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Unpacking Type 1 Diabetes (part 2): Management, Treatment and Prognosis

MANAGING AND TREATING TYPE 1 DIABETES 


Diabetes is a complex condition, so its management involves several strategies. In addition, diabetes affects everyone differently, so management plans are highly individualized.


Main Aspects of treating diabetes:


  • Blood sugar monitoring: Monitoring your blood sugar (glucose) is key to determining how well your current treatment plan is working. It gives you information on how to manage your diabetes on a daily — and sometimes even hourly — basis. You can monitor your levels with frequent checks with a glucose meter and finger stick and/or with a continuous glucose monitor (CGM). You and your healthcare provider will determine the best blood sugar range for you.


  • Insulin: People with Type 1 diabetes need to inject synthetic insulin to live and manage diabetes. There are several different types of synthetic insulin. They each start to work at different speeds and last in your body for different lengths of time. The four main ways you can take insulin include injectable insulin with a syringe (shot), insulin pens, insulin pumps and rapid-acting inhaled insulin.

Several types of insulin are available.

  1. Rapid-acting starts to work in about 15 minutes. It peaks about 1 hour after you take it and continues to work for 2 to 4 hours.

  2. Regular or short-acting gets to work in about 30 minutes. It peaks between 2 and 3 hours and keeps working for 3 to 6 hours.

  3. Intermediate-acting won’t get into your bloodstream for 2 to 4 hours after your shot. It peaks from 4 to 12 hours and works for 12 to 18 hours.

  4. Long-acting takes several hours to get into your system and lasts about 24 hours.

  • Diet: Meal planning and choosing a healthy diet for you are key aspects of diabetes management, as food greatly impacts blood sugar. If you take insulin, counting carbs in the food and drinks you consume is a large part of management. The amount of carbs you eat determines how much insulin you need at meals. Healthy eating habits can also help you manage your weight and reduce your heart disease risk.

  • Exercise: Physical activity increases insulin sensitivity (and helps reduce insulin resistance), so regular exercise is an important part of management for all people with diabetes.

  • Treating hypoglycaemia (low blood glucose)

Hypoglycaemia can occur when your blood glucose level becomes very low. It’s likely that you’ll develop hypoglycaemia from time to time.

Mild hypoglycaemia (or a “hypo”) can make you feel shaky, weak and hungry, and can be controlled by eating or drinking something sugary, such as:

  • 200ml pure fruit juice

  • 5 to 7 Dextrose tablets

  • 4 to 5 Glucotabs

  • 60ml Glucojuice

  • 5 jelly babies

  • 2-3 sugar sachets

You may also be able to take pure glucose, in the form of a tablet or fluid, if you need to control the symptoms of a hypo quickly.


If you develop severe hypoglycaemia, you can become drowsy and confused, and you may even lose consciousness. If this occurs, you’ll need assistance from another person who may be able to give you a glucose gel rubbed into your cheeks or an injection of glucagon into your muscle. Glucagon is a hormone that quickly increases your blood glucose levels.


Due to the increased risk for heart disease, it’s also important to maintain a healthy:

  • Weight.

  • Blood pressure.

  • Cholesterol.



How can I prevent diabetes?

You can’t prevent autoimmune and genetic forms of diabetes. But there are some steps you can take to lower your risk for developing prediabetes, including:

  • Eat a healthy balanced diet, such as the Mediterranean diet, with ample protein.

  • Get physically active. Aim for 30 minutes a day at least five days a week.

  • Work to achieve a weight that’s healthy for you.

  • Manage your stress.

  • Limit alcohol intake.

  • Get adequate sleep (typically 7 to 9 hours) and seek treatment for sleep disorders.

  • Quit smoking.

  • Take medications as directed by your healthcare provider to manage existing risk factors for heart disease.

It’s important to note that there are some diabetes risk factors you can’t change, such as your genetics/family history, age and race. 



PROGNOSIS

The prognosis (outlook) for diabetes varies greatly depending on several factors, including:

  • The type of diabetes.

  • How well you manage the condition over time and your access to diabetes care.

  • Your age at diagnosis/how long you’ve had diabetes.

  • If you have other health conditions.

  • If you develop diabetes complications.

Chronic high blood sugar can cause severe complications, which are usually irreversible. Several studies have shown that untreated chronic high blood sugar shortens your lifespan and worsens your quality of life.


In the United States, diabetes is the eighth leading cause of death. A large number of people with diabetes will die from a heart attack or stroke.


However, it’s important to know that you can live a healthy life with diabetes. The following are key to a better prognosis:

  • Lifestyle changes.

  • Regular exercise.

  • Dietary changes.

  • Regular blood sugar monitoring.

Studies show that people with diabetes may be able to reduce their risk of complications by consistently keeping their A1c levels below 7%. https://www.nhsinform.scot/illnesses-and-conditions/diabetes/type-1-diabetes/#treating-type-1-diabetes

 
 
 

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