Type 1 diabetes -- living with the disease

Thursday May 28, 2009 (foodconsumer.org) --Bronx-born Sonia Sotomayor, who could become the first Latina Supreme Court justice, has been living with type 1 diabetes for most of her life. Experts say the disease, if managed and monitored well, should have no effect on her ability to serve.

Sotomayor, 54 years old, is of Puerto Rican descent and was raised in the projects of the Bronx, according to HispanicBusiness.com. She was diagnosed with diabetes at the age of eight, during the 1960s, when the diagnosis was considered life-altering. Patients weren’t expected to live full, productive or long lives because of the side effects the disease can cause.

But with improvements in monitoring and treatment in the past 30 years, the outlook for type 1 diabetes patients has dramatically improved. A French study published in November of 2008 in SpringerLink looked at the lifestyles of type 1 diabetes patients who had lived with the disease for as long as 50 years.

“The life expectancy of patients with type 1 diabetes continues to improve,” wrote Dr. J.J. Altman and colleagues. “Better care has reduced the frequency of organic complications and improved their management.”

Type 1 diabetes, once called juvenile diabetes, affects approximately 3 million Americans, according to the American Diabetes Association.

Doctors do not know what causes the disease and there is no cure. Health experts think genetics, viruses and autoimmune problems may play a role. In type 1 diabetes, cells of the pancreas produce little or no insulin, the hormone that allows sugar (glucose) to enter body cells. Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy despite high levels in the bloodstream.

The following list about type 1 diabetes is compiled from information provided by the National Institutes of Health:

Symptoms of Type 1 Diabetes: Abdominal pain, absence of menstruation, fatigue, increased thirst, increased urination, nausea, vomiting, and weight loss despite increased appetite.

How Type 1 diabetes is diagnosed: Using a variety of blood tests taken at different times and under different circumstances, doctors will look at the blood glucose levels in patients. Ketone testing is also used in type 1 diabetes. Ketones are produced by the breakdown of fat and muscle. They are harmful at high levels. The ketone test is done using a urine sample.

Treatment: The immediate goals of treatment are to treat diabetic ketoacidosis and high blood glucose levels. Because type 1 diabetes can come on suddenly and the symptoms can be severe, newly diagnosed people may need to stay in the hospital.

Goals of treatment are: To prolong life, reduce symptoms, and prevent diabetes-related complications such as kidney failure, heart disease and amputation of limbs.

Recommendations for managing Type 1 diabetes: Careful self-testing of blood glucose levels, education, exercise, foot care, insulin use, meal planning and weight control.

Using Insulin: Insulin lowers blood sugar by allowing it to leave the bloodstream and enter cells. People with type 1 diabetes must use insulin everyday.

Insulin is usually injected under the skin. In some cases, a pump will deliver the insulin continuously. Insulin does not come in pill form. More than one type of insulin may be mixed together in an injection to achieve the best blood glucose control. Injections are needed, in general, from one to four times a day. A child’s injections may be given by a parent or other adult. By the age of 14, most children can be expected to give their own injections.

For more information on type 1 diabetes, including finding support groups, go to the National Institutes of Health website at http://www.nlm.nih.gov and for the American Diabetes Association go to http://www.diabetes.org.

(By Sheilah Downey, and edited by Heather Kelley)