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diabetes;
type 1

                          Diabetes

Researchers have expanded the link between sodas and increased risk for  “metabolic syndrome” and doubles a persons risk of developing heart disease, stroke or diabetes.

Margarine decreases insulin response.

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Memory Loss and Confusion 

were side effects experienced by more than 30% of aspartame reactors. The majority of them 62% consumed diet drinks. Their impaired memory increased after ingesting products with aspartame. Diabetics who use large quantities of aspartame and have diabetic dementia may need to give it up to regain their memory.
Type 1 Diabetes
From WebMD.com 
Understanding type 1 diabetes is the first step to managing it. Get information on type 1 diabetes causes, risk factors, warning signs, and prevention tips.

What Is Type 1 Diabetes?
Type 1 diabetes happens when your immune system destroys cells in your pancreas called beta cells. They’re the ones that make insulin.

Some people get a condition called secondary diabetes. It’s similar to type 1, except the immune system doesn’t destroy your beta cells. They’re wiped out by something else, like a disease or an injury to your pancreas.

   What   Does Insulin Do?
Insulin is a hormone that helps move sugar, or glucose, into your body's tissues. Cells use it as fuel.
  Damage to beta cells from type 1 diabetes throws the process off. Glucose doesn’t move into your cells because insulin isn’t there to do it. Instead it builds up in your blood and your cells starve. This causes high blood sugar, which can lead to:

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  • Dehydration. When there’s extra sugar in your blood, you pee more. That’s your body’s way of getting rid of it. A large amount of water goes out with that urine, causing your body to dry out.
  • Weight loss. The glucose that goes out when you pee takes calories with it. That’s why many people with high blood sugar lose weight.Dehydration also plays a part.
  • Diabetic ketoacidosis (DKA). If your body can't get enough glucose for fuel, it breaks down fat cells instead. This creates chemicals called ketones. Your liver releases the sugar it stores to help out. But your body can’t use it without insulin, so it builds up in your blood, along with the acidic ketones. This combination of extra glucose, dehydration, and acid buildup is known as "ketoacidosis" and can be life-threatening if not treated right away.

  • Damage to your body. Over time, high glucose levels in your blood can harm the nerves and small blood vessels in your eyes, kidneys, and heart. They can also make you more likely to get hardening of the arteries, or atherosclerosis, which can lead to heart attacks and strokes.

Who Gets Type 1 Diabetes?
It’s rare. Only about 5% of people with diabetes have type 1. It’s more common in whites than in African-Americans. It affects men and women equally. Although the disease usually starts in people under 20, it can happen at any age.

What Causes It?

Doctors don't know all the things that lead to type 1 diabetes. But they do know your genes play a role.
   They also know type 1 diabetes can result when something in the environment, like a virus, tells your immune system to go after your pancreas. Most people with type 1 diabetes have signs of this attack, called autoantibodies. They’re present in almost everyone who has the condition when their blood sugar is high.
   Type 1 diabetes can happen along with other autoimmune diseases, like Grave's disease or vitiligo.
What Are the Symptoms?
These are often subtle, but they can become severe. They include:
  • Heavy thirst
  • Increased hunger (especially after eating)
  • Dry mouth
  • Nausea and vomiting
  • Pain in your belly
  • Frequent urination
  • Unexplained weight loss (even though you’re eating and feel hungry)
  • Fatigue (weak, tired feeling)
  • Blurred vision
  • Heavy, labored breathing (your doctor will call this Kussmaul respiration)
  • Frequent infections of the skin, urinary tract, or vagina
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Signs of an emergency with type 1 diabetes include:
  • Shaking and confusion
  • Rapid breathing
  • Fruity smell to your breath
  • Pain in your belly
  • Loss of consciousness (rare)

How Is It Diagnosed?
If your doctor thinks you have type 1 diabetes, he’ll check your blood sugar levels. He may test your urine for glucose or chemicals your body makes when you don’t have enough insulin.

Right now there’s no way to prevent type 1 diabetes.


