This topic provides
information about
type 1 diabetes for adults and for 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 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. But 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. But 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 blood sugar 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.
When
insulin levels drop very low, blood sugar can rise
very high and 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.
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. But by taking your
insulin regularly and keeping your blood sugar levels in your target range, you
can avoid DKA.
The main symptoms of low blood sugar from diabetes
are:
Sweating (almost always present).
Nervousness, shakiness, and weakness.
Dizziness and headache.
Confusion and irritability.
Slurred speech.
Personality changes, such as anger or crying.
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 medicine (insulin), exercising
more than usual, or taking certain medicines that lower blood sugar can cause
your blood sugar to drop rapidly.
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. But 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 doctor set. You use a home glucose monitor to do
these tests.
At first, you will keep in close touch with your
doctor while finding the right dose of insulin that best keeps your blood sugar
levels within your target range. When your blood sugar levels are staying
within this range, you will continue to see your doctor about every 3 to 6
months. During these checkups, your doctor will look at your treatment to see
how well it is controlling your diabetes. If your treatment isn't working very
well, your doctor may have you try different things. You will also start having
a hemoglobin A1c test to find out what your average blood sugar level was
during the 2 to 3 months before your visit. This test checks your long-term
blood sugar control.
You also need to have regular tests to check
your
blood pressure and
cholesterol levels because 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. But some people-such as those whose blood sugar drops too low
with tight control-may need to set a different target range with their
doctor.
A normal to near-normal blood sugar level is 70 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 A1c 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.
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 medicine to keep your blood
pressure and cholesterol in the normal ranges. If you are 40 or older, you also
may take aspirin to lower your risk for having a heart attack.
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. But 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 doctors 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.
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. But 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 caused diabetes. But studies have found no
link between getting a vaccination and getting type 1 diabetes.2
Symptoms
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. The kidneys are trying to get rid of
the excess sugar in the blood. In order to do that, they have to excrete more
water. More water means more urine.
Extreme thirst and a dry mouth. This happens if you lose, through
frequent urination, enough water to become dehydrated.
Weight loss. This happens because you are dehydrated. Weight loss
may also happen if you are losing all of those sugar calories in your urine
instead of using them.
Increased hunger. You feel hungry because your body is not using
all the calories that it can. Many of them are being excreted in urine.
Blurred vision. Your vision may blur when sugar builds up in the
lens of your eye. The sugar sucks extra water into your eye, which changes the
shape of the lens and blurs your vision.
Fatigue. You feel tired for the same reason you feel hungry. Your
body is not using the calories you are eating, and your body is not getting the
energy it needs.
All of these symptoms will get better or go away when your
blood sugar levels are controlled.
If your blood sugar rose to
very high levels at the time you were diagnosed with diabetes, 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. But it can also develop quickly (in just a few hours) if
you eat a large meal or miss an insulin dose. 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.
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. But 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 insulin level may have been low enough to cause severe high
blood sugar, with symptoms such as confusion or even coma. This condition is
called
diabetic ketoacidosis and often requires treatment in
a hospital. During your hospital stay, you are given insulin injections and
fluids in a vein (intravenous or IV), and your condition is monitored closely.
You are still at risk for this emergency in the future if you don't take enough
insulin to keep your sugar levels and metabolism normal.
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. But when they become adolescents, their risk
begins to increase. Keeping blood sugar levels as close to normal as possible
at the beginning of the disease will help prevent these complications.3
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.2
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. Family members of people with type 1 diabetes can be
tested to see if they have islet cell antibodies. People who are found to have
islet cell antibodies may be able to participate in studies about preventing
type 1 diabetes.
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. But this does not mean that the child will
definitely develop the disease.
When To Call a Doctor
Call 911 or other emergency services immediately if you or your child is:
Unconscious or becomes very sleepy unexpectedly. You
or your child may have low blood sugar, called
hypoglycemia. While waiting for emergency help,
follow:
Drowsy, confused, breathing fast, and your or your child's
breath smells fruity. You or your child may have high blood sugar, called
hyperglycemia. A life-threatening condition called
diabetic ketoacidosis could be present.
Call a doctor immediately if you or
your child is vomiting and cannot keep down liquids and:
Your blood sugar is 300 mg/dL or higher.
Your child's blood sugar is 250 mg/dL or higher.
Call a doctor if you or your child:
Is sick for more than 2 days (unless it is a mild illness, such
as a cold), and you or your child:
Has been vomiting or had diarrhea for more than 6 hours.
Has 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
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.
Routine tests for
type 1 diabetes include a hemoglobin A1c 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 doctor
about every 3 to 6 months throughout your life for exams and tests to monitor
your condition and adjust your treatment.
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.
Other tests
You may need a
thyroid-stimulating hormone (TSH) test when type 1
diabetes is diagnosed and then every 1 to 2 years. This test checks for thyroid
problems, which are common among people with diabetes.
