type 1 diabetes essay conclusion

Essay on Diabetes for Students and Children

500+ words essay on diabetes.

Diabetes is a very common disease in the world. But people may never realize, how did they get diabetes and what will happen to them and what will they go through. It may not be your problem but you have to show respect and care for the one who has diabetes. It can help them and also benefited you to know more about it and have a better understanding of it. Diabetes is a metabolic disorder which is identified by the high blood sugar level. Increased blood glucose level damages the vital organs as well as other organs of the human’s body causing other potential health ailments.

Types of Diabetes

Diabetes  Mellitus can be described in two types:

Description of two types of Diabetes Mellitus are as follows

1) Type 1 Diabetes Mellitus is classified by a deficiency of insulin in the blood. The deficiency is caused by the loss of insulin-producing beta cells in the pancreas. This type of diabetes is found more commonly in children. An abnormally high or low blood sugar level is a characteristic of this type of Diabetes.

Most patients of type 1 diabetes require regular administration of insulin. Type 1 diabetes is also hereditary from your parents. You are most likely to have type 1 diabetes if any of your parents had it. Frequent urination, thirst, weight loss, and constant hunger are common symptoms of this.

2) Type 2 Diabetes Mellitus is characterized by the inefficiency of body tissues to effectively respond to insulin because of this it may be combined by insulin deficiency. Type 2 diabetes mellitus is the most common type of diabetes in people.

People with type 2 diabetes mellitus take medicines to improve the body’s responsiveness to insulin or to reduce the glucose produced by the liver. This type of diabetes mellitus is generally attributed to lifestyle factors like – obesity, low physical activity, irregular and unhealthy diet, excess consumption of sugar in the form of sweets, drinks, etc.

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Causes of Diabetes

By the process of digestion, food that we eat is broken down into useful compounds. One of these compounds is glucose, usually referred to as blood sugar. The blood performs the job of carrying glucose to the cells of the body. But mere carrying the glucose to the cells by blood isn’t enough for the cells to absorb glucose.

This is the job of the Insulin hormone. Pancreas supply insulin in the human body. Insulin acts as a bridge for glucose to transit from blood to the body cells. The problem arises when the pancreas fails to produce enough insulin or the body cells for some reason do not receive the glucose. Both the cases result in the excess of glucose in the blood, which is referred to as Diabetes or Diabetes Mellitus.

Symptoms of Diabetes

Most common symptoms of diabetes are fatigue, irritation, stress, tiredness, frequent urination and headache including loss of strength and stamina, weight loss, increase in appetite, etc.

Levels of Diabetes

There are two types of blood sugar levels – fasting blood sugar level and postprandial blood sugar level. The fasting sugar level is the sugar level that we measure after fasting for at least eight hours generally after an overnight fast. Blood sugar level below 100 mg/dL before eating food is considered normal. Postprandial glucose level or PP level is the sugar level which we measure after two hours of eating.

The PP blood sugar level should be below 140 mg/dL, two hours after the meals. Though the maximum limit in both the cases is defined, the permissible levels may vary among individuals. The range of the sugar level varies with people. Different people have different sugar level such as some people may have normal fasting sugar level of 60 mg/dL while some may have a normal value of 90 mg/dL.

Effects of Diabetes

Diabetes causes severe health consequences and it also affects vital body organs. Excessive glucose in blood damages kidneys, blood vessels, skin resulting in various cardiovascular and skin diseases and other ailments. Diabetes damages the kidneys, resulting in the accumulation of impurities in the body.

It also damages the heart’s blood vessels increasing the possibility of a heart attack. Apart from damaging vital organs, diabetes may also cause various skin infections and the infection in other parts of the body. The prime cause of all type of infections is the decreased immunity of body cells due to their inability to absorb glucose.

Diabetes is a serious life-threatening disease and must be constantly monitored and effectively subdued with proper medication and by adapting to a healthy lifestyle. By following a healthy lifestyle, regular checkups, and proper medication we can observe a healthy and long life.

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Design and Methods

Discussion and clinical implications, duality of interest, lessons learned from a life with type 1 diabetes: adult perspectives.

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Donna Freeborn , Tina Dyches , Susanne Olsen Roper; Lessons Learned From a Life With Type 1 Diabetes: Adult Perspectives. Diabetes Spectr 1 August 2017; 30 (3): 188–194. https://doi.org/10.2337/ds16-0032

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Adults who have lived much of their life with type 1 diabetes have learned lessons that can benefit health care providers (HCPs), families, and young people who live with the condition. This study was undertaken to gain a better understanding of the challenges of growing up and living with type 1 diabetes from adults who have experienced those challenges and to recommend strategies for parents, caregivers, and HCPs who work with children or adolescents with type 1 diabetes. Thirty-five adults with type 1 diabetes participated in this qualitative study consisting of two in-depth interviews with each participant. Six themes emerged: 1 ) It’s not who you are. 2 ) Don’t let it limit you. 3 ) Get involved in diabetes support groups. 4 ) It’s going to be OK. 5 ) Teach them; don’t scare them. 6 ) Don’t single kids out. Through hindsight and the more mature perspective of adulthood, study participants were able to share valuable insights that could inform the efforts of those who work with or care for younger people with type 1 diabetes.

