Monday, May 11, 2020

Type 1 Diabetes!

If you or your child or someone close to you have type 1diabetes, don't worry. Diabetes is a serious disease, but you can live a healthy, long life with proper nutrition therapy, medical therapy, regular exercise, and diabetes education.

What is Type 1 Diabetes?

The energy need of our body is provided by the basic nutrients in our foods from carbohydrates, protein, and fats. The most important of the nutrients that are separated into their smallest parts in order to be absorbed are simple sugars called “glucose”. Glucose is an important food source of all organs of the body, especially the brain. The cells use the glucose they need with the help of a hormone secreted by the pancreatic gland located behind the stomach. If this hormone known as insulin cannot be made in the body, the foods taken will not be used as energy.
Type 1 diabetes, which occurs as a result of the lack of insulin hormones are also called “Juvenile diabetes” since it often occurs in childhood and youth.
Type 1 diabetes occurs when insulin-producing beta cells in the pancreas are damaged by an autoimmune process. Since patients have an absolute or relative insulin deficiency, they have to take the hormone insulin from the outside (by injection) for life. Therefore, Type 1 diabetes is also called Insulin Dependent Diabetes Mellitus = IDDM. Generally, 10% of diabetes cases in society are Type 1 diabetes cases. The frequency of Type 1 diabetes in childhood varies between countries (regions) and diabetes develops in 1 to 42 of 100,000 children under the age of 15 each year. Type 1 diabetes is more common in northern countries in general.

What Causes Type 1 Diabetes?

Healthy individuals have an immune system that is responsible for protecting the body from foreign factors. Diseases caused by this system's perception, attack, and destruction of its own cells as a result of its deviation from normal for any reason such as virus, vaccination, medication, physical or psychic stress are called “autoimmune diseases”. Type 1 diabetes is also included in the group of autoimmune diseases. The immune system, activated for an unknown reason, destroys the pancreatic beta cells that undertake insulin production. When this damage reaches over 80%, disease symptoms appear.

Who Carries a High Risk for Type 1 Diabetes?

Risk of developing type 1 diabetes;
• Having relatives who have type 1 diabetes in their first degree relatives such as mother and father,
• Those who have many relatives with Type 2 diabetes,
• It is higher in women who have diabetes during pregnancy.

What Symptoms Will Occur If Blood Sugar Is Continuously High?

To urinate a lot, to urinate frequently
When insulin cannot be made in the body, functions that the insulin hormone is normally responsible for cannot be performed, that is, glucose cannot be used as energy by cells and accumulates in the blood. After a certain level, sugar begins to be excreted through the kidneys through urine. Since the sugar that is excreted in the urine will drag the water with it, the person starts to urinate a lot and to urinate frequently.
Drinking a lot of water
When excess water is lost with urine, excessive drinking water is needed.
Weight loss
On the other hand, the body cells, which cannot benefit from the food, begin to use the fats in the tanks as fuel as an energy source and the person becomes weak.
The time required for these symptoms to occur depends on the amount of destruction in beta cells of the pancreatic gland and the rate of burning. Destruction can take weeks, months, or even years. When destruction is completed quickly and in a short time, the body has to use its own proteins and fats for energy needs. The end products, called ketone bodies, which are formed by excessive breakdown of fats, are harmful wastes for the body, and they accumulate in the body and form an emergency table called ketoacidosis. Symptoms of ketoacidosis are abdominal pain, rapid breathing, extreme weakness, and fatigue. In such a case, it is necessary to urgently apply to the hospital.

How Should Treatment Be In Type 1 Diabetes?

The constant rule in the treatment of type 1 diabetes is insulin injection. Using insulin is a must in this type of diabetes and is life-saving. Other cornerstones of treatment are healthy nutrition, regular exercise, and training. Significant care and daily care are required throughout the day to ensure the ideal blood sugar level. Care should be made to make the lifestyle necessary for one to feel good and maintain a healthy life.

What Should Be Considered In Nutrition Therapy?

The purpose of regulating nutritional habits in diabetes is to create the most ideal nutrition program that an individual with diabetes can implement throughout his life.
• Keeping blood sugar within normal limits,
• To prevent acute complications such as hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar),
• To provide and maintain the ideal body weight.
To achieve the above goals, an individual with Type 1 diabetes;
• Eating enough and appropriate time according to individual characteristics, daily life plan, eating habits and insulin treatment scheme,
• Eating foods containing carbohydrates inappropriate amounts for blood sugar control,
• Providing diversity in food consumption,
• Increasing the amount of pulp taken with food,
• It is recommended to consume simple sugars (powder and sugar cubes, honey, dessert, juice, etc.) under the control of dieticians.

What are the Considerations for Exercise?

In the treatment of diabetes, the appropriate exercise type and program should be applied. The duration should be kept short (starting with 5-10 minutes a day) and gradually increased while starting the exercise. Exercise should be done regularly every day, cotton socks should be preferred during exercise. Insulin should not be applied to the muscles with active muscles during exercise and exercise should not be started on an empty stomach.
Care should be taken to prevent blood sugar drops that may occur during exercise and blood sugar should be measured. Despite the risk of hypoglycemia that may occur during exercise, foods containing simple sugar must be; Care should be taken to keep sugar (sugar cubes, sugar tablets or juices etc.).