If you are very ill
You may have found out that
you have type 1 diabetes when your insulin levels dropped very low 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 check
your blood sugar (glucose) level, levels of electrolytes in the blood, other
potential causes of acidosis, and general state of health
Urinalysis, to check 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. But
some people-such as those whose blood sugar drops too low with tight
control-may need to set a different target range with their doctor.
A normal to near-normal blood sugar level is 70 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 A1c 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.
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:
Diabetes in children: Giving insulin shots to a child.
At some point your child can learn to give an insulin injection. Talk to your
doctor and your child to find out when is a good time to start teaching your
child to give an insulin injection.
Spreading
carbohydrate throughout the day to prevent high blood
sugar levels after meals. For more information, see:
Doing
moderate activity at least 2½ hours a week. (Teens and
children-starting at age 6-should do moderate to vigorous activity at least 1
hour every day.) Some
tips for exercising safely may be helpful. It may also
help to keep track of your exercise on an
activity log(What is a PDF document?)
. Children with type 1 diabetes can participate in sports just
like children without diabetes. But children who use insulin are at risk of low
blood sugar. Some tips on
safe exercising for your child with type 1 diabetes can help prevent low
blood sugar. For more information, see the topic
Fitness.
Starting a routine. Your sugar levels may be easier to control if
you have a routine where you eat and exercise about the same amounts and at
about the same times every day.
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 doctor if you feel depressed.
Medicine, counseling, and other support can help you.
How often will I see my doctor?
At first, you will
keep in close touch with your doctor while you are trying to find the right
dose of insulin that best keeps your blood sugar levels within your target
range. After your blood sugar levels are staying within this range, you will
continue to see your doctor about every 3 to 6 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:4
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. After 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:
Keeping in close touch with your doctor.
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.
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 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 his or her diabetes care, with appropriate
supervision. For more information, see the topic
Type 1 Diabetes: Children Living With the Disease.
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.
Prevention
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.
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 70 milligrams per deciliter (mg/dL). Take
precautions when you are driving, and be prepared to
stop and treat low blood sugar.
Having a routine (when you eat, exercise, take your
insulin, and check your blood sugar at about the same time every day) can also
help prevent high and low blood sugar emergencies. When you have a routine,
your blood sugar levels may be more predictable. A routine will also help you
to remember to check your blood sugar and give yourself your insulin
injections.
Preventing soreness and infection at injection sites
You can prevent soreness and infection at your injection sites by:
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.
Home Treatment
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.
You need to take injections every
day because your
pancreas no longer produces
insulin. Eventually, your child can learn to give an
insulin injection. Talk to your doctor and your child to find out when is a
good time to start teaching your child to give an insulin injection.
Try to do
moderate activity at least 2½ hours a week.5 One way to do this is to be active 30 minutes a day, at least
5 days a week. Some
tips for exercising safely may help. It may also help
to keep track of your exercise on an
activity log(What is a PDF document?)
.
Encourage your child to do moderate to vigorous
activity at least 1 hour every day. It's okay for them to be active in smaller
blocks of time that add up to 1 hour or more each day. Children with type 1
diabetes can participate in sports just like children without diabetes. But
children who use insulin are at risk of low blood sugar. Some tips on
safe exercising for your child with type 1 diabetes can help prevent low
blood sugar.
Limit alcohol
In addition to exercising, it is a
good idea to limit the amount of alcohol you drink. The American Diabetes
Association recommends that women with diabetes have no more than one drink a
day and men with diabetes have no more than two drinks a day.6 One drink is
12 fl oz (0.4 L) of beer,
5 fl oz (0.2 L) of wine, or
1.5 fl oz (44.4 mL)
liquor.
Quit smoking
Tobacco has many bad health effects,
especially for people with diabetes. Having type 1 diabetes can cause a lot of
problems in your body. Smoking can make many of these problems worse,
especially heart and blood vessel disease. Smoking raises your
cholesterol and makes it harder for your body to heal.
No matter how long you've smoked, your health will improve after you quit. For
help quitting, see the topic
Quitting Smoking.
Insulin is 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). See a table that shows this information about
types of insulin.
There are no surgical treatments for recently
diagnosed
type 1 diabetes.
Other Treatment
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.
Other Places To Get Help
Organizations
American Diabetes Association (ADA)
1701 North Beauregard Street
Alexandria, VA 22311
Phone:
1-800-DIABETES (1-800-342-2383)
E-mail:
AskADA@diabetes.org
Web Address:
www.diabetes.org
The American Diabetes Association (ADA) is a national organization
for health professionals and consumers. Almost every state has a local office.
ADA sets the standards for the care of people with diabetes. Its focus is on
research for the prevention and treatment of all types of diabetes. ADA
provides patient and professional education mainly through its publications,
which include the monthly magazine Diabetes Forecast,
books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also
provides information for parents about caring for a child with diabetes.
Juvenile Diabetes Research Foundation
International
120 Wall Street
New York, NY 10005-4001
Phone:
1-800-533-CURE (1-800-533-2873)
Fax:
(212) 785-9595
E-mail:
info@jdrf.org
Web Address:
http://www.jdrf.org
The Juvenile Diabetes Research Foundation International is dedicated to finding a cure for type 1 diabetes and its complications. The organization funds research on type 1 diabetes, including research on prevention and treatment. This
organization publishes a wide variety of booklets, magazines, and e-newsletters on complications and
treatments of type 1 diabetes.