Type 1 diabetes, a chronic disease that is usually diagnosed in childhood, lasts a lifetime. Although it is most commonly diagnosed within a bimodal distribution peaking at ages 2–6 and again at 10–14 years of age ( 1 ), it can be diagnosed at any age. Recent studies suggest its incidence is rising. Research has shown a 3% annual increase in cases of type 1 diabetes in the United States, with ∼1 in every 400 children diagnosed (>13,000 annually) ( 2 – 4 ). In Europe, the increase in cases of type 1 diabetes is 3.9% per year for all age-groups, prompting the prediction of a significant increase in the number of cases by 2020 ( 5 , 6 ). In addition, the increasing mortality due to type 1 diabetes in areas such as sub-Saharan Africa, where it used to be extremely rare, underscores the worldwide significance of the disease ( 7 ).

Type 1 diabetes is an autoimmune disease that destroys insulin-producing cells of the pancreas, thus causing hyperglycemia when uncontrolled and hypoglycemia due to insulin administration or excess exercise. Both hypo- and hyperglycemia can lead to serious short- and long-term complications. Short-term complications such as weakness, confusion, seizures, ketoacidosis, and diuresis must be identified quickly and treated with either insulin or glucose administration, depending on the source of the symptoms ( 8 , 9 ). Long-term complications affect both micro- and macrovascular systems, leading to retinopathy and blindness, renal disease, cardiovascular disease, immune suppression, neuropathy, autonomic nervous system dysfunction, and peripheral arterial disease ( 9 , 10 ).

Properly managing glycemia by monitoring carbohydrate intake and blood glucose levels and administering insulin numerous times throughout the day ( 4 ) can prevent or minimize long-term complications associated with the heart, eye, and kidney ( 4 ). However, such management is challenging for children and adolescents with type 1 diabetes and their families, and success is related to family social support, parental supervision, and beliefs about a diabetes cure ( 11 – 13 ). Although children and adolescents exhibit knowledge about diabetes and its consequences ( 14 ), those believing adherence to their treatment regimen will not make a difference ( 11 ) or that there will be a cure ( 13 ) demonstrate low levels of adherence and higher A1C levels.

Children and adolescents with type 1 diabetes identify low blood glucose, dietary restrictions, insulin injections, and feelings of being different as stressors and challenges ( 15 – 18 ). Because such challenges can affect their adherence to their diabetes management regimen and their quality of life ( 19 ), it is important to learn appropriate strategies to assist them in coping with these challenges, adjusting to their situation, improving their quality of life, and encouraging more understanding and appropriate relationships within the family.

Adults with type 1 diabetes, who have faced the challenges of growing up and living with the condition, can provide a mature perspective not yet available to children and adolescents. However, little research has focused on these adults, except to investigate the challenges that arise during the transition from adolescence to young adulthood ( 16 , 20 – 23 ). Adult perspectives of growing up and living with type 1 diabetes can provide a greater understanding of childhood challenges, insights into what did and did not work for them, and suggestions regarding appropriate interventions for young people with the disease. The purposes of this study were 1 ) to gain a better understanding of the challenges of growing up and living with type 1 diabetes from adults who have experienced those challenges and can look back on them with adult perspectives and knowledge and 2 ) to recommend strategies or interventions for parents, caregivers, and health care providers (HCPs) who work with children and adolescents with type 1 diabetes.

A sample of 23 women and 12 men ranging in age from 19 to 70 years (mean 36.54, SD 16.65) were enrolled after obtaining university and hospital institutional review board approvals. Age at diagnosis ranged from 2 to 35 years (mean 15.06, SD 9.84), and time since diagnosis ranged from 1 to 54 years (mean 21.46, SD 12.87). Participants volunteered in response to a flyer distributed by a diabetes clinic or word of mouth. Inclusion criteria included diagnosis of type 1 diabetes and age ≥18 years. Interviews took place in locations convenient to participants or, if preferable to the participant, by phone.

This qualitative study, using the biographical method, consisted of two in-depth interviews. Two interviewers were present for each interview. On average, the interviews lasted 1 hour (range 45–90 minutes). The first interview allowed the participant to answer the prompt “Tell me about growing up and living with type 1 diabetes.” The interviewers used additional prompts such as “Tell me more about . . . ” or “Can you explain that further,” but the participant directed the interview. The second interview took place approximately 1 week later. At this session, the interviewers began by soliciting any necessary clarification from the first interview. The interviewers then asked the following questions: 1 ) Tell us about when you were diagnosed with type 1 diabetes. 2 ) What challenges do you remember? 3 ) How did your challenges change over time? 4 ) Tell us about how you self-manage your diabetes. 5 ) Tell us about interactions with your parents and family. 6 ) What would you share with parents of children/adolescents with diabetes? 7 ) What would you share with children/adolescents with diabetes?

Interviews were transcribed verbatim, entered into NVivo version 9 software (QSR International, Melbourne, Australia) and coded independently, and verified by two or three researchers. The initial coding was performed by a researcher with a doctorate in nursing. Coding was verified by a second researcher with a doctorate in specialized educational development. When questions about coding arose, a third researcher with a doctorate in family and child development provided additional verification.

