Type 1 Diabetes

The New Benchmark In Endocrinology

In type 1 diabetes, the body makes little or no insulin—called insulin deficiency. People with this type of diabetes must take insulin injections to live. That’s why you sometimes hear it referred to as “insulin-dependent diabetes.” Up to 1 in 10 people with diabetes have type 1. Although it usually begins when people are young, onset may occur at any age.

Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. However, it can develop at any age throughout adulthood. Generally, people with type 1 diabetes are diagnosed when symptoms appear suddenly or they experience extremely high blood sugar (glucose) levels.

The preferred test for diagnosing type 1 diabetes is the fasting plasma glucose (FPG) test. This blood test requires fasting (no food or drink except water) for at least 8 hours and is usually done in the morning.

Other tests used to diagnose diabetes are the casual plasma glucose test (a blood test taken at any time of day without regard to time since last meal), the oral glucose tolerance test (OGTT: a blood test taken 2 hours after drinking glucose dissolved in water), and the glycated hemoglobin (A1C). A person recently diagnosed with type 1 diabetes may not have an elevated A1C. This test is not often used when type 1 diabetes is suspected.

A diagnosis of diabetes is made if a person has any of the following test results1:

  • FPG is 126 mg/dL or higher.
  • High blood sugar (hyperglycemia) symptoms exist and casual plasma glucose is 200 mg/dL or higher.
  • Plasma glucose is 200 mg/dL or higher at 2 hours during an OGTT.
  • A1C is greater than or equal to 6.5%.

If any of these test results occur, testing should be repeated on a different day to confirm the diagnosis.

Treatment of Type 1 Diabetes

People with type 1 diabetes must take insulin shots to live because their bodies cannot produce insulin. The goal of type 1 diabetes treatment is to maintain blood sugar (glucose) levels as near to normal as safely possible. Blood sugar goals are different for different age groups and change as children grow into adulthood.

Good nutrition, careful monitoring of carbohydrate and fat intake, and regular physical activity are also important to managing type 1 diabetes and preventing long-term complications. See our Nutrition and Exercise section of this website to learn about healthy meal planning, counting carbohydrates, and more.

 

Children and Diabetes

When your child has diabetes, it affects the entire family. Keeping up with the latest information and tools to care for a child with diabetes is a vital role for parents. Not only are there frequent advances in diabetes care, but the needs of children with diabetes can change as they get older. Managing diabetes at any age requires skill and attention.

Today, diabetes can be managed effectively, allowing kids to stay healthier and live active lives. But you and your child can’t manage diabetes alone. You’ve got to have a team of healthcare professionals that can work with you. Your child’s team may include a doctor (pediatrician, endocrinologist, family physician, internist, or nurse practitioner), a diabetes educator, a dietitian, and other specialists. It’s important that you and your child are comfortable with those people that are part of the team, their level of experience in diabetes, and their approach to its treatment. Ask questions, and make sure to get answers you can understand.

 

Healthy eating

Your child’s eating habits are an important part of managing diabetes. This may require changes of habits and healthier eating for them and could also benefit you and the rest of your family. Creating a meal plan is a critical part of diabetes care. Four separate things have to be coordinated—what and how much your child eats, when they eat, how active they are, and their insulin schedule. Ideally, these all work together to help keep the blood sugar (glucose) level within the target range.

While it sounds complicated, it can be a relief knowing that no “special” foods are required. Rather, it will be important to learn how to match the amount of foods eaten (especially carbohydrates) with the amount of insulin taken. The ideal meal for a child with diabetes isn’t different than the kind of healthy meals recommended for all of us. A dietitian can help you create a meal plan that your child can enjoy.

For all children with diabetes, it’s necessary to balance food intake, activity levels, and medications to maintain a healthy blood sugar level. Monitoring blood sugar levels is important to understanding how these three things interact.

 

Keeping records

Record keeping is essential to managing your child’s diabetes. This helps you understand if your child’s treatment plan is keeping blood sugar levels within the target range. It also allows you to keep track of what happens to your child’s blood sugar on a daily basis and during those important events like the championship baseball game or pizza Wednesdays at school.

 

At school or daycare

Another common issue is diabetes management in school or daycare settings. It’s important that caregivers know how to check your child’s blood sugar and administer insulin or an injectable treatment for severe low blood sugar (hypoglycemia) in an emergency. There are several resources available to help parents develop a diabetes management plan with school or daycare personnel.

 

Getting support

You’ve already begun the process of managing your child’s diabetes. While it may seem like an overwhelming amount to learn right now, in time you’ll find it can become second nature. Watching your child grow and take on more responsibility for their own care will be challenging but can be gratifying.

It’s important to remember you’re not alone. You’ve got family, friends, and an entire team of healthcare providers supporting you. Ask for help when you need it and don’t forget to take care of yourself.