Sugar Matters
February 26, 2010
Some essential points about living with Type 1 Diabetes

THE ACTUAL diagnosis of Type 1 diabetes can be clinically based in some cases. For instance, if you are under the age of 18, very thin, and come into the hospital sick and measuring a blood sugar of 600mg/dL, you most likely have Type 1 Diabetes. It’s not 100%, but most likely the case. Most young people who are given the diagnosis of Type 1 diabetes do not have, or need, expensive testing to establish that diagnosis. Some others, including overweight children and older adults, do need some further testing, just to be sure.{{more}} Why does it matter? In the case of Type 1 Diabetes, it is critical to get the diagnosis right because people with type 1 diabetes DO NOT respond to pills for the most part. There are a very, very few exceptions, and it usually relates to how long you have had diabetes, but I won’t get into that right now.

Given this point, here is my first big declaration: people with Type 1 diabetes NEED insulin to survive. Why? It is because people with Type 1 diabetes make little or no insulin of their own. Without insulin, the body cannot use glucose in your blood, so two things happen: blood sugar levels build up and spill out into your kidneys and urine, and your body starts breaking down muscle to make fuel for your body. This is why people with untreated/undertreated Type 1 diabetes get thinner and thinner, can have a strange smell, and are always tired and sick. Even though your body can use protein for energy, it is not ideal, and the products from protein breakdown can eventually make you sick as well. Your body as a whole is built to use glucose for energy, and if insulin is not around to do that many things go wrong and eventually lead to death. In the old days when we did not have insulin, most people with Type 1 diabetes died shortly after their diagnosis. Very, very sad.

Second point: People with Type 1 diabetes tend to be sensitive to even small changes in their insulin amounts. Whereas someone with Type 2 diabetes may miss a day of insulin and feel badly, have somewhat high blood sugars but get back on track fairly quickly, in contrast the person with Type 1 who misses a day of insulin can become extremely sick within half a day.

Third Point: People with Type 1 diabetes can be prone to thyroid disease as well. Given that Type 1 diabetes is classified as an autoimmune disease (where your body essentially turns on itself), that means that some people will be more prone to developing other autoimmune disease, of which thyroid disease is one of the most common. The signs of thyroid disease may be subtle, so it is important that you and your doctor have it on your radar-if you don’t think of it, you won’t test for it. In children, especially, this can be missed often. If your child with Type 1 diabetes is not growing as he/she should be according to the growth chart, has had a change in personality or behavior pattern or is suddenly doing worse in school, for example, thyroid malfunction is one of the things that should be considered as a cause.

Okay, we are moving right along!!! Until next week, stay safe and healthy, Vincies!

Anita Ramsetty, MD [email protected]
Medical Director Endocrine Care Group
Tel: 843-798-4227