The transcripts were analyzed line by line for codes that revealed major and minor themes, following guidelines established by Denzin and Lincoln ( 24 ). Themes and subthemes were discussed until consensus was reached among the entire research team. Repetition of themes was noted both within and across interviews ( 25 ). Exemplars then were chosen. Trustworthiness, as demonstrated by objectivity of data, was established by having another investigator read the transcripts and confirm initial findings and through researcher and peer debriefings with two individuals with type 1 diabetes to establish an audit trail and provide triangulation of data ( 24 ).

Six major themes emerged related to experiences of living with type 1 diabetes: 1 ) It’s not who you are. 2 ) Don’t let it limit you. 3 ) Get diabetes support. 4 ) It’s going to be OK. 5 ) Teach them, don’t scare them. 6 ) Don’t single kids out.

It’s Not Who You Are

All nine participants who were diagnosed between the ages of 2 and 10 years emphasized that type 1 diabetes does not define who a person is. In addition, other participants, including one diagnosed between the ages of 11 and 19 years and two diagnosed after the age of 20 years, commented that diabetes was only a part of their lives—not their entire life. Participants who had lived most of their lives with type 1 diabetes wanted everyone to know that diabetes did not dictate their lives. As one 54-year-old woman who was diagnosed at age 10 stated, “I am a person with diabetes. I am not a diabetic. It does not dictate who I am or what I am. It is just part of my life.”

No participants suggested that having type 1 diabetes was easy or did not change their life. However, they emphasized that the disease did not make them different from other people, and most (55%) described how taking care of themselves kept them from being different. A 23-year-old woman who was diagnosed at age 2 explained:

You don’t have to let this take over your whole life. As long as you know what to expect or know the best way to deal with it, you can totally lead a normal life. Just kind of do what you want to do, as long as you’re a little more cautious and smart. Listen to your body.

A 24-year-old man who was diagnosed at age 4 gave a different perspective on how taking care of oneself keeps one from being different:

If you’re on top of it, it doesn’t take very long, and you aren’t different. You become increasingly more different than your peers when you’re not taking care of it. If I was always completely on top of my diabetes in high school, my blood sugar would be just like all my teammates. If you’re in control of it, there’s no reason it has to differentiate you from others, but if you’re out of control, then you’re completely different from other people.

Don’t Let It Limit You

Not allowing type 1 diabetes to limit their activities was important to participants whether they were diagnosed at a young age, in adolescence, or as adults. However, how they learned that the disease did not have to be limiting was different for those in each age-group. Those diagnosed at a young age credited their parents with instilling the attitude that they could do whatever they wanted. For example, a 24-year-old man who was diagnosed at age 4 stated, “The thing I respect most about how my parents raised me—they taught me that diabetes is not a problem. There’s no reason you can’t do anything because of your diabetes.”

Many participants who were diagnosed as adolescents initially struggled with the misunderstanding that there would be limits placed on them. However, over time, they changed their attitudes. For example, a 38-year-old man who was diagnosed at age 19 initially believed that type 1 diabetes would negatively affect his life. He said, “In my mind, it would affect everything I thought I could do.” Another participant, a 25-year-old man who was diagnosed at age 19, also initially thought his life would be limited, but later changed his mind. He stated, “Your life isn’t over. You can still do everything you want to do.”

Most participants who were diagnosed as adults emphasized that having a positive attitude and being careful allowed them to do anything they wanted. For example, a 63-year-old woman who was diagnosed at age 23 said, “Because I was determined that I was going to make the best of it, and it wasn’t going to stop me from doing anything I wanted to do, I just had a positive attitude that I was still going to live a good life.” Another participant, a 67-year-old man diagnosed at age 35, was determined to not allow type 1 diabetes to limit his activities—especially scuba diving. Instead, he learned what measures he would need to take to safely engage in scuba diving. As he said, “Well, I haven’t been limited. I like to scuba dive, and so when I scuba dive, I have to be real careful. I’ve done a lot of research on diabetic scuba diving, but I’m real careful.”

Get Diabetes Support

Seeking support and learning from others with type 1 diabetes was important to many participants. Support groups for children included diabetes camps. One participant, a 23-year-old woman diagnosed at age 2, described how going to camp helped her feel that she fit in:

I went to [diabetes] camps for 3 years, and it was the best time of my life. Because . . .suddenly you’re put in this situation with a hundred other kids that are suddenly just like you. And you all stop and check your blood sugar at the same time, and you all stop and have the same meals and sit down and count carbohydrates together and work with the nurse to figure out how much insulin you need. And it wasn’t just you, so it was that kind of “I fit in” type of feeling.

For participants diagnosed as adolescents or adults, knowing someone else with type 1 diabetes was important. One participant, a 31-year-old women diagnosed at age 12, explained how important having a friend with type 1 diabetes has been for her:

So now I have a really good friend who has type 1. We’ve been pregnant together. We’re able to call each other. We’re both on insulin pumps. We both just know. But we’re able to call each other all the time. That’s nice.

