Symptoms Of Type 1 Diabetes Onset In Adults
When an adult is diagnosed with diabetes, they are often mistakenly told that they have type 2 diabetes. This is because there may be a lack of understanding by some doctors that type 1 diabetes can start at any age, and in people of every race, shape and size. People with type 1 diabetes who have elevated blood glucose and classic risk factors for type 2 diabetes, such as being overweight or physically inactive, are often misdiagnosed. It can also be tricky because some adults with new-onset type 1 diabetes are not sick at first. Their doctor finds an elevated blood sugar level at a routine visit and starts them on diet, exercise and an oral medication.
Types Of Blood Tests Used To Diagnose Diabetes
- Random blood glucose level: This blood test for the level of glucose in your blood can diagnose diabetes, but the result depends on what food you have eaten before the test.
- HbA1c: This blood test measures the amount of glucose that has accumulated in your blood over a 3-month period. A high HbA1c result confirms the diagnosis of diabetes.
- Fasting blood glucose: This is a measure of how much glucose is in your blood when you have not eaten anything for the past 810 hours.
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How Is Diabetes Treated
Treatments for diabetes depend on your type of diabetes, how well controlled your blood glucose level is and your other existing health conditions.
- Type 1 diabetes: If you have this type, you must take insulin every day. Your pancreas no longer makes insulin.
- Type 2 diabetes: If you have this type, your treatments can include medications , insulin and lifestyle changes such as losing weight, making healthy food choices and being more physically active.
- Prediabetes: If you have prediabetes, the goal is to keep you from progressing to diabetes. Treatments are focused on treatable risk factors, such as losing weight by eating a healthy diet and exercising . Many of the strategies used to prevent diabetes are the same as those recommended to treat diabetes .
- Gestational diabetes: If you have this type and your glucose level is not too high, your initial treatment might be modifying your diet and getting regular exercise. If the target goal is still not met or your glucose level is very high, your healthcare team may start medication or insulin.
Oral medications and insulin work in one of these ways to treat your diabetes:
- Stimulates your pancreas to make and release more insulin.
- Slows down the release of glucose from your liver .
- Blocks the breakdown of carbohydrates in your stomach or intestines so that your tissues are more sensitive to insulin.
- Helps rid your body of glucose through increased urination.
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When Should I Call My Doctor
If you havent been diagnosed with diabetes, you should see your healthcare provider if you have any symptoms of diabetes. If you already have been diagnosed with diabetes, you should contact your provider if your blood glucose levels are outside of your target range, if current symptoms worsen or if you develop any new symptoms.
Treating Type 1 Diabetes
It’s important that diabetes is diagnosed as early as possible. If left untreated, type-1 diabetes is a life-threatening condition. It’s essential that treatment is started early.
Diabetes can’t be cured, but treatment aims to keep your blood glucose levels as normal as possible and control your symptoms, to prevent health problems developing later in life.
If you’re diagnosed with diabetes, you’ll be referred to a diabetes care team for specialist treatment and monitoring.
As your body can’t produce insulin, you’ll need regular insulin injections to keep your glucose levels normal. You’ll be taught how to do this and how to match the insulin you inject to the food you eat, taking into account your blood glucose level and how much exercise you do.
Insulin injections come in several different forms, with each working slightly differently. You’ll most likely need a combination of different insulin preparations.
Insulin is given to some patients by a continuous infusion of fast acting insulin . This is where a small device constantly pumps insulin into your bloodstream through a plastic tube that’s inserted under the skin with a needle.
There are alternatives to insulin injections and pumps, but they’re only suitable for a small number of patients. They are:
Read more about diagnosing diabetes and treating type 1 diabetes
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Monitoring Blood Sugar Levels Treatment
For people with diabetes, complications that can damage organs can be prevented or reduced by regulating their blood sugar level. This is done by pricking the finger and putting a drop of blood on a test strip. The strip is then placed in a monitor that reads the glucose level. Close monitoring of glucose levels allows you to regulate your blood sugar by either medication if the sugar is high, or taking in sugar if the level is low. If you are able to keep blood sugar levels in or near the normal range, you will decrease the likelihood of developing complications and have more energy and fewer problems related to diabetes.
Treatment For Type 1 Diabetes
The impairment of the pancreas ability to produce insulin in type 1 diabetes means that insulin treatment is necessary.
Most people will take insulin by injection with insulin pens. Insulin can also be delivered by wearing an insulin pump. Use of an insulin pump will be considered in people that express an interest in having one and that meet certain eligibility criteria.
It is important that you are given education on how to balance insulin doses with dietary intake and physical activity and how to use blood glucose testing to help you control your diabetes.