How Is It Medically Treated?
Many people with type 1 diabetes live long, healthy lives. The key to good health is to keep your blood sugar levels within the range your doctor gives you. You’ll need to check them often and adjust insulin, food, and activities to make that happen.

All people with type 1 diabetes must use insulin injections to control their blood sugar.
When your doctor talks about insulin, he’ll mention three main things:
  • "Onset" is the length of time before it reaches your bloodstream and begins lowering blood sugar.
  • "Peak time" is the time when insulin is doing the most work in terms of lowering blood sugar.
  • "Duration" is how long it keeps working after peak time.
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Several types of insulin are available.
  • Rapid-acting starts to work in about 15 minutes. It peaks around 1 hour after you take it and continues to work for 2 to 4 hours.
  • 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.
  • Intermediate-acting won’t get into your bloodstream for 2 to 4 hours after injection. It peaks from 4 to 12 hours and works for 12 to 18 hours.
  • Long-acting takes several hours to get into your system and lasts for about 24 hours.
Your doctor may start you out with two injections a day of two different types of insulin. You’ll probably progress to three or four shots a day.
Most insulin comes in a small glass bottle called a vial. You draw it out with a syringe that has a needle on the end, and give yourself the shot. Some now comes in a prefilled pen. One kind is inhaled. You can also get it from a pump -- a device you wear that sends it into your body via a small tube. Your doctor will help you to pick the type and the delivery method that’s best for you.
Lifestyle Changes
Exercise is an important part of treating type 1. But it isn’t as simple as going out for a run. You have to balance your insulin dose and the food you eat with any activity, even simple tasks around the house or yard.
   Knowledge is power. Check your blood sugar before, during, and after an activity to find out how it affects you. Some things will make your levels go up; others won't. You can lower your insulin or have a snack with carbs to prevent it from dropping too low. 
   If your test is high, test for ketones -- acids that can result from high sugar levels. If they’re OK, you should be good to go. If they’re high, skip the workout.
   You’ll also need to understand how food affects your blood sugar. Once you know the roles that carbs, fats, and protein play, you can build a healthy eating plan that helps keep your levels where they should be. A diabetes educator or registered dietitian can help you get started.

What Happens Without Treatment?

If you don’t keep your type 1 diabetes well controlled, you could set yourself up for serious or life-threatening problems:

  • Retinopathy. This eye problem happens in about 80% of adults who have had type 1 diabetes for more than 15 years. It’s rare before puberty no matter how long you’ve had the disease. To prevent it -- and keep your eyesight -- keep good control of blood sugar, blood pressure, cholesterol, and triglycerides.
  • Kidney damage. About 20% to 30% of people with type 1 diabetes get a condition called nephropathy. The chances grow over time. It’s most likely to show up 15 to 25 years after the onset of diabetes. It can lead to other serious problems like kidney failure and heart disease.
  • Poor blood circulation and nerve damage. Damaged nerves and hardened arteries lead to a loss of sensation in and a lack of blood supply to your feet. This raises your chances of injury and makes it harder for open sores and wounds to heal. And when that happens, you could lose a limb. Nerve damage can also cause digestive problems like nausea, vomiting, and diarrhea.
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Symptoms

Symptoms of type 1 diabetes usually develop quickly, over a few days to weeks, and are caused by high blood sugar. At first, symptoms may be overlooked or mistaken for another illness, like the flu.

High blood sugar symptoms include:
  • Urinating a lot, which may be more noticeable at night. The kidneys are trying to get rid of the excess sugar in the blood. To do that, they have to get rid of more water. More water means more urine.
  • Being very thirsty. This happens if you urinate so often that you lose enough water to become dehydrated.
  • Losing weight without trying. This happens because you are dehydrated. Weight loss may also happen if you are losing all of those sugar calories in your urine instead of using them.
  • Increased hunger. You feel hungry because your body isn't using all the calories that it can. Many of them leave your body in your urine instead.
  • Blurry vision. When sugar builds up in the lens of your eye, it sucks extra water into your eye. This changes the shape of the lens and blurs your vision.
  • Feeling very tired. You feel tired for the same reason you feel hungry. Your body isn't using the calories you are eating, and your body isn't getting the energy it needs.
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Diabetic ketoacidosis symptoms
Symptoms of diabetic ketoacidosis are:

  • Flushed, hot, dry skin.
  • Loss of appetite, belly pain, and vomiting.
  • A strong, fruity breath odor.
  • Rapid, deep breathing.
  • Restlessness, drowsiness, difficulty waking up, confusion, or coma. Young children may lack interest in their normal activities.
Risk factors for high and low blood sugar
  • Tight blood sugar control. Tight control of blood sugar helps prevent complications, such as eye, kidney, heart, blood vessel, and nerve disease. But it does put you at risk for frequent low blood sugar levels.
  • Adolescence. The rapid growth spurts and changing hormone levels of adolescence can make it difficult to keep blood sugar levels within your target range. Your target range is the blood sugar goal you set with your doctor.
  • Psychiatric conditions. Depression, anxiety disorder, panic disorder, and addiction to alcohol or drugs increase the risk of frequent high and low blood sugar levels.
  • Eating disorders. Teens are often concerned about their weight and body image, and they may skip insulin injections to lose weight.Eating disorders can be much more common in girls and women of all ages who have type 1 diabetes.
  • Lipohypertrophy, which is fat and scar tissue that can be caused by repeatedly injecting insulin in the same place. The area may feel firmer than the skin around it. Injecting insulin into an area of fat and scar tissue means it may not be absorbed at the same rate each time, which could cause high or low blood sugars.
  • Gastroparesis. Damage to the nerves of the body can change how the stomach contracts when digesting food. Food can take longer to digest, which can make it harder to know when insulin will work after eating. This can lead to high and low blood sugars.
  • Thyroid or kidney problems. Too little thyroid hormone can slow metabolism, which can cause some medicines (like insulin) to stay in the body longer. This can cause low blood sugar. And when the kidneys are damaged, insulin may stay in the body longer, causing low blood sugar. The kidneys may also have problems making glucose, causing low blood sugar.
Cause

Type 1 diabetes develops because the body's immune system destroys beta cells in a part of the pancreas called the islet tissue. These beta cells produce insulin. So people with type 1 diabetes can't make their own insulin.

The pancreas normally adjusts the amount of insulin it makes based on your changing blood sugar. When you have diabetes, your insulin injections can't control your blood sugar moment to moment, the way your pancreas would. So you may have high and low blood sugar levels from time to time.
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Causes of high blood sugar
Causes of high blood sugar include:
  • Not getting enough insulin.
  • Eating more food than usual.
  • Stress and being ill (such as with severe flu) or having an infection, especially if you aren't eating or drinking enough.
  • Taking medicines that can raise blood sugar levels, such as those for sleep, some decongestants, and corticosteroids (such as prednisone).
  • The dawn phenomenon or the Somogyi effect, which can cause early-morning high blood sugar.
  • Adolescence, because of hormone changes and rapid growth.
  • Pregnancy.
Diabetic ketoacidosis
Sometimes a person's blood sugar level rises greatly before he or she knows something is wrong. Because insulin isn't available, the cells in the body are unable to get the sugar (glucose) they need for energy. The body begins to break down fat and muscle for energy.

When fat is used for energy, ketones—or fatty acids—are produced and enter the bloodstream. This causes the chemical imbalance diabetic ketoacidosis. This can be a life-threatening condition.
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Causes of low blood sugar
Causes of low blood sugar include:

  • Taking too much insulin.
  • Skipping or delaying a meal or snack.
  • Exercising more than usual without eating enough food.
  • Drinking too much alcohol, especially on an empty stomach.
  • Taking medicines that can lower blood sugar, such as large amounts of aspirin and medicines for mental disorders.
  • Starting your menstrual period, because hormonal changes may affect how well insulin works.
Exams and Tests
Diagnostic tests

If your doctor thinks that you may have diabetes, he or she will order blood tests to measure how much sugar is in your blood. The tests used are:

  • Blood glucose tests.
  • Hemoglobin A1c.
Your doctor will use your blood test results and the American Diabetes Association (ADA) criteria to diagnose diabetes. He or she will also do a medical history and physical exam.