It’s Going to Be OK

Although being diagnosed with type 1 diabetes changes many aspects of a person’s life, all participants emphasized that everything was going to be OK. It did not matter whether a participant was diagnosed as a child, adolescent, or adult; each one learned that it was going to be OK. One participant, a 31-year-old man diagnosed at age 4, offered this advice: “It’s OK to be mad; it’s OK to be sad; it’s OK to cry. But despite all that, they are going to be OK. And it’s OK to express that emotion and share all that and be frustrated, but they are going to be OK.”

Another participant, a 30-year-old woman diagnosed at age 9, agreed that it was OK not to like diabetes; in fact, it was OK to hate it:

I think that diabetes is hard. Let kids know that it’s OK to hate it. It’s OK to not like it. It’s OK to wish you didn’t have it and wish that it would go away. You don’t have to pretend to be happy and minimize it. You know . . . at least it’s not cancer, at least it’s not AIDS, at least it’s not this or that. At the same time, your life is not over. Try and look at it realistically. I think oftentimes you see your diabetes as this huge problem, and it’s all you focus on, and it’s all you’re gonna see. Kind of the idea of the beam. If you have it up in front of your eye super close and it’s all you focus on, you can’t see everything in your life. So maybe diabetes . . .you don’t like it. That doesn’t have to mean your whole life stinks, so just learn to accept it as part of life, and that it can be OK.

A 23-year-old woman diagnosed at age 17 explained how the passage of time helped her understand that it was going to be OK: “It’s a lot, and you’re not going to believe it, but you’re going to look back 6 months from now and realize that life did go on, and you’re OK. Things really are alright.” Another participant, a 45-year-old man diagnosed at age 31, identified how using a pump helped to make everything OK for him: “Since I got the pump, you don’t have to worry about it as much. You always have it with you. It becomes just so much a part of my every day. I don’t hardly think about it much.”

Teach Them, Don’t Scare Them

Participants who were adolescents or preadolescents at the time of diagnosis described differences in the ways HCPs talked to them about the importance of diabetes management for long-term health outcomes and offered recommendations for HCPs. Some were concerned that HCPs used scare techniques to motivate them to manage their blood glucose better, whereas others felt that HCPs avoided teaching them about long-term consequences because they were worried about scaring them. One participant, a 28-year-old woman diagnosed at age 12, attended diabetes camp only once because of the negative experience she had:

… the people who were there, who were teaching us … I felt like they were using scare tactics.… it wasn’t like, “You can do this, and it’s going to be great, and you know people are diabetic. … If you don’t do it, you can have a really hard life, but you can do it!” It totally was not like that. It was like, “Look, this could kill you.”

Another participant, a 31-year-old man diagnosed at age 16, believed that it was important that those with type 1 diabetes be taught about the potential long-term consequences of the disease. However, he felt that it had to be done in a way that was not depressing or discouraging. He stated:

Certainly it’s depressing if someone is saying you could have kidney failure, you could have all these other things. I think that however you ended up packaging it would be the key. I think it’s still important, though, to educate them on the long-term effects of not taking care of yourself. It’s probably just a matter of how you deliver it. But, certainly, if it was delivered in a wrong way, it could be very discouraging.

Other participants also addressed the importance of teaching children and adolescents about the potential long-term consequences. One participant, a 31-year-old woman diagnosed at age 12, believed that she had not been taught about consequences because no one wanted to scare her. When her A1C reached high levels, her nurse sat down and talked with her:

She just told me, like, the facts: this is what can happen to people if they don’t take care of themselves. And she told me all the long-term consequences that can happen that no one really told me before. And probably because they don’t want to scare 12-year-olds, but by that time, I think I was 14 and, you know, … I’m sure she just wanted to take care of me. And the only way to do that is you [have to] take care of yourself.

Don’t Single Kids Out

Participants of all ages stressed that having diabetes did not make them different. Some participants, however, were made to feel different by being singled out. As a 28-year-old woman diagnosed at age 12 explained:

I just didn’t want to be singled out. I remember when I was a sophomore in high school and I went to my geography class and I had low blood sugar in the class, so I got out a juice box, and I drank my juice box, and I put it away. The teacher called me out and said, “There is no food or drink allowed in class, and you need to go throw it away right now.” I felt so embarrassed for being singled out.

Another participant, a 19-year-old woman diagnosed at age 7, explained how important it is to let kids be kids, stating:

Don’t go around your neighborhood on Halloween and give them healthy stuff to give to your kids. That’s just weird. I knew people that did that to their kids, and I mean, that’s fine, ’cuz they want to be healthy, and they don’t want their blood sugars to be crazy. But you still have to live; you still have to be a kid.

Participants noted that families can help their family member with diabetes be healthier without making them feel different. A 21-year-old woman diagnosed at age 16 explained:

My parents started running and started eating healthier. So we kids started as well. I think that helps a lot because I saw my parents eating healthier, and that’s what was in the cabinets too—healthier foods. So that’s what I would eat. Get the whole family to do it, ’cuz you’re supposed to be doing it anyway. I think you don’t have to single out your diabetic child and be like, “Hey, you need to eat healthier,” when you’re munching on a Little Debbie or something.

