Figuring out how to manage Type 1 diabetes is a challenge for anyone. The disease strikes without warning, and the thought of its many potential complications can be overwhelming. “You hear about how diabetes can affect your eyes, kidneys, feet and heart. People assume everyone will get the same complications and they get scared,” says Dr. Umesh Masharani, an endocrinologist and professor of medicine at the University of California–San Francisco.
But don’t jump to conclusions about what it is like to live with Type 1 diabetes. “You can have a long and healthy life as long as you take care of your diabetes,” Masharani says.
[See: 10 Myths About Diabetes.]
I Have Type 1 Diabetes
Type 1 diabetes is an autoimmune condition that occurs when the body mistakenly attacks cells (in the pancreas) that make insulin. We rely on insulin to get sugar from digested carbohydrates (glucose) into cells so they can convert it into energy or store it in the muscles, fat and liver.
When you’re living with Type 1 diabetes, you stop producing insulin. Glucose builds up in the bloodstream and doesn’t get to your cells, a condition known as high blood sugar, or hyperglycemia. Untreated hyperglycemia can result in a coma or even death.
Learning how to control Type 1 diabetes requires that you manage blood glucose and insulin. This is done by monitoring blood glucose levels throughout the day and providing insulin to the body by injection or insulin pump before various activities, such as eating or sleeping. Your doctors, nurses and diabetes educators can help train you in the specifics of this procedure. “Good diabetes centers are really educators and coaches. I don’t fix my patients’ diabetes, I give them guidance. I’m not there when they’re ordering a Frappuccino. My job is making sure they have the skill set to make the right decisions,” Masharani says.
It takes a number of additional strategies to keep blood glucose under control and avoid the side effects of Type 1 diabetes.
The Type 1 Diabetes Diet
The Type 1 diabetes diet is the same as any other healthy eating program that includes vegetables, fruits, legumes, whole grains, dairy products, unsaturated fats (such as olive oil and avocados) and proteins (poultry, fish and lean meat). But a person with Type 1 diabetes must pay attention to the amount of carbs on his or her plate and take enough insulin to process the food. “I don’t tell patients they can’t eat dessert. They just have to match food and insulin needs,” Masharani says.
Determining the right dose may require a little trial and error, as each person’s insulin-to-carb ratio is different. But don’t overdo your carbs. “You can’t eat huge amounts, like 20 pancakes soaked in syrup, because the insulin injections will not be able to control the glucose spikes,” Masharani explains.
[The Best Foods to Prevent and Manage Diabetes.]
Type 1 Diabetes Exercise
When you have Type 1 diabetes, exercise can cause blood glucose levels to dip too low. That’s because:
— You’re not eating, and therefore you’re not stoking blood glucose levels.
— Your muscles exhaust their stores of glucose (glycogen).
— Insulin injections keep the liver from releasing its stores of glycogen. “Insulin signals the liver that food is around (even when it’s not),” explains Dr. Lorena Alarcon-Casas Wright, an endocrinologist and assistant professor of medicine at the University of Washington.
Low blood glucose levels, or hypoglycemia, can lead to dizziness, mental confusion or even seizures.
Don’t let that discourage you from exercising. “Exercise is good for well-being, diabetes control and bone and cardiovascular health,” explains Wright, who recommends talking to your doctor before engaging in an exercise routine to ensure your insulin doses can be adjusted appropriately.
Some general tips: “With the meal that comes before exercise, give yourself half the amount of insulin so there is less on board when you exercise later,” she advises, “and check your blood sugar levels before and after exercising.”
Also, keep a carb-rich snack handy in case you feel your blood sugar is low.
Preventing Health Complications
Type 1 diabetes increases the risk for many conditions including:
— Cardiovascular disease. Type 1 raises the risks for heart attack, stroke and impaired circulation.
— Kidney disease. Diabetic nephropathy can cause kidney failure.
— Vision loss. The retina in the back of the eye can be damaged, known as diabetic retinopathy.
— Neuropathy. The loss of sensation in the limbs may lead to balance problems, falls and lack of awareness when cuts or ulcers develop on the legs or feet.
— Amputation. Impaired circulation makes wounds on the legs and feet harder to heal and may make amputation necessary.
— Hypoglycemia unawareness. “When you have hypoglycemia frequently, the brain’s ability to sense low blood sugar is blunted,” Wright explains. “Patients may not realize their blood sugar is low and may not correct it.” She warns that low blood sugar when driving can lead to accidents.
How to stay on top of these potential problems:
— Be vigilant about managing blood sugar.
— Keep regular doctor appointments.
— Get annual vision and kidney function tests.
— Have your feet checked by a doctor for signs of nerve problems once a year.
— Check blood sugar frequently, especially before driving, to avoid hypoglycemia.
[See: Got Diabetes? Why You Must Protect Your Feet.]
Lifestyle Changes for Diabetes Type 1
Lifestyle change can also ward off complications. Unhealthy habits like smoking, not getting enough sleep and being stressed all the time take a toll on people with Type 1 diabetes. ” Sleep deprivation and stress can increase blood sugar levels,” Wright says. “Smoking exacerbates the risk for both cardiovascular and kidney disease in Type 1 diabetes,” Wright notes.
Wright urges patients to live as clean a lifestyle as possible and strive to quit smoking, exercise regularly, get seven to eight hours of sleep per night, eat a healthy diet and manage stress using methods such as yoga or meditation.
Getting More Help
Tackling Type 1 diabetes management on your own can be daunting. Get some help by assembling a team of experts that includes:
— A primary care physician.
— An endocrinologist.
— Nurses to answer your day-to-day questions.
— Diabetes educators.
— An ophthalmologist (eye doctor).
— A cardiologist if you have heart issues.
— A nephrologist if you have kidney disease.
— A podiatrist for foot exams.
— A psychologist or therapist to address mood disorders or stress.
Type 1 diabetes support groups with members who share tips, experiences and support can also help you cope. “It can be very lonely trying to figure out how to take care of yourself. Getting support from other people and hearing how they’re managing Type 1 diabetes makes a difference,” Masharani says. He recommends attending Type 1 diabetes support groups in person through a doctor’s office or hospital or online via Facebook or nonprofit websites such as JDRF’s typeonenation.org or the American Diabetes Association Support Community community.diabetes.org.
The encouraging news: Taking advantage of support and medical services can pay off. “When diabetes is well controlled, the risk of complications is very low. I have patient’s who’ve had Type 1 diabetes for 50 years and have minimal complications,” Wright says. “With diligence and a good team, it is possible to live with diabetes and have a good quality of life without complications.”
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The Best Foods to Prevent and Manage Diabetes
Got Diabetes? Why You Must Protect Your Feet
Tips for Living With Type 1 Diabetes originally appeared on usnews.com