Staying physically active and exercising regularly and eating a healthy diet are also important towards maintaining good blood glucose control and minimising the risk of long term diabetes complications. Although diet and exercise have a role to play in type 1 diabetes management, they cannot reverse the disease or eliminate the need for insulin.
- If you have recently been diagnosed, see our newly diagnosed with type 1 diabetes guide.
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Sensory And Autonomic Neuropathy
Sensory and autonomic neuropathy in people with diabetes are caused by axonal degeneration and segmental demyelination. Many factors are involved, including the accumulation of sorbitol in peripheral sensory nerves from sustained hyperglycemia. Motor neuropathy and cranial mononeuropathy result from vascular disease in blood vessels supplying nerves.
Pancreatic Islet Cell Transplant
Some people with diabetes fail with insulin therapy and may have reactions to the insulin that is injected. These people may be candidates for islet transplantation. The procedure is a transfer of healthy insulin-producing cells from a donor into the pancreas of the person with type 1 diabetes. Although there are benefits to this procedure, there are also drawbacks including medications with serious side effects that must be used to prevent rejection of the donor cells. One major study found that 9 in 10 transplant patients had their A1c level under control 1 year after the procedure. However, this procedure is not a cure for type 1 diabetes.
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How Else Can I Manage Type 1 Diabetes
Along with insulin and any other medicines you use, you can manage your diabetes by taking care of yourself each day. Following your diabetes meal plan, being physically active, and checking your blood glucose often are some of the ways you can take care of yourself. Work with your health care team to come up with a diabetes care plan that works for you. If you are planning a pregnancy with diabetes, try to get your blood glucose levels in your target range before you get pregnant.
What Kind Of Doctor Treats Diabetes
Endocrinology is the specialty of medicine that deals with hormone disturbances, and both endocrinologists and pediatric endocrinologists manage patients with diabetes. People with diabetes may also be treated by family medicine or internal medicine specialists. When complications arise, people with diabetes may be treated by other specialists, including neurologists, gastroenterologists, ophthalmologists, surgeons, cardiologists, or others.
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Do I Have Other Treatment Options For My Type 1 Diabetes
The National Institute of Diabetes and Digestive and Kidney Diseases has played an important role in developing artificial pancreas technology. An artificial pancreas replaces manual blood glucose testing and the use of insulin shots. A single system monitors blood glucose levels around the clock and provides insulin or a combination of insulin and glucagon automatically. The system can also be monitored remotely, for example by parents or medical staff.
In 2016, the U.S. Food and Drug Administration approved a type of artificial pancreas system called a hybrid closed-loop system. This system tests your glucose level every 5 minutes throughout the day and night through a continuous glucose monitor, and automatically gives you the right amount of basal insulin, a long-acting insulin, through a separate insulin pump. You still need to manually adjust the amount of insulin the pump delivers at mealtimes and when you need a correction dose. You also will need to test your blood with a glucose meter several times a day. Talk with your health care provider about whether this system might be right for you.
The illustration below shows the parts of a type of artificial pancreas system.
Starting in late 2016 and early 2017, the NIDDK has funded several important studies on different types of artificial pancreas devices to better help people with type 1 diabetes manage their disease. The devices may also help people with type 2 diabetes and gestational diabetes.
Treating High Blood Glucose
Hyperglycaemia can occur when your blood glucose levels become too high. It can happen for several reasons, such as eating too much, being unwell or not taking enough insulin.
If you develop hyperglycaemia, you may need to adjust your diet or your insulin dose to keep your glucose levels normal. Your diabetes care team can advise you about the best way to do this.
If hyperglycaemia isn’t treated, it can lead to a condition called diabetic ketoacidosis, where the body begins to break down fats for energy instead of glucose, resulting in a build-up of ketones in your blood.
Diabetic ketoacidosis is very serious and, if not addressed quickly, it can lead to unconsciousness and, eventually, death.
The signs of diabetic ketoacidosis include:
- frequently passing urine
Read more about the symptoms of diabetic ketoacidosis
Your healthcare team will educate you on how to decrease your risk of ketoacidosis by testing your own blood for ketones using blood ketone sticks if you’re unwell.
If you develop diabetic ketoacidosis, you’ll need urgent hospital treatment. You’ll be given insulin directly into a vein . You may also need other fluids given by a drip if you’re dehydrated, including salt solution and potassium.
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Newly Diagnosed With Type 1 Diabetes
It can be difficult to know where to get started with your new type 1 diagnosis, but were here to help you find the information you need.
As well as reading through the guidance and advice on this page, why not try our Learning Zone? With videos, quizzes and interactive tools tailored just for you, its the perfect way to discover more about your diabetes.
“She made me feel normal, when my normal had completely changed.”
– Laura, on being diagnosed with type 1 diabetes. Read her story.
