⁴
• Drinking cow's milk. Children who have a genetic tendency for type 1 diabetes and stop breast-feeding before 3 months of age or who are given cow's milk formula before 4 months of age have a slightly increased risk for developing type 1 diabetes. Children who have a sibling with diabetes and drink more than two 8 fl oz (23.7 cL) glasses of cow's milk per day during childhood may have a 4 times greater risk of developing antibodies for type 1 diabetes, increasing the risk of developing the disease. Doctors are uncertain whether cow's milk actually plays a role in the development of type 1 diabetes.

Call 911 if you or your child with type 1 diabetes becomes sleepy or lethargic, and the blood sugar level is less than 60 mg/dL. While waiting for emergency help, follow the appropriate guideline:

• Emergency care for low blood sugar
• Emergency care for low blood sugar in a child

Call a health professional if:

• Your blood sugar level stays above your target range after following the steps for high blood sugar.
• Your child's blood sugar level stays above his or her target range after following the steps for high blood sugar.
• Your or your child's blood sugar level stays below the target range after eating some quick-sugar food.
• Your or your child's blood sugar level stays high after taking a missed dose of insulin or taking an extra dose of insulin (if prescribed by the doctor).
• You or your child has frequent problems with high or low blood sugar levels. The insulin dose or schedule may need changing.
• You or your child is having problems following the meal plan or getting physical activity, and you want help.

Watchful Waiting

Watchful waiting is not appropriate if you or your child with type 1 diabetes is losing consciousness and has high or low blood sugar. High and low blood sugar levels need treatment early so that the level does not continue to rise or drop and cause an emergency situation.

Watchful waiting is not appropriate if you or your child with diabetes is frequently having high or low blood sugar levels. The insulin type, dose, or schedule may need changing.

Who To See

Health professionals who can treat type 1 diabetes include:

• A family medicine doctor or general practitioner.
• An internist.
• An endocrinologist.
• A pediatrician, if your child has diabetes.
• A certified diabetes educator (CDE).
• A registered dietitian. You need to talk with a dietitian soon after being diagnosed with diabetes to set up a daily meal and snack plan that spreads carbohydrate throughout your day. From time to time, you may need to talk with the dietitian to make adjustments in your meal plan.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Routine tests

Routine tests for type 1 diabetes include a hemoglobin A_1c or similar test (glycosylated hemoglobin or glycohemoglobin) that estimates your average blood sugar level over the previous 2 to 3 months. It helps monitor blood sugar control after treatment has started.

You need to see your health professional about every 3 to 4 months throughout your life for exams and tests to monitor your condition and adjust your treatment.

For more information, see the schedule for exams and tests beginning at diagnosis.

After you have had diabetes for 3 to 5 years, you will need annual tests to watch for signs of damage to your eyes (diabetic retinopathy), kidneys (diabetic nephropathy), heart, blood vessels, and nerves (diabetic neuropathy). If your child has diabetes, this testing should begin at puberty.

If you are very ill

You may have found out that you have type 1 diabetes when your blood sugar levels rose very high and you were admitted to a hospital for diabetic ketoacidosis (DKA). The following tests were likely used to diagnose and monitor treatment of ketoacidosis. You may have these tests again if you develop DKA in the future.

• Chemistry screen, arterial blood gases, and other blood tests, to learn your blood sugar (glucose) level, levels of electrolytes in the blood, other potential causes of acidosis, and general state of health
• Urinalysis, to discover whether high amounts of ketones and sugar (glucose) are in your urine

The focus of your treatment for type 1 diabetes is to keep your blood sugar level within a normal or near-normal range. This is called tight control. It is the best way to reduce your risk of diabetes complications. However, some people—such as those whose blood sugar drops too low with tight control—may need to set a different target range with their health professional.

A normal to near-normal blood sugar level is 90 mg/dL to 130 mg/dL before eating or less than 180 mg/dL 1 to 2 hours after eating. It also may be measured as a hemoglobin A_1c of 6% or less (normal) to 7% (near normal). This is a test of your blood sugar control for the past 2 to 3 months. If you do not have problems with low blood sugar, you may be able to tightly control your blood sugar to an A_1c of 6% or less.