If it is hard to tell if you have type 2 or type 1 diabetes, your doctor may do a C-peptide test or an autoantibodies test. (Autoantibodies are produced when the body's immune system does not work right.) For example, many people with type 1 diabetes produce the autoantibody zinc transporter 8 (ZnT8Ab). People with type 2 diabetes or gestational diabetes do not produce ZnT8Ab. These tests may not be able to confirm the type of diabetes you have. Getting a definite diagnosis may take months or years. In either case, your blood sugar levels will need to be controlled right away.

Tests to check your health
You'll need to see your doctor every 3 to 6 months.
 At your visits, your doctor may:
  • Check your blood sugar levels since your last visit and review your target range.
  • Check your blood pressure and start or adjust treatment, if needed. Nerve and blood vessel damage can result from high blood pressure, leading to heart problems and strokes. For more information, see the topic High Blood Pressure.
  • Check your feet for signs of problems, especially if you have had diabetes for a few years. Nerve damage in your feet makes it hard to feel an injury or infection. Take off your socks each time you see the doctor to be sure you both remember to check your feet. At least once a year your doctor will do a complete examination of your feet.
  • Have a hemoglobin A1c test. This blood test shows how steady your blood sugar levels have been over time.
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Review your progress regularly 
Regular visits and checkups with your doctor are also a good time to:

  • Review your meal plan.
    • Food List
    • Tracking My Foods and Blood Sugar Levels
  • Review your physical activity.
    • Physical Activity Log
  • Review your mental health.
    • Tracking My Feelings About Diabetes
    • How Do You Cope With Stress?
  • Review your blood sugar records.
    • Blood Sugar Testing Times Form
    • Home Blood Sugar Diary
  • Review your medicines.
    • Master List of Medicines
These visits are also a good time to talk with your doctor about how you're feeling. It's normal to feel frustrated or overwhelmed with all there is to do. If you're having trouble coping, your doctor can help.

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Tests to screen for complications

After you have had type 1 diabetes for 3 to 5 years, your doctor may recommend these tests.
  • A complete eye exam by an ophthalmologist or optometrist. High blood sugar levels from diabetes can damage your eyes. This test can find problems early. If you do not have any signs of diabetic retinopathy, your doctor may recommend less frequent exams. For example, you may have this test every 2 years.
  • A foot exam to check for diabetic neuropathy. Your doctor may look at your feet for sores and calluses at every visit. If you have one or more foot problems, you may need to have your feet checked more than once a year. A child who has diabetes may not need a thorough examination of his or her feet each year until after puberty.
  • A cholesterol and triglyceride test. This test shows your LDL cholesterol level. You and your doctor can adjust your treatment plan according to how high it is. If you are an adult and have normal results, you may be tested every 2 years. If your child's levels are normal, then he or she can be tested every 5 years.
  • A urine test, to check for protein. If protein is found, you'll have more tests to help guide the best treatment. Protein in the urine can be a sign of kidney damage (diabetic nephropathy).
  • A blood test for creatinine and glomerular filtration rate (GFR). These tests check for kidney disease.
  • A liver function test. This test looks for damage to the liver.
  • A thyroid-stimulating hormone test. This test checks for thyroid problems, which are common among people who have diabetes. If the test is normal, your doctor may suggest you have the test again every 1 to 2 years.
Dental checkups
  • Dental exam. See your dentist twice a year for professional cleaning of your teeth and to look for gum disease. Seeing your dentist is one part of taking care of your teeth and gums when you have diabetes.
  • Eye exams during pregnancy