The purpose of this study was to gain an understanding of the experiences of growing up with type 1 diabetes from the perspective of adults diagnosed with the disorder. This study included 35 adults who had widely varying durations of diabetes (diagnosed 1–54 years before the study; mean duration 22.13 years). With a wealth of experience and the maturity that comes with age, participants provided a unique perspective on the experience of growing up and living with type 1 diabetes. Learning from adults who have lived for many years with type 1 diabetes can help HCPs and the parents and caregivers of children and adolescents evaluate and improve their own health promotion and diabetes management strategies.

Participants repeatedly emphasized that type 1 diabetes is “not who you are.” This is an important message for children and adolescents with type 1 diabetes, who often identify feeling different as a major challenge of living with the disease ( 26 ). Feeling defined by their diabetes may contribute to feeling different from others, which can result in refusing to participate in diabetes management when with peers ( 27 ). Parents and HCPs can help children and adolescents understand that good diabetes management can prevent the health challenges that make them different from their peers. As stated by participants, “you aren’t different” but “if you’re out of control, then you’re completely different from other people.”

Participants also emphasized that type 1 diabetes did not limit their activities and that having a positive attitude about their abilities allowed them to continue their favorite activities; as they stated, a person with type 1 diabetes can “do everything you want to do.” Although the American Diabetes Association ( 28 ) emphasizes that individuals with type 1 diabetes can participate in normal activities and strive to achieve their goals, participants mentioned that, as children and adolescents, they worried that they would not be able to do the things they had planned to do with their lives. Participants emphasized that it is important for children and adolescents to understand that they do not need to limit their activities. In fact, studies have shown that physical activity and participation in organized sports have positive health benefits for children and adolescents with type 1 diabetes ( 29 , 30 ). Parents and HCPs should promote an honest discussion with their child/patients about their future goals and how they can accomplish those goals despite having type 1 diabetes. This can promote a more positive attitude and help children and adolescents understand how maintaining good diabetes management allows them to participate in their desired activities.

Participants stressed the importance of associating with other people who have type 1 diabetes such as at a diabetes camp. These associations and friendships helped participants feel that they fit in and that they had someone they could talk with about the challenges of living with diabetes. Although many studies have explored the health benefits of diabetes camps for children and adolescents with type 1 diabetes, few have reported on their psychosocial benefits as discussed in this study, with adults reflecting on their experiences. Kimmelblatt ( 31 ), however, found that children attending diabetes camp demonstrated a decrease in depression and anxiety, an increase in self-concept, and an improved attitude about having type 1 diabetes. Parents and HCPs should encourage their children/patients to participate in diabetes camps, support groups, or other activities that allow them to interact with other people their age who have type 1 diabetes.

Most participants wanted children and adolescents with diabetes to understand that everything was going to be OK. They acknowledged that, at their diagnosis, the prospect of living with type 1 diabetes was overwhelming, and most of them believed that their life as they knew it was over and that nothing would ever be the same. The participants wanted young people to know that it was OK to be angry and upset, but that they could do what they wanted to do with few limitations. Although quality of life is a frequent focus of type 1 diabetes research ( 32 – 34 ), no studies have addressed the importance of children and adolescents with type 1 diabetes learning that they can still do the things they had previously planned on doing in life. Participants emphasized how important it is for parents and HCPs to demonstrate a positive attitude about type 1 diabetes and avoid comments that may validate young people’s belief that the life they knew is over because of their diagnosis.

Participants addressed the challenge of educating young people about type 1 diabetes without using fear tactics focused on devastating complications or, the other extreme, of failing to educate them adequately to avoid scaring them about potential complications. Neither approach was acceptable to participants, who emphasized the importance of teaching young people about type 1 diabetes in a respectful, factual manner, but without drama or predictions of future catastrophes. Although studies have examined the effectiveness of diabetes education programs for patients with type 1 diabetes, their focus has been on achieving improved glycemic control ( 35 , 36 ), not on patients’ perceptions of the teaching techniques. Parents and HCPs should be aware of the negative effect that scare tactics may have on children or adolescents with type 1 diabetes. Teaching these young people about the importance of diabetes management should be done in a matter-of-fact manner, without dwelling on potential complications, just as teaching a young person the importance of using a seat belt while driving or wearing a helmet while riding a bike does not necessitate vivid descriptions of potential life-threatening injuries.

Finally, participants stressed the importance of families and teachers not treating young people with type 1 diabetes differently from other children. Participants shared their experiences of being treated differently and other experiences when they were treated similarly to other classmates or family members. For children and adolescents with type 1 diabetes who are struggling to feel normal, being treated normally is important. This is consistent with studies reporting the benefits of not treating children or adolescents differently from their peers ( 37 , 38 ). HCPs should address this issue with parents, not only at the time of their child’s diagnosis, but also as the child or adolescent grows and develops. HCPs should remind parents of the importance of having age-appropriate expectations and not focusing on only diabetes management requirements, but rather on the child as a whole person.

Participants ranged in age from 19 to 70 years and had had type 1 diabetes for 1–54 years. For some, their diabetes experiences began before the advent of home blood glucose testing and insulin pumps. However, as adults, they had the ability to look back over their experiences and understand what worked for them and what did not, and they were able to share many insights. The lessons they learned from living to adulthood with type 1 diabetes can be valuable to parents and HCPs. In addition to heeding these lessons, however, parents and HCPs should give the children and adolescents they care for the opportunity to talk about their own experiences and what is and is not working for them. Care can then be personalized to better meet both their physical and their psychosocial needs.