To keep your blood sugar as close to normal as possible, your daily treatment includes:

• Testing your blood sugar several times every day. Do additional blood sugar testing whenever you have symptoms of high or low blood sugar, and occasionally test during the night. It is possible for your blood sugar level to change while you are sleeping. Testing at night will determine if this is happening to you. If it is, your doctor may change your treatment plan. For more information see:

  Home blood sugar monitoring.

  Home blood sugar monitoring for a child.

• Taking (several) insulin injections or using an insulin pump. Even children can use an insulin pump. For more information see:

  Preparing and giving an insulin injection.

  Preparing and giving an insulin injection to a child. If your child is age 13 or older, he or she can learn to give an insulin injection.

• Spreading carbohydrate throughout the day to prevent high blood sugar levels after meals. For more information see:

  Carbohydrate counting.

• Getting at least 30 minutes of physical exercise (1 hour for children) on most days of the week. Some tips for exercising safely may be helpful. Let your child participate in sports activities, but let the coach know that your child has diabetes. Take a snack along to all practices and games, and check your child's blood sugar levels before and after the activity.

Chronic illnesses such as diabetes take a toll on your energy and emotions. It's normal to feel down sometimes. But if you feel seriously overwhelmed, tearful, and not yourself, you may be suffering from depression. Talk to your health professional if you feel depressed. Medication, counseling, and other support can help you.

How often will I see my doctor?

At first, your doctor will want to talk with you daily or at least every few days while finding the treatment that best keeps your blood sugar levels within your target range. Once your blood sugar levels are staying within this range, you will continue to see your doctor about every 3 to 4 months. During these checkups, your doctor will evaluate and adjust your treatment. You will also start having exams and tests that check your blood sugar control and monitor your condition on a regular basis.

After you have had diabetes for 3 to 5 years, you will start having yearly exams and tests to monitor for signs of complications, particularly eye and kidney damage. If your child has diabetes, this testing should begin at puberty.

What if I have diabetic ketoacidosis?

If your blood sugar level was very high at the time you were diagnosed with diabetes, you may have been treated for diabetic ketoacidosis. This life-threatening condition can happen to you again if you do not take enough insulin, have a severe infection or other illness, or become severely dehydrated. Treatment for diabetic ketoacidosis requires hospitalization and includes:⁵

• Fluids given through a vein (intravenous, or IV), to replace body fluids lost from dehydration and to correct the electrolyte imbalance.
• Frequent monitoring of blood pressure, heart rate (pulse), breathing rate (respirations), and level of consciousness.
• Frequent blood tests for glucose and electrolytes.
• Insulin given through the IV fluid. Once blood sugar levels are closer to your target range and you are no longer dehydrated, you can have insulin injected under the skin (subcutaneous).

Will I need treatment during the honeymoon period?

If your blood sugar levels return to the normal range soon after diagnosis, you are in what is called the "honeymoon period." This is a time when the remaining insulin-producing cells in your pancreas are working harder to supply enough insulin for your body. Treatment during this time may include:

• Talking with your doctor every day or so until the honeymoon period is over.
• Monitoring your blood sugar level frequently to see whether it is rising.
• Taking very small amounts of insulin or no insulin. Even though you may not need insulin, some doctors prefer that you take small doses of insulin daily throughout the honeymoon period. This may decrease the stress on the pancreas. It may also help prevent your child with diabetes from thinking that the disease is gone.

What To Think About

When your child has diabetes

Talk with your child's teachers and the staff at his or her school (or child care center) to develop a plan for diabetes care at school. This plan needs to include clear instructions for dealing with low blood sugar, when to test the child's blood sugar, contents of school meals and snacks, and emergency contact information.

Allow your child with diabetes to participate in his or her daily care to the extent that is appropriate for your child's age and development. For example, your 4-year-old child cannot be responsible for testing his or her blood sugar, but he or she can get out the supplies and perform some of the simpler steps. By the time your child is an adolescent, he or she should be able to take responsibility for the diabetes care, with appropriate supervision.