Further Information And Support
For further information and support contact your doctor, practice nurse, or: Diabetes New Zealand Freephone: 0800 DIABETES Email: admin@diabetes.org.nz Website: www.diabetes.org.nz Diabetes New Zealand provides education and support resources specifically for young New Zealanders with type 1 diabetes and many of its branches around the country host Type 1 youth support groups.
Kids Health Website: www.kidsheatlh.org.nz
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Continuous Glucose Monitoring Treatment
Another device that measures glucose is termed a continuous glucose monitoring system . This system consists of a tiny sensor under the skin to check blood sugar levels. It sends the information to a device that records an average glucose value every five minutes for several days, depending on the sensor design. CGM is now accepted for long term use in some people with models that turn off insulin infusion when sugars start to drop. Some devices alert you if the blood glucose level falls outside of preset range.
How Do I Check My Blood Glucose Level Why Is This Important
Checking your blood glucose level is important because the results help guide decisions about what to eat, your physical activity and any needed medication and insulin adjustments or additions.
The most common way to check your blood glucose level is with a blood glucose meter. With this test, you prick the side of your finger, apply the drop of blood to a test strip, insert the strip into the meter and the meter will show your glucose level at that moment in time. Your healthcare provider will tell you how often youll need to check your glucose level.
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How Do Health Care Professionals Diagnose Type 1 Diabetes
Health care professionals usually test people for type 1 diabetes if they have clear-cut diabetes symptoms. Health care professionals most often use the random plasma glucose test to diagnose type 1 diabetes. This blood test measures your blood glucose level at a single point in time. Sometimes health professionals also use the A1C blood test to find out how long someone has had high blood glucose.
Even though these tests can confirm that you have diabetes, they cant identify what type you have. Treatment depends on the type of diabetes, so knowing whether you have type 1 or type 2 is important.
To find out if your diabetes is type 1, your health care professional may test your blood for certain autoantibodies. Autoantibodies are antibodies that attack your healthy tissues and cells by mistake. The presence of certain types of autoantibodies is common in type 1 but not in type 2 diabetes.
What Is Hyperglycemic Hyperosmolar Nonketotic Syndrome
Hyperglycemic hyperosmolar nonketotic syndrome develops more slowly than diabetic ketoacidosis. It occurs in patients with Type 2 diabetes, especially the elderly and usually occurs when patients are ill or stressed.If you have HHNS, you blood glucose level is typically greater than 600 mg/dL. Symptoms include frequent urination, drowsiness, lack of energy and dehydration. HHNS is not associated with ketones in the blood. It can cause coma or death. Youll need to be treated in the hospital.
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What Medicines Do I Need To Treat My Type 1 Diabetes
If you have type 1 diabetes, you must take insulin because your body no longer makes this hormone. Different types of insulin start to work at different speeds, and the effects of each last a different length of time. You may need to use more than one type. You can take insulin a number of ways. Common options include a needle and syringe, insulin pen, or insulin pump.
Some people who have trouble reaching their blood glucose targets with insulin alone also might need to take another type of diabetes medicine that works with insulin, such as pramlintide. Pramlintide, given by injection, helps keep blood glucose levels from going too high after eating. Few people with type 1 diabetes take pramlintide, however. The NIH has recently funded a large research study to test use of pramlintide along with insulin and glucagon in people with type 1 diabetes. Another diabetes medicine, metformin, may help decrease the amount of insulin you need to take, but more studies are needed to confirm this. Reseachers are also studying other diabetes pills that people with type 1 diabetes might take along with insulin.
Hypoglycemia, or low blood sugar, can occur if you take insulin but dont match your dose with your food or physical activity. Severe hypoglycemia can be dangerous and needs to be treated right away. Learn more about hypoglycemia and how to prevent or treat it.
How Does Diabetes Affect Fat Metabolism
When a person has enough insulin, their body is able to use and store glucose effectively.
However, without insulin, the body can switch to using stored fat instead. This happens through a process that experts refer to as ketosis.
During ketosis, the body releases ketones, which are chemicals that break down from fats. If ketone levels become too high, they can make the blood acidic. This results in a serious condition known as diabetic ketoacidosis .
DKA mainly occurs in people with type 1 diabetes, but it can also develop in those with type 2 diabetes. It is a potentially life threatening condition that requires emergency treatment.
Blood ketone monitors or urine testing strips can help people check their ketone levels.
Diet, exercise, and body weight have a significant influence on metabolism and the risk of developing type 2 diabetes.
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How Does Diabetes Affect Protein Metabolism
In addition to carbohydrates, the body can use protein as an energy source. In some situations, the body can break down protein from its own muscles for energy. Experts term this catabolism.
An older 2008 article notes that people with type 1 diabetes who do not have enough insulin from their medication may experience catabolism, leading to a significant reduction in muscle mass. This same effect does not occur in people with type 2 diabetes.