DiabetesResearchers 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 Confusionwere 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.
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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?
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:
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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- 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.
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.
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What Are the Symptoms?
These are often subtle, but they can become severe. They include:
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Signs of an emergency with type 1 diabetes include:
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:
- Shaking and confusion
- Rapid breathing
- Fruity smell to your breath
- Pain in your belly
- Loss of consciousness (rare)
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.
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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.
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.
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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:
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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:
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:
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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.
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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:
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.
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:
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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:
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.
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:
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.
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Tests to check your health
You'll need to see your doctor every 3 to 6 months. At your visits, your doctor may:
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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.
- Review your physical activity.
- Review your mental health.
- Review your blood sugar records.
- Review your medicines.
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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.
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- 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.
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Dental checkups
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Treatment Overview
Type 1 diabetes requires treatment to keep blood sugar levels within a target range. Treatment includes:
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.
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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
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:
- 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
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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:
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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.)
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.
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.
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
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