Coping with the disease

You (or your child) have just been diagnosed with a disease that requires daily attention and will last for the rest of your life. It is difficult to accept and adjust to all the lifestyle changes that you need to make, such as eating the right amount of carbohydrate at each meal and snack, giving injections every day, and coping with blood sugar variations.

Anger, resentment, or denial are normal feelings in these circumstances and can be expected because you are experiencing the loss of what your life was like before you got type 1 diabetes. Allow yourself time to deal with your feelings and grieve your loss. For more information, see the topic Grief and Grieving.

Wear medical identification

Wear medical identification at all times. If you have an accident or you are taken to a hospital, this identification lets people know that you have diabetes so that they can care for you appropriately. You can buy medical identification in bracelets, necklaces, or other forms of jewelry at your local pharmacy.

Prevent high and low blood sugar emergencies

Blood sugar usually rises above a normal or near-normal range slowly, but it can lead to a life-threatening emergency unless it is treated promptly. Your blood sugar is likely to rise when you are sick. For more information, see guidelines for when you are sick.

Preventing high blood sugar emergencies.

Preventing high blood sugar emergencies in children.

Low blood sugar (hypoglycemia) can develop very quickly. It can lead to a life-threatening emergency if it is not treated quickly. Low blood sugar can be especially dangerous if you drive. Do not drive if your blood sugar level is below 65 milligrams per deciliter (mg/dL). Take precautions when you are driving, and be prepared to stop and treat low blood sugar.

Dealing with low blood sugar emergencies

Dealing with low blood sugar in a child

Preventing soreness and infection at injection sites

You can prevent soreness and infection at your injection sites by:

• Varying the place where you give your injections. See the diagram of injection sites .
• Washing your hands before preparing and giving an injection.
• Cleaning the injection area with a piece of cotton dipped in alcohol or with a commercial alcohol wipe.
• Not using needles that are bent or have been reused several times.

Your daily routine now includes new tasks and safety measures because you have type 1 diabetes. You can help keep your blood sugar levels as close to normal as possible by following a routine. This means testing your blood sugar and eating at regular times. It also means consistently eating about the same amount of food every day. There is a lot to learn about this complex disease, but for now concentrate on these critical steps:

Spread carbohydrate throughout the day

Carbohydrate is the one nutrient in your diet that most affects blood sugar levels. A registered dietitian can help you learn about what foods contain carbohydrate and how to manage it in your diet. If your child has diabetes, talk with the dietitian about how to adjust meals and snacks for your child's varying appetite.

Carbohydrate counting

Take insulin

You need to take injections every day because your pancreas no longer produces insulin. If your child with diabetes is 10 years old, he or she may be able to give an injection with your supervision. However, children generally do not give all of their own injections until about age 13.

Preparing and giving an insulin injection

Preparing and giving an insulin injection to a child

Check your blood sugar often

Your doctor will want you to test your blood sugar level several times a day.

Home blood sugar monitoring

Home blood sugar monitoring for a child

Exercise regularly

Get at least 30 minutes of physical activity on most days of the week. Some tips for exercising safely may help.

If your child or teen has diabetes, experts recommend they get an hour of physical activity on most days of the week. Children and teens can participate in sports and other organized activities as long as they take precautions to prevent and treat low blood sugar (hypoglycemia).

• Let the coach know that your child has diabetes. Give the coach a copy of the symptoms of low blood sugar and the emergency care for a child with diabetes.
• Check your child's blood sugar level before and after a practice or game.
• Take a snack that contains carbohydrate to all practice sessions and games.

Insulin is the only medication used to treat type 1 diabetes. There are several different types of insulin, and most people with type 1 diabetes need a combination of long-acting and short-acting insulins.

Never skip a dose of insulin without the advice of your doctor. Know:

• The dose of each type of insulin you are taking.
• The daily schedule for your insulin injections. Usually people with type 1 diabetes take a long-acting insulin once or twice a day and a short-acting insulin with meals.
• How long it takes for each type of insulin to start working (onset), when it will have its greatest effect (peak), and how long it will work (duration).
• How to prepare and give an insulin injection.

