Type 1 diabetes is a disease that can be extremely complicated, especially when considering the many parts of the body that the disease affects. Many other factors tend to add to the complexity of the disease, such as hemoglobin A1C levels that need to be maintained despite the many factors that tend to curve the results. Maintenance of the disease is difficult as well. Diabetics must be conscious, alert, and aware of what they do regarding their health. Every aspect of the diabetic’s life must revolve around their blood glucose level and whether or not the activity they partake in will affect it. There are many interventions available and in the making in order to help the diabetic with keeping control of their A1C level and help prevent the diabetic from experiencing the unpleasant consequences of a high A1C level. Diabetes consumes a lot of a diabetic’s life, especially considering all of the mechanisms involved when caring for such a complicated disease.
Complex and Deadly: Type 1 Diabetes
There are an estimated 382 million people worldwide that have diabetes and over 29.1 million of those people resides in the United States. This essay focuses on information to help a reader better understand type 1 diabetes. The research discussed in this essay includes “Magil’s Medical Guide, Seventh Edition on Diabetes Mellitus” by Hiliar Klandorf and Sharon W. Stark, “Diabetes Mellitus Type 1 in Children Aged 0-12 Years” by Amber Bruggman and Kimberly Ortiz-Hartman, “A1C and eAG”, “How Do Insulin Pumps Work”, and “Checking Your Blood Glucose” by the American Diabetes Association, and “Bionic Pancreas Treats Adults with Type 1 Diabetes” and “Preventing Diabetes Problems” by the National Institutes of Health. Type 1 diabetes is a complex disease that affects all aspects of life.
Diabetes is a complex disease that wreaks havoc on the body; therefore, it does not go unnoticed very long before a diagnosis is made. Diabetes has many serious symptoms that may present themselves when untreated. The first sign of diabetes is excessive thirst and urination. The next landmark to look for when attempting to diagnose diabetes is excessive sweating and sometimes even blurred vision. If left untreated too long, a diabetic could go into a state of ketoacidosis. Ketoacidosis is essentially a toxic level of sugar in the blood that damages internal organs and may even cause the diabetic to lose concisions. While the symptoms seem simple and easy to diagnose, what is happening within a type 1 diabetic’s body is not quite as simple. When symptoms start to present themselves, it means that the beta cells in the pancreas have been attacked. The National Institutes of Health (NIH) states, “In type 1 diabetes, the body’s own immune system attacks and destroys beta cells.” (“Bionic Pancreas Treats Adults with Type 1 Diabetes”, 2017). According to Hillar Klandorf and Sharon Stark, this is called an autoimmune attack; this is when the immune system attacks a part of the body that it was not intended to attack. When the beta cells are attacked, they stop producing insulin and glycogen. Without these key hormones, a diabetics blood sugar now can drop low and shoot high. The diabetic is now dependent on artificial insulin and a meter in order to keep their blood sugar under control.
Perhaps one of the hardest things to do when living with diabetes is keeping their sugar levels managed. Keeping diabetes in check is a complex and sometimes extremely frustrating process. A normal diabetic’s sugar should range from 80-120; however, this is an extremely hard goal to achieve (“Checking Your Blood Glucose”, 2015). There are many factors that influence a person’s blood glucose level. Most people without diabetes do not notice factors, like random bursts of hormones, that cause glucose levels to rise; however, a diabetic will notice all of these random bursts because their glucose levels will rise to sometimes even a dangerously high level. Another factor that has a major contribution on a diabetic’s sugar level is their diet. A diabetic must watch the types of foods and the portions that they eat. In order to maintain glucose levels in the optimal range, a diabetic must take insulin at specific times and check their sugar frequently. According to the American Diabetes Association, a diabetic should check their sugar when they wake up, before each meal, and before they go to bed (“Checking Your Blood Glucose”, 2015). Checking blood glucose levels is a process that can be quite painful and time consuming. The process involves preparing the diabetics finger, operating the meter, and also knowing how to properly use a lancing device (Checking Your Blood Glucose, 2015). Maintaining diabetes is a rigorous challenge that involves many obstacles.