    If you get pregnant, you will need to have an eye exam sometime during the first 3 months. You'll also need close follow-up during your pregnancy and for 1 year after you have your baby. Pregnancy may increase your risk for diabetic retinopathy. If you already have eye disease and get pregnant, the disease can quickly get worse.
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Treatment Overview
Type 1 diabetes requires treatment to keep blood sugar levels within a target range. Treatment includes:
  • Taking several insulin injections every day or using an insulin pump.
  • Monitoring blood sugar levels several times a day.
  • Eating a healthy diet that spreads carbohydrate throughout the day.
  • Regular physical activity or exercise. Exercise helps the body to use insulin more efficiently. It may also lower your risk for heart and blood vessel disease.
  • Regular medical checkups. You will get routine screening tests and exams to watch for signs of complications, such as eye, kidney, heart, blood vessel, and nerve diseases.
  • Not smoking.
  • Not drinking alcohol if you are at risk for periods of low blood sugar.
Blood sugars are easier to predict and control when mealtimes, amounts of food, and exercise are similar every day. So getting into a daily routine helps a lot.
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Diabetic ketoacidosis
Some people find out that they have type 1 diabetes when they are admitted to a hospital for diabetic ketoacidosis. If their symptoms are severe, they may need to be treated in an intensive care unit.

Treatment for diabetic ketoacidosis includes fluids given through a vein (intravenous, or IV) to treat dehydration and to balance electrolytes, and insulin to lower the blood sugar level and stop the body from producing ketones.

The honeymoon period
If your blood sugar levels return to the normal range soon after diagnosis, you are in what is called the "honeymoon period."
Types of Insulin for Diabetes Treatment In this article
  • What Type of Insulin Is Best for My Diabetes?
  • How Are Doses Scheduled?
  • Exceptions to Insulin Dosing and Timing

Many forms of insulin treat diabetes. 
They're grouped by how fast they start to work and how long their effects last.

The types of insulin include:
  • Rapid-acting
  • Short-acting
  • Intermediate-acting
  • Long-acting
  • Pre-mixed
Assess Yourself: Is Your Type 1 Diabetes Under Control?
What Type of Insulin Is Best for My Diabetes?Your doctor will work with you to prescribe the type of insulin that's best for you and your diabetes. Making that choice will depend on many things, including:
  • How you respond to insulin. (How long it takes the body to absorb it and how long it remains active varies from person to person.)
  • Lifestyle choices. The type of food you eat, how much alcohol you drink, or how much exercise you get will all affect how your body uses insulin.
  • Your willingness to give yourself multiple injections per day
  • How often you check your blood sugar
  • Your age
  • Your goals for managing your blood sugar
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Afrezza, a rapid-acting inhaled insulin, is now FDA-approved for use before meals for both type 1 and type 2 diabetes. The drug peaks in your blood in about 15-20 minutes, researchers say, and it clears your body in 2-3 hours. It must be used along with long-acting insulin in people with type 1 diabetes.

The chart below lists the types of injectable insulin with details about onset (the length of time before insulin reaches the bloodstream and begins to lower blood sugar), peak (the time period when it best lowers blood sugar) and duration (how long insulin continues to work). These three things may vary. The final column offers some insight into the "coverage" provided by the different insulin types in relation to mealtime.

Type of Insulin & Brand Names


                      This needs a chart                                           
Rapid-Acting; 
Rapid-acting insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is often used with longer-acting insulin  
Lispro (Humalog)                 15-30 min.30-90 min3-5 hours.
Aspart (Novolog)        10-20 min.40-50 min.3-5 hours
Glulisine (Apidra)20-30 min.30-90 min.1-2½ hours


Short-Acting Regular (R) Short-acting insulin covers insulin needs for meals eaten within 30-60 minutes
 humulinor novolin30 min. -1 hour2-5 hours5-8 hours.
Velosulin (for use in the insulin pump)30 min.-1 hour2-3 hours2-3 hours