• Giving an insulin injection

You are not likely to be eligible for either of the surgeries that treat type 1 diabetes.

• A pancreas transplant is done only if a person has received or is receiving another organ, such as a kidney.
• Islet cell transplants are experimental and available only at medical centers that are doing studies.

These surgeries are very expensive, and after having one, you must take medication to prevent your body from rejecting the new tissue (immunosuppression medications) for the rest of your life.

Avoid products that promise a “cure” for diabetes. No such cure exists. If you have questions about a product for diabetes, check with your local American Diabetes Association office, your doctor, or a diabetes educator.

Other types of meal plans

You may hear of people with diabetes following meal plans other than carbohydrate counting, or using low glycemic-index foods to prevent high blood sugar levels (hyperglycemia) after meals. Talk with a registered dietitian before choosing an alternate meal planning method for your or your child's diabetes diet.

Complementary therapies

Complementary therapies, such as acupuncture or biofeedback, may help relieve stress and muscle tension and improve your overall well-being and quality of life. Talk with your doctor if you are using any complementary or alternative therapies, including chiropractic therapy and osteopathy.

Studies indicate that soluble fiber may help people with type 1 diabetes keep blood sugar levels within a normal or near-normal range. Other herbal medicines and natural substances, such as antioxidants, vanadium, magnesium, or chromium, may be helpful also. Talk with your doctor about any herbal or natural products that you are taking or that you want to take.

Online Resource

Organizations

• Diabetic Nephropathy
• Diabetic Neuropathy
• Diabetic Retinopathy
• Gestational Diabetes
• Type 1 Diabetes
• Type 1 Diabetes: Children Living With the Disease
• Type 1 Diabetes: Living With Complications
• Type 1 Diabetes: Living With the Disease
• Type 2 Diabetes
• Type 2 Diabetes in Children
• Type 2 Diabetes: Living With Complications
• Type 2 Diabetes: Living With the Disease
• Type 2 Diabetes: Recently Diagnosed

Citations

1. Devendra D, et al. (2004). Type 1 diabetes: Recent developments. BMJ, 328(7442): 750–754.

2. Lawson ML, Muirhead SE (2001). What is type 1 diabetes? In HC Gerstein, RB Haynes, eds., Evidence-Based Diabetes Care, pp. 124–150. Hamilton, ON: BC Decker.

3. Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group (2001). Beneficial effects of intensive therapy of diabetes during adolescence: Outcomes after the conclusion of the Diabetes Control and Complications Trial (DCCT). Journal of Pediatrics, 139(6): 804–812.

4. Atkinson MA, Eisenbarth GS (2001). Type 1 diabetes: New perspectives on disease pathogenesis and treatment. Lancet, 358(9277): 221–229.

5. American Diabetes Association (2004). Hyperglycemic crises in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S94–S102.

Other Works Consulted

• American Diabetes Association (2004). Pancreas transplantation in type 1 diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S105.

• Bazian Ltd. (2003). Glycaemic control in diabetes. Clinical Evidence (10): 667–675.

• Goguen JM, Leiter LA (2001). Alternative therapy: The role of selected minerals, vitamins, fiber, and herbs in treating hyperglycemia. In HC Gerstein, RB Haynes, eds., Evidence-Based Diabetes Care, pp. 295–322. Hamilton, ON: BC Decker.

• Ludwig DS (2002). The glycemic index: Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA, 287(18): 2414–2423.

• Pickup J, Keen H (2002). Continuous subcutaneous insulin infusion at 25 years. Diabetes Care, 25(30): 593–598.

• White SA, et al. (2001). Human islet cell transplantation: Future prospects. Diabetic Medicine, 18(2): 78–103.

Author:	Nancy Bateman Marianne Flagg	Last Updated February 17, 2005
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine David C.W. Lau, MD, PhD, FRCPC - Endocrinology & Metabolism
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