Diabetes mellitus type 1, normally known as Type 1 Diabetes, is a type of diabetes that is caused by the lack of insulin resulting from the destruction of insulin-producing cells. Since insulin regulates the amount of glucose in the body, the destruction of the insulin-producing cells subsequently leads to high level of glucose in blood and urine. As a result, Type 1 Diabetes is normally associated with frequent urination, increased thirst and hunger, and drastic weight loss in case of poor lifestyle management. Type 1 Diabetes is less common as compared to Type 2 Diabetes and is normally referred to as juvenile diabetes because it mainly affects children and adolescents (Diabetes UK 2011). In contrast, Type 2 Diabetes is observed when the insulin is being produced but the body does not use it efficiently, leading to high glucose level. The body responds by producing more and more insulin, eventually exhausting the insulin-producing cells and making them fail, thus, provoking the onset of Type 2 Diabetes. This form of diabetes is the most common one, accounting for more than 80% of all cases of diabetes in the UK. Its cause is mainly attributed to obesity (WebMD 2012).
Living with Type 1 Diabetes
Type 1 Diabetes can be fatal if it is not managed properly. One of the most common methods of managing the disease is through the administration of insulin shots. It could be made through injections or inhalation. Having Type 1 Diabetes does not necessarily lead to poor health and a diabetic can still live his/her full life. The following list outlines how patients can manage their lifestyles to reduce the risk of long-term health complications.
Seeking to Learn More about the Disease
When it is first diagnosed, most people always have little insight into the disease and try to have access to any information that can create awareness. Consequently, the patients experience a steep learning curve as they try to comprehend all the information obtained from various media. Unfortunately, most people stop learning because they assume that just after a few months they know enough (WebMD 2012). This is a mistake as learning should be a continuous process. Deeper knowledge about the condition increases the confidence in the ability to manage it. Besides, through learning, a patient is able to get tips on the ways of managing the side effects of Type 1 Diabetes from professionals and people who have diabetes themselves (WebMD 2012). There are a number of materials that offer simplified information on how the disease can be conducted and one should read these materials occasionally.
Daily Management of Diabetes
There are four main pillars for managing Type 1 Diabetes Mellitus (T1DM). They are insulin, food, exercise, and blood glucose level testing. A well balanced diet is the first step to control the disease as it helps coordinate the amounts of blood glucose, blood fats, and blood pressure.
Since T1DM is caused by a deficiency of insulin in the blood, its introduction is vital towards reducing blood glucose level. The main purpose for administration of insulin in the body is to lower blood glucose and hence avoid long-term health complications which affect the nervous system (e.g. poor cognition abilities, loss of conscience, etc), and the cardiovascular system (e.g. heart attack and loss of sight). Insulin administration is achieved through injection or inhalation of insulin which is manufactured artificially. Continuous glucose monitoring can be used to alert patients of severely high or low glucose levels. People who have the disease for a long time will know when their blood glucose levels fluctuate as this illness affects various physiological processes and patients learn to associate them with low blood glucose (BG) levels, such as thirst or fatigue (Silverstein et al. 2005, p199). However, blood testing is the surest way of knowing BG levels and there are simple kits that can be used to carry out a home blood sugar test (WebMD 2012).
A balanced diet also helps regulate body weight and hence reduce the risk of heart attacks. It is important to find a balance between the quantity of carbohydrates and fats in any diet (Silverstein et al. 2005, p189). Patients should consume less fats, especially animal fats as this could lead to heart illnesses. Monosaturated fats such as olive oil and rapeseed oil are encouraged. Oily fish should be consumed at least twice a week as it contains monosaturated fats as well. Other low-fat foods include eggs, lean meat and pulses (such as lentils). Regular meals should contain more carbohydrates and starch (Silverstein et al. 2005, p200). Such foods include bread, pasta, chapattis, potatoes, noodles, low fat fruit yoghurt, baked beans, rice, and cereals (Gillespie, Kulkarni & Daly 1998, p901). Meals should be accompanied with adequate amounts of fresh fruits and vegetables (WebMD 2012).
