All about type 1 diabetes treatment and everyday suitability
The aim of conventional medical type 1 diabetes treatment is to give insulin artificially, thereby, lowering and stabilizing blood sugar levels. This reduces the risk of complications and long-term damage and provides the greatest health added value.
The basis of the therapy is an adapted, healthy lifestyle with many nutrients, moderate carbohydrates, physical activity and other factors that reduce the insulin requirement of the body. More on this in the article Diabetes Type 1 Diet and Lifestyle.
Before insulin therapy, there is an inpatient stay in which an experienced doctor tests which insulin form the patient can best tolerate, when the insulin is given, how the insulin works depending on the time of day and how much is needed.
After that, the patient becomes self-employed. After initial patient training, insulin therapy follows consisting of three stages: blood sugar control, insulin injections, and the calculation of carbohydrates from food.
1. Blood sugar control
This takes place before eating, before exercising, before sleeping, in the case of illnesses and with symptoms of hypoglycemia (tremors, palpitations, cravings, problems with concentration).
There are three ways to check blood sugar:
Conventionally, the measurement occurs with a lancet, which one uses to prick his finger. A blood glucose meter then measures the blood sugar in a drop of blood.
Flash Glucose Monitoring (FGM): The patient wears a device on his body which is connected to the bloodstream.
The measurement is carried out by a manual scan. The advantage here: The patient does not have to prick his finger several times a day.
Continuous Glucose Monitoring (CGM): This form of blood sugar measurement is very modern and designed for type 1 diabetics.
This system works like FGM, but the blood sugar is measured around the clock, 24 hours a day. The advantage here is more accurate data and a more efficient adaptation of the food to the blood sugar.
After checking your blood sugar, go to step 2: insulin injection.
2. Insulin injections
While extracts from pig pancreas were previously taken, today it is almost everywhere genetically engineered insulin (analog insulin) that patients receive. Biotechnology has made significant progress here in recent years.
There are three different types of insulin:
Fast-acting insulin: Fast-acting effect after 5 minutes, duration of action 3 to 4 hours.
Delay insulin: Applied before eating and works for up to 8 to 12 hours.
Slow-acting insulin: slowly released and slowly broken down. The administration is only necessary once or twice a day, with a duration of action of up to 48 hours.
The advantage here is that the patient is less restricted in his daily routine and does not have to carefully calculate the carbohydrates at every meal. The decisive factor is the daily amount of carbohydrates.
The goal of most diabetologists is to give the patient freedom in their daily planning and, therefore, to use slow-acting forms of insulin.
The insulin therapy scheme can be divided into 3 forms
CT (conventional insulin therapy): The patient has to inject certain amounts of insulin at a fixed time of day according to a fixed schedule. This system is quite rigid and inflexible and is less and less used today.
ICT (Intensified Conventional Insulin Therapy): Use of delayed or long-term insulin. The goal is to imitate the natural insulin pattern of the human body. The insulin requirement can be flexibly adapted to daily needs, for example, less insulin is required during exercise.
CSII / insulin pump therapy (continuous subcutaneous insulin infusion): Here, a device gets connected to the patient’s bloodstream and constantly releases insulin into the blood.
Scientists are currently developing a closed-loop system, which is an artificial pancreas. It measures blood sugar around the clock and automatically releases the required amount of insulin into the bloodstream.
An insulin pump is very advisable for some groups of people, especially shift workers, patients with neuropathy, children and patients with frequent and poorly perceived hypoglycemia.
After checking blood sugar and injecting insulin, we now come to the carbohydrates in the diet:
3. Carbohydrates in food
The amount of insulin injected depends on the number of carbohydrates in your diet.
The patient must learn to calculate the carbohydrates in their food and, thus, inject the right amount of insulin. Carbohydrates in food are given in BU (bread unit, 12 g carbohydrates) or CU (carbohydrate unit, 10 g carbohydrates).
Now, we’ve covered the most important things regarding type 1 diabetes treatment. The following chapters deal with everyday suitability.
Type 1 diabetes in everyday life – what to look out for?
As a type 1 diabetic, you should pay particular attention to some situations:
Hypoglycemia: Especially in new patients, it is often the case that they inject too much insulin and hypoglycemia occurs. This is the case for blood sugar below 70 mg/dl.
Symptoms of acute hypoglycemia include tremors, palpitations, cravings, and difficulty concentrating. For acute hypoglycemia, the addition of 1 to 2 bread units in the form of quickly digestible glucose, juice, gummy bears or sugar-rich soda is recommended.
Families and loved ones should be educated about the hypoglycemia, symptoms, and countermeasures to avoid dangerous hypoglycemic shock.
Driving: Ideally, type 1 diabetics should measure their blood sugar before getting on the road and be prepared to react immediately to symptoms of hypoglycemia. Otherwise, the patient, passengers and other road users are at risk!
Profession: Get advice from a doctor about the extent to which you can continue practicing your profession despite type 1 diabetes. Some professions harbor risks for themselves and for other people (medical professions, pilots, truck drivers).
These were the most important factors to look out for in type 1 diabetes in everyday life. Now let’s focus on a frequently asked question:
Type 1 diabetes pregnancy – what to watch out for?
Women who are trying to become pregnant and suffer from type 1 diabetes should take special care.
A too high or too low blood sugar level is problematic for the unborn child. The metabolism is already a little messed up in pregnancy.
Type 1 diabetes can lead to additional complications. Good planning and consultation with an experienced doctor are absolute necessities. Likewise, regular and close monitoring of blood values.
Please follow my advice on healthy living (see nutrition and lifestyle) for type 1 diabetes.
So far I have dealt with and focused on the disease itself, the symptoms, diagnosis, therapy and pregnancy.
However, I have, so far, seemingly neglected the causes and risk factors that can lead to the onset of the disorder. This I made up for in the following article:
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