No potential conflicts of interest relevant to this article were reported.

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Diabetes Mellitus Type 1 Discussion

General information.

Diabetes mellitus type 1, normally known as Type 1 Diabetes, is a type of diabetes that is caused by the lack of insulin resulting from the destruction of insulin-producing cells. Since insulin regulates the amount of glucose in the body, the destruction of the insulin-producing cells subsequently leads to high level of glucose in blood and urine. As a result, Type 1 Diabetes is normally associated with frequent urination, increased thirst and hunger, and drastic weight loss in case of poor lifestyle management. Type 1 Diabetes is less common as compared to Type 2 Diabetes and is normally referred to as juvenile diabetes because it mainly affects children and adolescents (Diabetes UK 2011). In contrast, Type 2 Diabetes is observed when the insulin is being produced but the body does not use it efficiently, leading to high glucose level. The body responds by producing more and more insulin, eventually exhausting the insulin-producing cells and making them fail, thus, provoking the onset of Type 2 Diabetes. This form of diabetes is the most common one, accounting for more than 80% of all cases of diabetes in the UK. Its cause is mainly attributed to obesity (WebMD 2012).

Living with Type 1 Diabetes

Type 1 Diabetes can be fatal if it is not managed properly. One of the most common methods of managing the disease is through the administration of insulin shots. It could be made through injections or inhalation. Having Type 1 Diabetes does not necessarily lead to poor health and a diabetic can still live his/her full life. The following list outlines how patients can manage their lifestyles to reduce the risk of long-term health complications.

Seeking to Learn More about the Disease

When it is first diagnosed, most people always have little insight into the disease and try to have access to any information that can create awareness. Consequently, the patients experience a steep learning curve as they try to comprehend all the information obtained from various media. Unfortunately, most people stop learning because they assume that just after a few months they know enough (WebMD 2012). This is a mistake as learning should be a continuous process. Deeper knowledge about the condition increases the confidence in the ability to manage it. Besides, through learning, a patient is able to get tips on the ways of managing the side effects of Type 1 Diabetes from professionals and people who have diabetes themselves (WebMD 2012). There are a number of materials that offer simplified information on how the disease can be conducted and one should read these materials occasionally.

Daily Management of Diabetes

There are four main pillars for managing Type 1 Diabetes Mellitus (T1DM). They are insulin, food, exercise, and blood glucose level testing. A well balanced diet is the first step to control the disease as it helps coordinate the amounts of blood glucose, blood fats, and blood pressure.

Since T1DM is caused by a deficiency of insulin in the blood, its introduction is vital towards reducing blood glucose level. The main purpose for administration of insulin in the body is to lower blood glucose and hence avoid long-term health complications which affect the nervous system (e.g. poor cognition abilities, loss of conscience, etc), and the cardiovascular system (e.g. heart attack and loss of sight). Insulin administration is achieved through injection or inhalation of insulin which is manufactured artificially. Continuous glucose monitoring can be used to alert patients of severely high or low glucose levels. People who have the disease for a long time will know when their blood glucose levels fluctuate as this illness affects various physiological processes and patients learn to associate them with low blood glucose (BG) levels, such as thirst or fatigue (Silverstein et al. 2005, p199). However, blood testing is the surest way of knowing BG levels and there are simple kits that can be used to carry out a home blood sugar test (WebMD 2012).

A balanced diet also helps regulate body weight and hence reduce the risk of heart attacks. It is important to find a balance between the quantity of carbohydrates and fats in any diet (Silverstein et al. 2005, p189). Patients should consume less fats, especially animal fats as this could lead to heart illnesses. Monosaturated fats such as olive oil and rapeseed oil are encouraged. Oily fish should be consumed at least twice a week as it contains monosaturated fats as well. Other low-fat foods include eggs, lean meat and pulses (such as lentils). Regular meals should contain more carbohydrates and starch (Silverstein et al. 2005, p200). Such foods include bread, pasta, chapattis, potatoes, noodles, low fat fruit yoghurt, baked beans, rice, and cereals (Gillespie, Kulkarni & Daly 1998, p901). Meals should be accompanied with adequate amounts of fresh fruits and vegetables (WebMD 2012).

Exercises are very important in the management of T1DM since they increase glucose absorption by the body tissues and hence reduce insulin requirements. With adequate exercises, the amount of insulin administered into the body can be lowered significantly. Besides, there are numerous health-related benefits in regards to exercises, such as lowering blood pressure, managing body weight, and helping in lipid metabolism. Children with Type 1 Diabetes should exercise at least three to four times a week for about 20-60 minutes. A physician should provide a piece of advice on the best activities to exercise (Silverstein et al. 2005, p208). However, such activities as running, walking, cycling, swimming, dancing or gardening are recommended.

Avoid Stress

Stressful conditions cause the body to react as if it were under attack by hormones and sugars that are released into the blood stream. Such conditions can elevate BG levels within a short period of time and result in serious health complications (WebMD 2012). Any signs of stress, such as difficulty in concentrating and difficulty in falling asleep, should be handled in a relaxed manner, like breathing deeply or exercising.