Exercises are very important in the management of T1DM since they increase glucose absorption by the body tissues and hence reduce insulin requirements. With adequate exercises, the amount of insulin administered into the body can be lowered significantly. Besides, there are numerous health-related benefits in regards to exercises, such as lowering blood pressure, managing body weight, and helping in lipid metabolism. Children with Type 1 Diabetes should exercise at least three to four times a week for about 20-60 minutes. A physician should provide a piece of advice on the best activities to exercise (Silverstein et al. 2005, p208). However, such activities as running, walking, cycling, swimming, dancing or gardening are recommended.
Stressful conditions cause the body to react as if it were under attack by hormones and sugars that are released into the blood stream. Such conditions can elevate BG levels within a short period of time and result in serious health complications (WebMD 2012). Any signs of stress, such as difficulty in concentrating and difficulty in falling asleep, should be handled in a relaxed manner, like breathing deeply or exercising.
People with T1DM can benefit immensely from participating in diabetes support groups and other diabetes events such as the Diabetes UK event. Assistance can also be sought from family members and friends. One should not be ashamed of telling others about their diabetic condition as there are more than 2.5 million people living with the condition in the UK (Diabetes UK 2011). Therefore, telling others about the disease not only helps the person, but also encourages others to open up (BBC 2012).
National Service Framework Standards for Diabetes
In spite of the fact that diabetes is the fourth leading killer in the UK, response to the disease has been slow and studies show that 50% of older people with diabetes remain undiagnosed, and many of those diagnosed have normally had the disease for many years prior to the diagnosis (Harris et al. 1992, p817). In order to improve the national management of diabetes, the National Service Framework (NSF) set up 12 standards with an aim of preventing diabetes, to identify people with diabetes, and ensure that diabetics get given high-quality, evidence-based care. These 12 standards are outlined below:
Standard 1: Prevention of Type 2 Diabetes Mellitus (T2DM)
The NSF will create, execute, and monitor policies to reduce the risk of developing T2DM in the whole UK and reduce the inequalities in the risk of developing T2DM. Under this standard, the NSF aims to increase awareness of the causative factors of T2DM, such as obesity. The NSF will also inform people about strategies that can be used to lower the risks of developing the disease, such as education to promote healthy eating and exercise, assisting people to lose and maintain weight (Nazarko 2003).
Standard 2: Identification of Persons with Diabetes
A number of people remain undiagnosed with T2DM for many years. During those years, complications arising from the disease develop significantly. This standard aims to identify persons suffering from the disease at the initial stage (Nazarko 2003). The government undertakes regular screenings with assistance from the National Screening Committee to help identify these people and place them on diabetes management programs.
Standard 3: Empowering People with Diabetes
All children, adolescents, and adults with diabetes will receive a service that promotes partnership in decision-making, supports them in diabetes management, and assists them in adopting and maintaining a lifestyle that does not put their lives at risk. Generally, people with diabetes who are not necessarily professionals are given freedom to exercise personal control over their lives in the day-to-day management of the condition.
Standard 4: Clinical Care of Adults with Diabetes
All diabetic adults will be given high-quality care throughout their lifetime. This care will include support to ensure that they exercise adequate control of their BG levels, blood pressure, and other risk factors in the management of diabetes. This standard aims to get experts work together with diabetics in order to assist them in weight control, increase activity levels, and firmly control the BG and cholesterol levels and hypertension (Nazarko 2003).
Standard 5 & 6: Clinical Care of Children and Young People with Diabetes
All children and young people with diabetes will always be given high-quality care and, together with their families and others partaking in their routine care, will receive assistance to optimize the control of their BG and their physical, psychological, intellectual, educational, and social development. All children and adolescents with diabetes will have a smooth transition of care from paediatric diabetes management to adult diabetes services in any healthcare institution. The transition will be arranged in consultation with each patient separately at an appropriate age.
Standard 7: Management of Diabetic Emergencies
The NSF will develop, implement, and supervise common protocols for speedy and effectual treatment of diabetic emergencies with the help of expert care professionals. Such protocols include the management of serious complications and procedures to alleviate the risk of recurrence.
