Diabetes Education

Type 1 Diabetes

Q. What is Type 1 Diabetes?

A. Type 1 diabetes is a chronic medical condition that affects how the body normally gets energy from food. Type 1 diabetes results when a person’s pancreas stops making the insulin hormone. When insulin production ceases, the body cannot get the energy it needs from the foods that are eaten.

The exact cause of Type 1 diabetes is not known. What we do know is that Type 1 diabetes does not result from overconsumption of sugar or sweets.

Q. What happens when the pancreas no longer produces insulin?

A. In Type 1 diabetes, food is still broken down into glucose, as in regular digestion. However, in regular digestion, insulin is available to allow glucose to enter the body cells. In a person with Type 1 diabetes, glucose (blood sugar) builds up in the bloodstream because there is no insulin hormone secreted by the beta cells of the pancreas. The blood glucose levels increase and rise to numbers much higher than normal.

Q. What is the result of the elevated blood sugar levels?

A. When the body cells cannot get glucose due to a lack of insulin, the body cells try to get energy or fuel from stored fat. Fat is not the body’s preferred source of energy. Ketones are a type of acid that is present in the bodystream when the body tries to use fat for energy. When ketones build up in the body, a potentially dangerous medical condition called "diabetic ketoacidosis: DKA" results. Most persons with Type 1 diabetes have DKA when they are first diagnosed. Ketoacidosis usually develops slowly and can poison the body. If vomiting occurs, then this condition is considered life-threatening.

Q. What are the treatments for Type 1 Diabetes?

A. The primary treatment for Type 1 diabetes is insulin injection. Insulin injections are necessary to replace the insulin that is not being produced by the body. Most insulin is man-made, however the insulin works just like the body’s own insulin to allow glucose to enter the body cells. Insulin can be injected into the body using needles or by an insulin pump inserted under the skin.

Q. What does the term "Honeymoon Phase" mean?

A. The "Honeymoon Phase" for newly diagnosed Type 1 diabetes can occur within two to several weeks. During this phase the body does attempt to produce some insulin. This phase may last for a few months or longer. The person with Type 1 diabetes will require very little insulin during a honeymoon phase. The decreased need for insulin will cause some persons to think that perhaps the diabetes has gone away. However this "Honeymoon Phase" is only temporary, and the pancreas will eventually completely cease or stop making any insulin.

Q. What lifestyle adjustments are necessary for people with Type 1 diabetes?

A. Checking blood glucose levels will need to be done daily. This is important for persons with Type 1 diabetes because controlling blood glucose levels is the key goal for appropriate wellness and diabetes management. A person with Type 1 diabetes will be taught how to use a blood glucose meter for blood glucose monitoring. Also, a healthcare team will provide education on how to set individual goals for target blood glucose ranges and ongoing blood sugar monitoring.

Q. Now that you've checked blood glucose levels, what’s next?

A. Record keeping is very important for anyone with diabetes and especially for people who have Type 1 diabetes. A logbook (which should be provided with the glucose meter) should be kept as a "record book" by the patient/person with Type 1 diabetes which lists: blood glucose readings, times of day readings are taken, and the type, times and amounts of insulin taken. Most logbooks offer sections to record food and exercise entries, and the readings along with the other entries help medical providers to determine patterns and solve any blood glucose management problems.

Q. What can be done to reduce the pain from "finger sticking" when monitoring blood glucose?

A. Here are some things to try when getting a blood sample:

  • Use the side of the finger, rather than the tip of the finger.
  • Use a meter that will require a small blood sample.
  • Use a lancing device that is adjustable.
  • Purchase "fine" (high gauge) lancets.
  • Clean finger with soap and water, rather than alcohol.

Q. What will happen if blood sugar is too low? What is "Hypoglycemia?"

A. Low blood sugar is called "Hypoglycemia." Hypoglycemia results when blood glucose levels are too low - below 70 mg/dl. Causes for hypoglycemia are generally eating too little food, skipping a meal or snack, or taking too much insulin.