National Diabetes Education Program
(NDEP)
1 Diabetes Way
Bethesda, MD 20814-9692
Phone:
1-800-438-5383 to order materials (301) 496-3583
E-mail:
ndep@mail.nih.gov
Web Address:
http://ndep.nih.gov
The National Diabetes Education Program (NDEP) is
sponsored by the U.S. National Institutes of Health (NIH) and the U.S. Centers
for Disease Control and Prevention (CDC). The program's goal is to improve the
treatment of people who have diabetes, to promote early diagnosis, and to
prevent the development of diabetes. Information about the program can be found
on two Web sites: one managed by NIH (http://ndep.nih.gov) and the other by CDC
(www.cdc.gov/team-ndep).
National Diabetes Information Clearinghouse
(NDIC)
1 Information Way
Bethesda, MD 20892-3560
Phone:
1-800-860-8747
Fax:
(703) 738-4929
TDD:
1-866-569-1162 toll-free
E-mail:
ndic@info.niddk.nih.gov
Web Address:
http://diabetes.niddk.nih.gov
This clearinghouse provides information about research
and clinical trials supported by the U.S. National Institutes of Health. This
service is provided by the National Institute of Diabetes and Digestive and
Kidney Disease (NIDDK), a part of the National Institutes of Health (NIH).
Devendra D, et al. (2004). Type 1 diabetes: Recent
developments. BMJ, 328(7442): 750-754.
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.
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.
American Diabetes Association (2004). Hyperglycemic
crises in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S94-S102.
U.S. Department of Health and Human Services (2008).
2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office.
Available online:
http://www.health.gov/paguidelines/pdf/paguide.pdf.
American Diabetes Association (2008). Standards of
medical care in diabetes. Clinical Practice Recommendations 2008.
Diabetes Care, 31(Suppl 1): S12-S54.
Other Works Consulted
American Diabetes Association (2004). Dyslipidemia
management in adults with diabetes. Clinical Practice Recommendations 2004.
Diabetes Care, 27(Suppl 1): S68-S71.
American Diabetes Association (2006). Pancreas and islet transplantation in type 1 diabetes. Position statement. Diabetes Care, 29(4): 935.
Anderson JW (2006). Diabetes mellitus: Medical
nutrition therapy. In ME Shils et al., eds., Modern Nutrition in Health and Disease, 10th ed., pp. 1043-1066. Philadelphia: Lippincott
Williams and Wilkins.
Campbell A (2006). Glycaemic control in type 1
diabetes, search date December 2005. Online version of BMJ Clinical Evidence. Also available online:
http://www.clinicalevidence.com.
Campbell AP, Beaser RS (2007). Designing a
conventional insulin treatment program. In RS Beaser et al., eds.,
Joslin's Diabetes Deskbook, pp. 281-323. Boston: Joslin
Diabetes Center.
Campbell AP, Beaser RS (2007). Medical nutrition
therapy. In RS Beaser et al., eds., Joslin's Diabetes Deskbook, pp. 81-125. Boston: Joslin Diabetes Center.
Centers for Disease Control and Prevention (2005).
National Diabetes Fact Sheet: General Information and National Estimates on Diabetes in the United States, 2005. Atlanta: U.S.
Department of Health and Human Services. Available online:
http://www.diabetes.org/diabetes-statistics.jsp.
Chalmers KH (2005). Medical nutrition therapy. In
Joslin's Diabetes Mellitus, 14th ed., pp. 611-631.
Philadelphia: Lippincott Williams and Wilkins.
Cheng AYY, Zinman B (2005). Principles of insulin
therapy. In CR Kahn et al., eds., Joslin's Diabetes Mellitus, 14th ed., pp. 659-670. Philadelphia: Lippincott Williams and
Wilkins.
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.
Hviid A, et al. (2004). Childhood vaccination and type
1 diabetes. New England Journal of Medicine, 350(14):
1398-1404.
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.
Weir GC (2005). Pancreas and islet transplantation. In
Joslin's Diabetes Mellitus, 14th ed., pp. 757-776.
Philadelphia: Lippincott Williams and Wilkins.
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
Devendra D, et al. (2004). Type 1 diabetes: Recent
developments. BMJ, 328(7442): 750-754.
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.
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.
American Diabetes Association (2004). Hyperglycemic
crises in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S94-S102.
U.S. Department of Health and Human Services (2008).
2008 Physical Activity Guidelines for Americans (ODPHP
Publication No. U0036). Washington, DC: U.S. Government Printing Office.
Available online:
http://www.health.gov/paguidelines/pdf/paguide.pdf.
American Diabetes Association (2008). Standards of
medical care in diabetes. Clinical Practice Recommendations 2008.
Diabetes Care, 31(Suppl 1): S12-S54.