Who Should Get Professional Help for a Successful Diabetes Prevention?
Since Type 1 diabetes is a lifelong disease that affects every organ with a vein in the body, the prerequisite for good care in individuals with Type 1 diabetes is a team requirement.
Many people are the assistant of diabetics to teach daily care and maintenance. Physicians who specialized in this field are the leading assistants. The physician implements a medical treatment program for the individual with diabetes.
A nutritionist is a person you will ask for help in arranging a healthy diet plan, which is the cornerstone of the treatment, and gaining healthy eating habits.
Your diabetes nurse will help you with insulin administration technique, blood glucose measurement method, hypoglycemia, foot care and so on.
The diabetes educator is the healthcare professionals who provide diabetes education to people with diabetes. A nurse, nutritionist, or general practitioner can be a diabetes educator. Diabetes educators provide training on what to do in special situations, in cases of illness or when blood sugar drops. In addition, some voluntary organizations, associations, and foundations providing training in chronic diseases are other assistants (Diabetes Schools) that guide the people with diabetes.


How Is Insulin Therapy Done?

Since insulin is a hormone in protein structure, it is digested in the stomach. For this reason, it cannot be used as a pill by mouth; it can only be used in the injection style. Today, purified preparations are used in a structure similar to human insulin.
Daily insulin requirement varies according to the patient's height, weight, age, food consumption, and activity level. Also, another intervening disease, stress, or medications can affect your insulin dose. Insulin storage conditions are +4 degrees / + 8 degrees.
As a result of technological developments and researches, insulin can be made with pen injectors and insulin pump besides classical injectors.
How To Follow Up Blood Sugar At Home?
Measuring your blood glucose on certain days of the week gives your doctor information about whether your blood sugar regimen is going well and the changes that need to be made in insulin doses. Measurements are also important for your dietitian to adjust nutritional therapy and inform you about the effects of the foods, you eat on your blood sugar.
People with type 1 diabetes should measure blood glucose with a glucometer (blood glucose meter) four times a day, before breakfast and at noon and at dinner and at night, or at different meals on different days before and two hours after meals. Your doctor/dietitian determines how many times this week should be taken.
You can get help from your healthcare team in the preparation of the blood glucose measurement program best suited to your disease and living conditions.

What are the Urgent Problems in Type 1 Diabetes?

A person with type 1 diabetes can lead a problem-free life by following a scientific and healthy diet program, regular exercise, and appropriate insulin therapy. However, blood sugar may increase (hyperglycemia) in people with diabetes who do not make insulin with the appropriate technique, inadequate doses and on time, do not adapt to nutritional treatment, and consume excessive carbohydrates or disrupt the exercise. In contrast, in diabetics who overdose insulin or do not consume recommended foods, especially carbohydrate-containing foods in time and adequately, drink alcohol, or exercise excessively, blood sugar may drop suddenly and rapidly (hypoglycemia).

What should be done when blood sugar drops?

It is an important condition that requires urgent intervention, such as low blood sugar or rising. For this reason, the person with diabetes should carry the identity of diabetes in a necklace, bracelet, or watch strap. In the case of hypoglycemia, which may occur as a result of delaying a meal or snack or by consuming more energy by doing more than usual, a diabetic person will notice sweating, chills, color paleness, irritability, and restlessness. If the necessary precautions are not taken, there may be difficulty in adaptation and loss of consciousness.
The type of treatment to be performed in hypoglycemia varies according to the symptoms observed in the person with diabetes. When the symptoms are mild, 5-6 pieces of sugar can be melted and drunk in a glass of warm water or 1 large tea glass of sugar juice can be given. If there are no signs of improvement, 2 teaspoons of sugar or 5-6 sugar cubes should be dissolved in a small amount of water and drunk in small sips. In hypoglycemia, where there is a loss of consciousness, sugar or sugar water cannot be given by mouth. In this case, intramuscular injection of glucagon is required and it is vital to make this needle.

What should be done when blood sugar rises?

It means high blood sugar in diabetics with frequent urination, dry mouth, drinking too much water, dry skin, and late healing wounds, weakness, fatigue, and slimming. What needs to be done in this case is to investigate whether the expiration date, dose, and
application technique of the insulin used are correct. If hyperglycemia continues despite the full compliance with the recommended insulin regimen and nutrition plan, drinking diabetes, the person with diabetes should contact their doctor immediately.


What are the Innovations in Type 1 Diabetes Treatment?

Today, in the treatment of type 1 diabetes, islet tissue or pancreatic transplantation has been brought to the agenda instead of insulin. However, the biggest problem in these transplants is tissue rejection and expensive drugs with important side effects, called immunosuppressive, are used to prevent tissue rejection. For this reason, researchers looking for a definitive solution to islet transplant treatment are looking for less harmful immunosuppressive drugs.

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