Standard 8: Care of People with Diabetes during Admission to Hospital
All children, young people, and adults with diabetes who are for whatever reason admitted to hospital will be given appropriate care pertaining to their condition. Where possible, the patients will continue to get involved in choices regarding the management of their diabetes (Nazarko 2003).
Standard 9: Diabetes and Pregnancy
The NHS will develop, implement, and monitor strategies with the hope of empowering and supporting women with diabetes to ensure the pregnancy is not affected by the disease.
Standard 10, 11 and 12: Discovery and Management of Long-Term Complications
All children, young people, and adults with diabetes will be monitored regularly to manage the long-term complications of the disease. The National Health Service (NHS) will develop, implement, and monitor approved protocols and systems of care to ensure that people who develop long-term complications are given immediate, appropriate, and effective monitoring and treatment to lower risks of disability and early death (Nazarko 2003). All people with diabetes and those who require multi-agency support will receive integrated support and care.
Near Future Issues for Children with Diabetes
During the teenage years and youth, the insulin requirements of children and young people may change over time and this will change their diabetes management plan. Over the years, their insulin requirements will increase and this may lead to a shift in the daily meal plans. Moreover, the way they administer insulin (using shots or an insulin pump) may change too. Generally, as children grow up, they must continue controlling the BG levels and carefully monitor their lifestyle in order to reduce the likelihood of developing acute complications. Due to increased metabolic processes and physical activity while growing up, children may have to increase the monitoring of their BG levels. In addition, a change in the meal plan will make up for increased physical activity.
Although there are specific types of meals recommended for people with diabetes, this does not necessarily mean that the children will be restricted to similar food for the rest of their lifetime. Instead, the children can consume a variety of meals as long as these meals are high in nutrition and low in fats and calories. Fruits, vegetables, and all kinds of grains are highly recommended while animal products and sugary foods will be minimized. The quantity of carbohydrates in any meal must be controlled since that is the main determinant of BG levels. Sugary foods such as sweets, fruit juices, and soft drinks should be consumed moderately.
As years go by, lifestyle will be of high importance in managing BG levels. Activities such as smoking and drinking can create complications for people suffering from Type 1 diabetes. While smoking increases the chances of getting diabetes, it also makes the management of diabetes difficult for people who have the condition already. Smoking also creates other complications such as heart disease, renal diseases, vascular disease, increased blood pressure, and so on. Diabetics should consume alcohol with extreme caution since alcohol substances contain calories and carbohydrates that may complicate BG level management. Some alcohol products can cause low blood sugars. Drug use can cause fluctuations in BG levels apart from creating serious health complications since some drugs can become harmful when they come into contact with various medications used to manage diabetes.
Over the years, people with diabetes may require additional treatment to supplement the insulin administration and a healthy lifestyle to manage T1DM. This treatment can be in the form of tablets. However, they can only be used upon advice of a healthcare professional (BBC 2012). Finding out the best treatment options is vital for managing diabetes.
BBC 2012, Health. Diet and diabetes. Web.
Diabetes UK 2011, Children and diabetes. Web.
Gillespie, S. J., Kulkarni, K. D. & Daly, A. E. 1998, ‘Using carbohydrate counting in diabetes clinical practice’, Journal of the American Dietetic Association, vol. 98, no. 8, pp. 897-905.
Harris, M. I., Klein, R., Welborn, T. A. & Knuiman, M. W. 1992, ‘Onset of non-insulin dependent diabetes occurs at least 4-7 years before clinical diagnosis’, Diabetes Care, vol. 15, pp. 815-819.
Nazarko, L. 2003, ‘Meeting the national service framework standards for diabetes‘, Nursing Times. Web.
Silverstein, J., Klingensmith, G., Copeland, K., Plotnick, L., Kaufman, F., Laffel, L., Deeb, L., Grey, M., Anderson, B., Holzmeister, L. A., & Clark, H. 2005, ‘Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association’, Diabetes Care, vol. 28, no. 1, pp. 186-212.
WebMD 2012, ‘Type 1 Diabetes: Children Living With the Disease – Topic Overview‘, Diabetes Health Center. Web.