Sugar Matters
March 5, 2010
Caring for yourself as someone with Type 1 diabetes

As we wind up this short series on Type 1 diabetes, I wanted to touch on a number of important self-care pointers. Most are right in line with Type 2 diabetes as well, so they should not be too much of a surprise to you:

1) Remember insulin is a necessity — as we talked about last week, people with Type 1 diabetes do not have any insulin of their own. This means that they absolutely NEED insulin to survive.{{more}} For most, it also means that even small changes in your insulin use can make big differences. So missing that dose in the morning can mean VERY HIGH blood sugars and feeling sick later on in the day.

2) Your margin of error is not large — what this means, similar to what I said above, is that small differences in insulin can have very big effects. Most people with Type1 diabetes are what we call “insulin sensitive” meaning that it only takes small amounts of insulin to cause big changes in blood sugars. While EVERYONE who takes insulin should be careful, it is especially critical in people with Type 1 diabetes because mistakes can cause serious trouble. So pay close attention to what your doctor tells you about your doses, and please call him/her with any questions instead of guessing on your own.

3) Your eyes, feet, heart, kidneys are always on attack if you don’t keep your blood sugars controlled. Juts like Type 2 diabetes, high blood sugars over many years can cause serious damage to many areas of the body. The difference is that because Type 1 diabetes tends to start at a younger age, you can develop these problems earlier. Youth is not going to protect you from kidney failure and blindness: watch those blood sugars and keep them at target as best you can.

4) Get to know your trouble spots — for some it is dehydration when it gets too hot and you don’t keep up with drinking fluids; for others it is the cold season when they get sick and blood sugars go crazy; for some women it is the week before their menstrual periods when their blood sugars suddenly get much harder to control; for others it is times of travel, or the week before exams etc. Once you realize what your trouble spots are with regard to blood sugars, you can start keeping a closer eye and learn how to manage those extra challenging days.

5) Be sure to stay in contact with your doctor. This is especially true for women of reproductive age who also have Type 1 diabetes because you need good pre-conception (that is, before you get pregnant) control of your diabetes to ensure a healthy pregnancy. However for all people with Type 1 diabetes, because your control is so sensitive at times, you need to be on good and close terms with your doctor. Diabetes is a chronic disease, and for those with Type 1 we do not yet have a cure so it is here to stay. Think of your doctor as your experienced co-pilot. You hold most of the control, but you need a good co-pilot to help you through this voyage, especially when things get turbulent.

Until next week, stay safe and healthy Vincies! Remember you can send email questions to me as well. I have received a number of questions — thanks and keep them coming!

Anita Ramsetty, MD
Medical Director Endocrine Care Group
Tel: 843-798-4227