Seek Support

People with T1DM can benefit immensely from participating in diabetes support groups and other diabetes events such as the Diabetes UK event. Assistance can also be sought from family members and friends. One should not be ashamed of telling others about their diabetic condition as there are more than 2.5 million people living with the condition in the UK (Diabetes UK 2011). Therefore, telling others about the disease not only helps the person, but also encourages others to open up (BBC 2012).

National Service Framework Standards for Diabetes

In spite of the fact that diabetes is the fourth leading killer in the UK, response to the disease has been slow and studies show that 50% of older people with diabetes remain undiagnosed, and many of those diagnosed have normally had the disease for many years prior to the diagnosis (Harris et al. 1992, p817). In order to improve the national management of diabetes, the National Service Framework (NSF) set up 12 standards with an aim of preventing diabetes, to identify people with diabetes, and ensure that diabetics get given high-quality, evidence-based care. These 12 standards are outlined below:

Standard 1: Prevention of Type 2 Diabetes Mellitus (T2DM)

The NSF will create, execute, and monitor policies to reduce the risk of developing T2DM in the whole UK and reduce the inequalities in the risk of developing T2DM. Under this standard, the NSF aims to increase awareness of the causative factors of T2DM, such as obesity. The NSF will also inform people about strategies that can be used to lower the risks of developing the disease, such as education to promote healthy eating and exercise, assisting people to lose and maintain weight (Nazarko 2003).

Standard 2: Identification of Persons with Diabetes

A number of people remain undiagnosed with T2DM for many years. During those years, complications arising from the disease develop significantly. This standard aims to identify persons suffering from the disease at the initial stage (Nazarko 2003). The government undertakes regular screenings with assistance from the National Screening Committee to help identify these people and place them on diabetes management programs.

Standard 3: Empowering People with Diabetes

All children, adolescents, and adults with diabetes will receive a service that promotes partnership in decision-making, supports them in diabetes management, and assists them in adopting and maintaining a lifestyle that does not put their lives at risk. Generally, people with diabetes who are not necessarily professionals are given freedom to exercise personal control over their lives in the day-to-day management of the condition.

Standard 4: Clinical Care of Adults with Diabetes

All diabetic adults will be given high-quality care throughout their lifetime. This care will include support to ensure that they exercise adequate control of their BG levels, blood pressure, and other risk factors in the management of diabetes. This standard aims to get experts work together with diabetics in order to assist them in weight control, increase activity levels, and firmly control the BG and cholesterol levels and hypertension (Nazarko 2003).

Standard 5 & 6: Clinical Care of Children and Young People with Diabetes

All children and young people with diabetes will always be given high-quality care and, together with their families and others partaking in their routine care, will receive assistance to optimize the control of their BG and their physical, psychological, intellectual, educational, and social development. All children and adolescents with diabetes will have a smooth transition of care from paediatric diabetes management to adult diabetes services in any healthcare institution. The transition will be arranged in consultation with each patient separately at an appropriate age.

Standard 7: Management of Diabetic Emergencies

The NSF will develop, implement, and supervise common protocols for speedy and effectual treatment of diabetic emergencies with the help of expert care professionals. Such protocols include the management of serious complications and procedures to alleviate the risk of recurrence.

Standard 8: Care of People with Diabetes during Admission to Hospital

All children, young people, and adults with diabetes who are for whatever reason admitted to hospital will be given appropriate care pertaining to their condition. Where possible, the patients will continue to get involved in choices regarding the management of their diabetes (Nazarko 2003).

Standard 9: Diabetes and Pregnancy

The NHS will develop, implement, and monitor strategies with the hope of empowering and supporting women with diabetes to ensure the pregnancy is not affected by the disease.

Standard 10, 11 and 12: Discovery and Management of Long-Term Complications

All children, young people, and adults with diabetes will be monitored regularly to manage the long-term complications of the disease. The National Health Service (NHS) will develop, implement, and monitor approved protocols and systems of care to ensure that people who develop long-term complications are given immediate, appropriate, and effective monitoring and treatment to lower risks of disability and early death (Nazarko 2003). All people with diabetes and those who require multi-agency support will receive integrated support and care.

Near Future Issues for Children with Diabetes

During the teenage years and youth, the insulin requirements of children and young people may change over time and this will change their diabetes management plan. Over the years, their insulin requirements will increase and this may lead to a shift in the daily meal plans. Moreover, the way they administer insulin (using shots or an insulin pump) may change too. Generally, as children grow up, they must continue controlling the BG levels and carefully monitor their lifestyle in order to reduce the likelihood of developing acute complications. Due to increased metabolic processes and physical activity while growing up, children may have to increase the monitoring of their BG levels. In addition, a change in the meal plan will make up for increased physical activity.

Although there are specific types of meals recommended for people with diabetes, this does not necessarily mean that the children will be restricted to similar food for the rest of their lifetime. Instead, the children can consume a variety of meals as long as these meals are high in nutrition and low in fats and calories. Fruits, vegetables, and all kinds of grains are highly recommended while animal products and sugary foods will be minimized. The quantity of carbohydrates in any meal must be controlled since that is the main determinant of BG levels. Sugary foods such as sweets, fruit juices, and soft drinks should be consumed moderately.

