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Am Fam Physician. 2018;98(3):online

See related article on type 1 diabetes management strategies

What is type 1 diabetes?

Type 1 diabetes is sometimes called juvenile diabetes or insulin-dependent diabetes. It means that your body can't make insulin. We need insulin to live. Insulin helps your body use the sugar it makes from the food you eat. Your body uses this sugar for energy. Without insulin, your blood sugar level goes up, but you can't use it. Instead, it makes you sick. You get thirsty and you urinate a lot.

What problems can type 1 diabetes cause?

People with type 1 diabetes have a higher risk of heart disease, stroke, kidney failure, high blood pressure, blindness, nerve damage, and gum disease. These things happen two to four times more often in people with diabetes than in people without diabetes. Untreated type 1 diabetes can cause a coma. It can even kill you. The good news is that treatment can help you avoid these problems.

How do I prevent these problems?

Keep your blood sugar under tight control, eat a healthy diet, exercise regularly, don't smoke, and keep your blood pressure and cholesterol levels low.

How do I keep my blood sugar under tight control?

Insulin helps people with type 1 diabetes keep their blood sugar at a normal level. You will need to give yourself several daily insulin injections or use an insulin pump. Studies show that checking your blood sugar level often helps keep it under tight control. Some people also need a continuous glucose monitor that checks your blood sugar levels for you automatically.

What should I do if my blood sugar level is too high?

If your blood sugar level is too high, you may need to take an extra dose of short-acting insulin to return your blood sugar to the normal range. Talk to your doctor about the correct amount of insulin to take.

What should I eat?

The best diet is low in fat, salt, and added sugars. It should include lots of complex carbohydrates (like whole-grain breads, cereals, and pasta), fruits, and vegetables. This diet will help you control your blood pressure and cholesterol levels too. It is important not to eat too much so you don't gain weight. You can eat something sweet once in a while, but, when you do, take enough insulin to keep your blood sugar level in the normal range.

What are the signs of low blood sugar?

People who take insulin may have times when their blood sugar level is too low. This is called hypoglycemia. Some of the symptoms include:

  • Feeling tired for no reason

  • Yawning a lot

  • Being unable to speak or think clearly

  • Losing muscle coordination

  • Sweating

  • Twitching

  • Seizures

  • Suddenly feeling like you are going to pass out

  • Becoming very pale

If you have any of these problems, you should eat or drink something sweet right away. Juice, soda, candy, glucose tablets, or anything else with a lot of sugar will work. Try not to eat or drink too much of it, though, or your blood sugar level will get too high. The proper amount is 15 g of carbohydrates.

Be sure to teach your friends, coworkers, and family members how to treat hypoglycemia, because sometimes you may need their help. Keep a supply of glucagon at home. It is another type of medicine that can raise your blood sugar level. If you are unconscious or can't take food or fluids by mouth, another person can give you a shot of glucagon. This will help raise your blood sugar level.

Can I have a normal life with type 1 diabetes?

Yes, you can live a normal life. Many successful athletes and members of all professions have type 1 diabetes. You can stay healthy if you control your diabetes.

Where can I get more information?

Your doctor

American Diabetes Association

American Heart Association

Beyond Type 1 – Support Network

Juvenile Diabetes Research Foundation

National Institute of Diabetes and Digestive and Kidney Diseases

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