Intermediate-Acting  
Intermediate-acting insulin covers insulin needs for about half the day or overnight. This type of insulin is often combined with a rapid- or short-acting type.
Long-ActingLong-acting insulin covers insulin needs for about one full day. This type is often combined, when needed, with rapid- or short-acting insulin.
NPH (N)1-2 hours4-12 hours18-24 hours
Insulin glargine (Lantus)1-1½ hour
No peak time. Insulin is delivered at a steady level.20-24 hoursInsulin detemir (Levemir)1-2 hours6-8 hoursUp to 24 hoursPre-Mixed*Humulin 70/3030 min.2-4 hours14-24 hoursThese products are generally taken two or three times a day before mealtime.Novolin 70/3030 min.2-12 hoursUp to 24 hoursNovolog 70/3010-20 min.1-4 hoursUp to 24 hoursHumulin 50/5030 min.2-5 hours18-24 hoursHumalog mix 75/2515 min.30 min.-2½ hours16-20 hours*Premixed insulins combine specific amounts of intermediate-acting and short-acting insulin in one bottle or insulin pen. (The numbers following the brand name indicate the percentage of each type of insulin.)
How Are Doses Scheduled?

Follow your doctor's guidelines on when to take your insulin. The time span between your shot and meals may vary depending on the type you use.

In general, though, you should coordinate your injection with a meal. From the chart on page 1, the "onset" column shows when the insulin will begin to work in your body. You want that to happen at the same time you're absorbing food. Good timing will help you avoid low blood sugar levels.

  • Rapid acting insulins: About 15 minutes before mealtime
  • Short-acting insulins: 30 to 60 minutes before a meal
  • Intermediate-acting insulins: Up to 1 hour prior to a meal
  • Pre-mixed insulins: Depending on the product, between 10 minutes or 30 to 45 minutes before mealtime



Exceptions to Insulin Dosing and TimingLong-acting insulins aren’t tied to mealtimes. You’ll take detemir (Levemir) once or twice a day no matter when you eat. And you’ll take glargine (Lantus) once a day, always at the same time. But some people do have to pair a long-acting insulin with a shorter-acting type or another medication that does have to be taken at meal time. 

Rapid-acting products can also be taken right after you eat, rather than 15 minutes before mealtime. You can take some of them at bedtime.

For more information about when to take insulin, read the "dosing and administration" section of the insulin product package insert that came with your insulin product, or talk with your doctor.

Prevention

Currently there is no way to prevent type 1 diabetes, but ongoing studies are exploring ways to prevent diabetes in those who are most likely to get it. People who have a parent, brother, or sister with type 1 diabetes and are willing to participate in one of these studies should talk with their doctors.



Preventing diabetes complicationsPeople who have type 1 diabetes can help prevent or delay the development of complications by keeping their blood sugar in a target range. They also need regular medical checkups to detect early signs of complications. If complications are treated early, the damage may be stopped, slowed, or possibly reversed.

People who have other health problems along with diabetes, such as high blood pressure or high cholesterol, need to treat those conditions. Also, not smoking can reduce the risk of complications. Having other health problems can increase the risk for complications from diabetes.

Preventing diseaseWhen you have diabetes, you need a flu vaccine every year. You also need a hepatitis B (Hep B) vaccine.


You also need a pneumococcal shot. Your doctor can help you choose between the pneumococcal polysaccharide vaccine (Pneumovax) or the pneumococcal conjugate vaccine (Prevnar).

You may need or want additional immunizations if certain situations raise your chance for exposure to disease.


WebMD Medical Reference from Healthwise

Read the GENESIS Disclaimer.
Disclaimer: I, (Teresa Biggins) am not a Medical Doctor, and cannot prescribe, cure or diagnose. 
     Many of these articles have not been written by me. They have been copied , usually word for word from Web sites, periodicals, books and fliers with full credits given. 
      ALL information on any page not intended for prescribing, diagnosing, or curing  any ailment you may have. These articles may not be misconstrued as medical advise or  instruction. Readers who fail to consult with with appropriate health professionals assume the risk of any injury.
Teresa Biggins ND                    Text847-736-3030          teresabiggins@gmail.com
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