Type 1 Diabetes - Medical Condition

Treatment of type 1 diabetes involves a comprehensive management plan that includes education (about diabetes, nutrition, and exercise), insulin treatment, and the prevention and treatment of complications. Many health care professionals (nurses, dietitians, doctors, specialists, pharmacists, social workers) can be part of a diabetes care team, but the most important member of the team is the person with diabetes.

It is important that people with type 1 diabetes learn about diabetes and its management, as this allows them to have greater involvement and control over their diabetes. Your doctor may refer you to a certified diabetes educator or a diabetes education clinic as part of your diabetes management.

Lifelong replacement therapy with insulin is needed for type 1 diabetes. Insulin treatment needs to be injected and can’t be taken by mouth, as it is broken down in the stomach. There are many types of insulin, classified as short-acting, intermediate-acting, and long-acting. Premixed insulins are also available – these are short-acting and intermediate-acting insulins mixed together. Most people with type 1 diabetes are on a combination of a rapid-acting insulin with meals and a long-acting insulin at bedtime. Instead of taking multiple injections per day, some people use an insulin pump, which is a small device that is worn and delivers a continuous amount of insulin under the skin.

Proper nutrition is important, and a dietary plan made in consultation with a dietitian should be part of diabetes care. Following a healthy, balanced meal plan helps control blood sugar. This means watching what you eat, when you eat it, and how much you eat. Nutrition as part of diabetes management is not as restrictive as it once was. A healthy diet can include some sugars. The aim is to match the calories that are consumed with the insulin needed.

Exercise also helps to improve blood sugar control. Lightweight training with aerobic exercise (such as jogging or walking) has been shown to help improve your body’s response to insulin. It also helps to reduce the risk of heart problems such as high blood pressure and heart attack. Exercise, however, can sometimes make blood sugars difficult to control for patients with type 1 diabetes, so it’s important for them to check their blood sugar level before, during, and after exercise. A snack or change of insulin dose may also be needed.

As part of proper diabetes management, a person with diabetes should know the symptoms of abnormal blood sugar levels, their target blood sugar levels, and how to properly monitor blood sugar levels using a home glucose monitor. Blood glucose self-monitoring is necessary for all people with diabetes taking insulin. Your doctor or diabetes educator will help determine your blood sugar targets based on your medical history, risk factors (e.g., age), and lifestyle factors. For most people with diabetes, the target blood sugar levels are 4 mmol/L to 7 mmol/L before eating, and 5 mmol/L to 10 mmol/L 2 hours after eating.

Regular testing throughout the day will guide you and your doctor in determining how much insulin you need to keep your blood sugar levels close to your targets. Most people with type 1 diabetes should monitor their blood sugar levels 3 times a day or more. There are many different glucose monitors available on the market, such as blood glucose meters, flash glucose monitoring systems, and continuous glucose monitoring systems. Before buying a device, you should speak to your doctor, diabetes educator, or pharmacist about which ones are most suited to your needs.

Remember to always keep glucose tablets, candies containing sugar, or other sources of quickly absorbed glucose (e.g., juice, regular soft drinks) with you at all times to treat mild hypoglycemia. Your doctor, diabetes educator, or pharmacist can help you identify appropriate sources of glucose. It’s important to have a glucagon emergency kit available for use in the event of severe hypoglycemia, when someone with diabetes might be unresponsive and unable to ingest a glucose-containing product. Family members or caregivers would be the ones to carry out this rescue therapy, so they should be familiar with how to use it.

To prevent complications, it’s important to follow your diabetes management plan and keep your blood sugar levels as close to your targets as possible.

Here are some tips to help you stay healthy and prevent some of the long-term complications of diabetes:

• foot care: A foot examination should be done at least once each year. Poor circulation and nerve damage caused by diabetes can reduce sensitivity in the feet. It’s important to check your feet regularly, looking for any blisters, cuts, or sores. Always keep your feet clean and dry and protect them by wearing socks and comfortable shoes. If you notice any changes in your feet, contact your doctor.
• eye care: Eye problems (retinopathy) due to diabetes can ultimately lead to blindness if left untreated. People with type 1 diabetes should have their eyes checked by an eye doctor (ophthalmologist) within 5 years of diagnosis, and then every year if the eye exam is normal. By treating problems early, you can avoid serious complications.
• skin care: High blood glucose and poor circulation can lead to skin problems, such as slow healing after an injury or frequent infections. Make sure you wash every day with a mild soap and warm water, protect your skin by using sunscreen, take good care of any cuts or scrapes with proper cleansing and bandaging, and see a doctor when cuts heal slowly or if an infection develops.
• immunizations: It is important for people with diabetes to get an influenza shot annually, and be up to date on their pneumococcal and COVID-19 vaccinations to help prevent illness.

*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.

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