Notes

What Is Type One Diabetes
By Bryelle Truncali

You are definitely wondering what type one diabetes is. That's most definitely why you are reading this. Well keep reading this and you will find everything about type one diabetes and more.
This paragraph is about the meaning of type one diabetes. Type one diabetes is where your pancreas doesn't produce enough insulin. Some signs of type one diabetes is:
Frequent passing of urine ( that means just peeing alot)
Consistent thirst ( also known as very thirsty)
weight loss
Always pay attention if you notice these signs on someone, yourself or your child. For type 1 diabetics they have to either inject themselves with insulin or use a pump to get insulin in their body to live. There are also type 2 diabetics and pre diabetics but I will get into those later.
Now I am going into the basic facts you need to know about type one diabetes. You're probably wondering what causes type one diabetes. Well these three things are believed to cause type 1 diabetes:
Genetics
Self-allergy
Possibly a virus ( or other stimulant)
Here is the explanation how it's possible that type one diabetes can be caused by these three things. Genetics: a person with type one diabetes most likely inherited the gene combination DR3/DR4 one is from the dad and one is from the mom. Self-allergy: is when your immune system attacks the pancreas because it thinks it doesn't belong there. Your immune system's job is to protect your body from anything dangerous. But in this case we will say it malfunctioned and thought that the pancreas was dangerous. Here are some antibodies that may be found in type 1 diabetics:
IAA ( insulin autoantibody)
GAD antibody
ICA512 antibody
ZnT8 antibody
Islet cell antibodies ( by fluorescent light)
Sometimes these antibodies are present for many years before the signs of diabetes appear. Virus ( or other stimulant): there is a gene that allows a virus or a stimulant to get into the islet cell and will cause damage. That will put the body into self-allergy.How do they diagnos and treat type one diabetes? Well as i said in the first paragraph those are the symptoms to look out for of type one diabetes. But you're probably wondering how they treat it. Well type one diabetes is always treated with insulin nothing else. You also want to keep checking your blood sugar frequently and follow a food plan and get exercise daily. After you are first diagnosed with type one diabetes there is a time period called “honeymoon” the honeymoon phase happens a few weeks or months after you are diagnosed. What is the honeymoon phase? Well it's a phase that makes the person seem like they don't have T1D ( type one diabetes) but they do. This happens because the insulin dosage may become lower. For T1DS they have to check their blood sugar at least 4 times a day. People would get insulin pumps and cgms ( sensors) to make their life easier.
How do you treat low blood sugar? There are multiple ways to treat low blood sugar. Just keep reading and you will learn all about it. Any low blood sugars are considered 70mg/dl or lower. But a “true low” blood sugar is when your blood sugar is less than 60 mg/dl. This level should not show up in people who don't have T1D or other disorders. Some of the causes of low blood sugar is:
Late or missed meals or snacks
Extra exercise (the low may be delayed during the night)
Too much insulin/wrong dose
Taking a bath, shower or hot tub too soon after injection ( dangerous)
A previous low blood sugar ( for any reason, particularly at bedtime) and failing to do a follow-up blood sugar 15-30 mins later to make sure the value ( also known as the number) has come up as a result of the treatment (‘hypoglycemia can cause further hypoglycemia”)
Illness, especially with vomiting
Alcohol intake
Some signs you should watch out for in someone who has T1D and their blood sugar may be low is:
Hunger
Feeling shaky, sweaty and/or weak
Confusion
Sleepiness (at unusual times)
Behavioral / mood changes
Double vision
The signs of nighttime lows may be the same, or may include waking up alert, crying, or having bad dreams.
Low blood sugars come on very quickly and it's important to treat them immediately by the person or someone close by. For you guys to understand how to treat low blood sugar is to follow the “ rule 15 “. Rule 15 is when you give the person 15 grams of carbs and wait 15 mins to recheck their finger to see if their levels went up. If a low is not treated immediately it can cause loss of consciousness or a seizure may occur. There are different ways to treat each low. There is a mild low, moderate low, and a severe low. Here is how you treat all of these lows and what the symptoms are and how fast they can recover from it.
Mild low:
Alertness: ALERT ( they are conscious)
Symptoms: mood changes, shaky, sweaty, weak pale , hungry, fatigue.
Actions to take: check blood sugar, give 2-8 oz of sugary fluid, recheck blood sugar in 10-15 mins, if the blood sugar is less than 70mg/dl repeat the process, is blood sugar is greater than 70mg/dl give a solid snack, slight risk for more lows in the next 24 hours.
Recovery time: 10-20 minutes
Moderate low:
Alertness: NOT ALERT. Unable to drink safely ( choking risk) needs help from another person.
Symptoms: lack of focus, headache, confused, disoriented, ‘out of control’ ( bite, kick), cant self treat.