In medicine, there are constantly technology updates and new inventions to better improve the quality or health of a person or their life; these updates and inventions are called innovations. There are many innovations that have come to the field of endocrinology in the past years with a special focus on diabetes. Some of the new technologies include contentious glucose monitor (CGM), insulin pumps, and even bionic pancreases. A CGM allows for a diabetic to know what their sugar is at all times of the day. One of the leading innovators in CGM technology is a company known as Dexcom; Dexcom is a type of CGM that is attached to the diabetic’s side at all times with an adhesive strip (“Bionic Pancreas Treats Adults with Type 1 Diabetes”, 2017). The Dexcom works by sending a Bluetooth signal to the diabetic’s phone and alerts them anytime that their sugar is high or low. This allows the diabetic to take action immediately to adjust for the high or low. Another popular technology is an insulin pump. There are many types of insulin pumps; for example, some are pods with an insulin reserve and is built much like the Dexcom, and some contain tubes and attach to the diabetic’s belt clip. An insulin pump allows for a diabetic to take insulin at any given time without the need for a shot. An insulin pump also eliminates the need for a long-acting shot. This elimination is made possible by a basal rate. According to the American Diabetes Association, a basal rate is insulin that is delivered over a 24-hour period of time in order to keep blood glucose levels within optimum range between meals and at night (“How do Insulin Pumps Work?”, 2013). One of the newest innovations to be affiliated with diabetics is the bionic pancreas. A bionic pancreas is really a combination of a CGM and an insulin pump. According to the National Institute of Health, “the bionic pancreas system includes a continuous glucose monitor and a smartphone app that wirelessly connects with insulin and glucose pumps.” (“Bionic Pancreas Treats Adults with Type 1 Diabetes”, 2017). The bionic pancreas could allow diabetics to live a normal life without the need to worry for a shot or a finger prick. All of the new innovations have allowed a diabetic to be more unimpeded by the constant struggle of living with type 1 diabetes.
Perhaps one of the best ways for a doctor and a diabetic to know whether or not the diabetic's sugar is under control is checking their hemoglobin A1C level. According to Amber Bruggman and Kimberly Hartman, “The A1C test indicates average blood glucose control over the last 2 to 3 months by testing the percentage of glycated hemoglobin in the blood.” (“Diabetes Mellitus Type 1 in Children Aged 0-12 Years”, 2017). For an average person, a hemoglobin level of 6.5 percent or higher is considered to be an abnormally high result (“Diabetes Mellitus Type 1 in Children Aged 0-12 Years”, 2017). In type 1 diabetics, however, the American Diabetes Association suggests that the diabetic attempt to maintain an A1C of 7% or lower (“A1C and eAG”, 2013). There are exceptions to a diabetics A1C level; for example, a diabetic in their teenage years would be expected to have an A1C level that is much higher than a diabetic in their adult years. The major difference in the age of a diabetic is the amount of hormone secretion within the body. The hormones that are secreted in a diabetic’s teenage years can be a major factor on the diabetic’s blood glucose levels. Hemoglobin A1C is a major tool that can help a diabetic and their endocrinologist determine whether or not their sugar is under control or if there is some type of action that needs to be taken.
Management of diabetes is extremely important; there can be major consequences if a diabetic would choose to not take care of their sugar. Some of these consequences include nerve damage, heart disease, stroke, dental problems, as well as eye and foot problems (“Preventing Diabetes Problems”, 2016). Unmanaged type 1 diabetes can lead to nerve damage due to the low amounts of insulin in the body, which leads to damaged and sometimes even dead nerve fibers. Heart disease is a major problem for long term diabetics. This problem occurs from the damage to blood vessels and their walls. The NIH states, “In adults with type 1 diabetes, the most common causes of death are heart disease and stroke.” (“Preventing Diabetes Problems”, 2016). One of the most common concerns for a type 1 diabetic is the loss of eyesight. The loss of eyesight connects strongly to the damage of the nerve fibers. After the optic nerve becomes damaged due to high or low glucose levels, the diabetic may begin to have simple vision problems that start with simply needing glasses; however, these problems can develop into temporary or sometimes even permanent blindness. The most common and earliest symptoms that comes from type 1 diabetes are foot problems. Foot problems can consist of simply athlete's foot or can be as complex as circulation damage in which an amputation is required. Leaving diabetes unmanaged can have fatal and life changing consequences.
Type 1 Diabetes can have a lasting impact on a diabetic’s life due to its complexity and constant need for maintenance. Type 1 diabetes is complex in the way that it works within the body and is managed. It is also very important to be up to date on new innovations, hemoglobin a1c levels and management of the disease. Without keeping up to date on these aspects of a diabetic’s life could cause havoc in the diabetic’s health and potentially even death.