Low blood sugar can result when there has been increased physical activity, even when the activity was several hours earlier. If low blood sugar is not treated and becomes severe, it can lead to passing out or seizures. Learn to recognize the symptoms of low blood sugar to prevent blood glucose readings below 70 mg/dl.

Q. What are the symptoms of hypoglycemia?

A. Low blood sugar (glucose) symptoms are:

  • Dizziness
  • Hunger
  • Weakness
  • Irritability
  • Headache
  • Shakiness
  • Confusion

When these symptoms occur, treat low blood sugar immediately. If low blood sugar (glucose) happens often, the patient will lose the ability to sense when the blood glucose level is too low.

Q. How is low blood glucose treated?

A. Check your blood glucose level if the symptoms of low blood sugar appear. If you are unable to check the glucose level, still treat for low blood glucose.

Low Blood Glucose Treatment:

  • Take 3 glucose tablets if the blood sugar is below 70mg/dl. (If glucose tablets or glucose gel is not available, use 4 ounces of juice or regular soda, or 8 ounces of lowfat or nonfat milk).
  • Recheck blood glucose 15 minutes after taking the 3 glucose tablets.
  • If the blood glucose is still 70mg/dl or below repeat with 3 more glucose tablets. Wait another 15 minutes, then check blood glucose level again.
  • Once the blood glucose level returns to normal range, eat a small snack to avoid another low level before the next meal.

Low Blood Glucose Prevention:

  • Always carry glucose gel or glucose tablets with you.
  • Always carry a medical ID card and wear a medical ID bracelet or other identification jewelry.
  • Inject insulin in a body part that is not going to be exercised. For example, do not inject insulin in the leg if you are planning to ride a bicycle.
  • Eat a small snack before exercising, eat meals at regularly scheduled times, and eat snacks on time.
  • Check your blood glucose levels after activity or exercise.

NOTE: Glucagon emergency kits, which are available with a physician prescription, are required to treat severe low blood sugar episodes. Glucagon is given by injection. A family member or loved one should learn how to inject the patient with glucagon if necessary. After an injection with glucagon, you should be responsive in 5-20 minutes and able to swallow or chew. You may vomit after injection with glucagon, so keep the head elevated.

Q. What is "Hyperglycemia?"

A. "Hyperglycemia" is elevated or high blood glucose (above 240 mg/dl). Hyperglycemia occurs when there is too much blood glucose in the body. Some common causes for hyperglycemia include: too much food, too little insulin, illness, stress, and hormone changes. Long-term complications may result if blood glucose levels are too high, too often. Treat elevated blood sugars quickly when they occur.

Q. What are the signs of Hyperglycemia?

A. Symptoms of Hyperglycemia include blurry vision, nausea, frequent thirst and frequent urination are signs of high or elevated blood glucose. Some patients may feel weak or dizzy.

Q. What is the treatment for Hyperglycemia?

A. If the blood sugar is above 240 mg/dl, drink sugar free drinks and extra water. You may have to take extra insulin as well. Follow the treatment plan that is provided by your physician.

Q. How can I prevent Hyperglycemia?

A. You can prevent Hyperglycemia by following these recommendations:

  • Practice good diabetes management including monitoring your blood glucose levels regularly. Follow the instructions provided by your doctor, nurse or other diabetes education health professional.
  • Take insulin on time, and in the proper prescribed amount.
  • Store insulin properly - according to the manufacturer’s instructions - so it will work properly.

Jeanna Rhoulhac, RD, LD/N, CDE, has been dedicated to helping people with diabetes for almost 20 years. Jeanna’s interest in diabetes began at an early age as her maternal grandmother had type 2 diabetes. Providing her clients with an individualized plan of care is very important to Jeanna, who strives to motivate and support her clients in every way.

The goal of Destination Diabetes® is to be a useful and credible resource for the more than 20 million children and adults who have diabetes in the U.S. and their families. Destination Diabetes® provides information on a wide range of diabetes health and wellness topics. Articles are written or reviewed by diabetes advisors who have experience in diabetes education.