Actions to take: place in position of safety, check blood sugar, if on insulin pump may disconnect or suspend until fully recovered from low blood sugar ( awake and alert.), give insta- glucose or cake decorating gel- put between gums and check and rub in, look for person to wake up, recheck blood sugar in 10-20mins, once alert- follow “actions” under the mild category, moderate risk for more lows in next 24 hours.
Recovery time: 20-45 mins.
Severe:
Alertness: UNRESPONSIVE, loss of consciousness, seizure, needs constant adult help ( position of safety) give nothing by mouth ( extreme choking risk).
Symptoms: loss of consciousness, seizure.
Actions to take: place is position of safety, check blood sugar, if on an insulin pump disconnect or suspend until fully recovered from low blood sugar ( awake and alert), glucagon can be given with an insulin syringe like insulin: under 6 years: 30 units (3/10cc). 6-12 years: 50 unts ( 1/2cc). Over 12 years: 100 units ( all dose or 1cc), if given 50 or 100 init doses may use syringe in box and inject through clothing, check blood sugar every 10-15 mins until greater than 70mg/dl, if no response may need to call 911, check blood sugar every hour for 4-5 hours, high risk for more lows for 24 hours ( need to increase food intake and decrease insulin doses).
Recovery time: call rn/md and report the episode. Effects can last 2-12 hours.
You guys are probably wondering what a glucagon is. A glucagon is a hormone that helps break down glycogen to glucose in the liver. But in this case you would use the syringe that has it in it. You would find it in either a red casing or orange casing.
In this paragraph I will be telling you all about blood sugar monitoring ( also known as checking blood sugar) to check your or somebody else's blood sugar involves you pricking their or yours finger with a lancet and placing it on a test strip and the machine will tell what the blood sugar is. How do I know when blood sugars should be checked? Well here is a list that would help you understand it:
You should check your finger 4 or more times a day ( usually before meals and exercise and before bedtime)
Anytime the symptoms of a low blood sugar are felt.
Occasionally during the night.
Anytime unusual symptoms
You have to know what your targets are for your blood sugar. For each person it is different. This depends on age groups. Your blood sugars have to be in range ( which means perfect number.) it is helpful to have a log book of your blood sugars and insulin dosages and when you eat so you can give it to your doctor.
Now we are on the topic of insulin types and activity. Insulin is a hormone that is created in the islet cells of your pancreas. Insulin allows sugars to pass through the bodys cells to be used for energy. You're probably asking yourself then why it is important for T1Ds to take insulin shots. Here are some reasons why they are important to T1Ds:
Not enough insulin is made in the pancreas of a person with T1D.
Insulin cant be taken as a pill because it would be destroyed by stomach acid.
Some of the insulins listed below are made available in premixed commercial insulin combinations.
There are different types of insulin. People take different types of insulin because it depends if they need it to act fast or long lasting. Here is a list of the insulins and what they do:
“ rapid-acting / short lasting” ( Humalog, Novolog and Apidra) and regular
Humalog, Novolog and Apidra are more rapid acting than regular; they peak earlier and do not last as long as regular insulin.
Humalog, Novolog and Apidra and regular insulins are clear.
“Intermediate-lasting” ( NPH)
NPH insulin is cloudy and must be mixed prior to injecting.
The bottles should be turned gently up and down at least 20 times before drawing the insulin into the syringe.
NPH insulin peaks 3-8 hours after being given and lasts 12-15 hours.
“ long-lasting” ( lantusⓇ and levemirⓇ )
These are basal ( flat-acting, minimal peak) insulins that last approximately 24 hours.
They are clear insulins ( don't get confused with rapid acting insulins).
Best given in the bottom ( butt, seat) to make sure the insulin is given into fat, or into a pinch of fat.
“ ultra-long lasting ( TresibaⓇ [ called Degludec in some countries])
A new insulin, Tresiba, has recently been approved in Europe, Japan and Mexico, but not in the US.
Although used on a daily basis, it lasts for up to 3 days.
It has lower day-to-day variability of action and may reduce nighttime low blood sugars.
* insulin must be stored so that it does not freeze or get over 90°F because it will spil. Otherwise, the insulin vial being used can be kept at room temperature for 30 days. *
Insulin should be used when you have to give yourself a bolus or a correction. But you don't want to give insulin two earlier. For me I have to wait 2 hours after I give myself insulin before I can give myself more insulin. When you give yourself insulin you want to put the needle in the fattest part of your body. You can put it in your arm, stomach, thighs and your butt.
Now I'm going to talk about ketones. Ketones are an organic compound containing a carbonyl group CO bonded to two hydrocarbon groups, made by oxidizing secondary alcohols. The simplest such compound is acetone.