As years go by, lifestyle will be of high importance in managing BG levels. Activities such as smoking and drinking can create complications for people suffering from Type 1 diabetes. While smoking increases the chances of getting diabetes, it also makes the management of diabetes difficult for people who have the condition already. Smoking also creates other complications such as heart disease, renal diseases, vascular disease, increased blood pressure, and so on. Diabetics should consume alcohol with extreme caution since alcohol substances contain calories and carbohydrates that may complicate BG level management. Some alcohol products can cause low blood sugars. Drug use can cause fluctuations in BG levels apart from creating serious health complications since some drugs can become harmful when they come into contact with various medications used to manage diabetes.

Over the years, people with diabetes may require additional treatment to supplement the insulin administration and a healthy lifestyle to manage T1DM. This treatment can be in the form of tablets. However, they can only be used upon advice of a healthcare professional (BBC 2012). Finding out the best treatment options is vital for managing diabetes.

Reference List

BBC 2012, Health. Diet and diabetes . Web.

Diabetes UK 2011, Children and diabetes . Web.

Gillespie, S. J., Kulkarni, K. D. & Daly, A. E. 1998, ‘Using carbohydrate counting in diabetes clinical practice’, Journal of the American Dietetic Association, vol. 98, no. 8, pp. 897-905.

Harris, M. I., Klein, R., Welborn, T. A. & Knuiman, M. W. 1992, ‘Onset of non-insulin dependent diabetes occurs at least 4-7 years before clinical diagnosis’, Diabetes Care, vol. 15, pp. 815-819.

Nazarko, L. 2003, ‘ Meeting the national service framework standards for diabetes ‘, Nursing Times . Web.

Silverstein, J., Klingensmith, G., Copeland, K., Plotnick, L., Kaufman, F., Laffel, L., Deeb, L., Grey, M., Anderson, B., Holzmeister, L. A., & Clark, H. 2005, ‘Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association’, Diabetes Care, vol. 28, no. 1, pp. 186-212.

WebMD 2012, ‘ Type 1 Diabetes: Children Living With the Disease – Topic Overview ‘, Diabetes Health Center . Web.

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What Is Type 1 Diabetes?

People of all ages can develop type 1 diabetes.

If you have type 1 diabetes, your pancreas doesn’t make insulin or makes very little insulin. Insulin helps blood sugar enter the cells in your body for use as energy. Without insulin, blood sugar can’t get into cells and builds up in the bloodstream. High blood sugar is damaging to the body and causes many of the symptoms and complications of diabetes.

Type 1 diabetes was once called insulin-dependent or juvenile diabetes, but it can develop at any age.

Type 1 diabetes is less common than  type 2 —about 5-10% of people with diabetes have type 1. Currently, no one knows how to prevent type 1 diabetes, but it can be treated successfully by:

• Following your doctor’s recommendations for living a healthy lifestyle.
• Managing your blood sugar.
• Getting regular health checkups.
• Getting diabetes self-management education and support .

For Parents

If your child has type 1 diabetes—especially a young child—you’ll handle diabetes care on a day-to-day basis. Daily care will include serving healthy foods, giving insulin injections, and watching for and  treating hypoglycemia  (low blood sugar). You’ll also need to stay in close contact with your child’s health care team. They will help you understand the treatment plan and how to help your child stay healthy.

Much of the information that follows applies to children as well as adults. You can also  visit JDRF’s T1D Resources  for more information on managing your child’s type 1 diabetes.

What Causes Type 1 Diabetes?

Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake). This reaction destroys the cells in the pancreas that make insulin, called beta cells. This process can go on for months or years before any symptoms appear.

Some people have certain genes (traits passed on from parent to child) that make them more likely to develop type 1 diabetes. However, many of them won’t go on to have type 1 diabetes even if they have the genes. A trigger in the environment, such as a virus, may also play a part in developing type 1 diabetes. Diet and lifestyle habits don’t cause type 1 diabetes.

Symptoms and Risk Factors

It can take months or years before  symptoms  of type 1 diabetes are noticed. Type 1 diabetes symptoms can develop in just a few weeks or months. Once symptoms appear, they can be severe.

Some type 1 diabetes symptoms are similar to symptoms of other health conditions. Don’t guess! If you think you could have type 1 diabetes, see your doctor to get your blood sugar tested. Untreated diabetes can lead to very serious—even fatal—health problems.

Risk factors  for type 1 diabetes are not as clear as for prediabetes and type 2 diabetes. However, studies show that family history plays a part.

Testing for Type 1 Diabetes

A  simple blood test  will let you know if you have diabetes. If you were tested at a health fair or pharmacy, follow up at a clinic or doctor’s office. That way you’ll be sure the results are accurate.

If your doctor thinks you have type 1 diabetes, your blood may also be tested for autoantibodies. These substances indicate your body is attacking itself and are often found with type 1 diabetes but not with type 2. You may have your urine tested for ketones too. Ketones are produced when your body burns fat for energy. Having ketones in your urine indicates you have type 1 diabetes instead of type 2.

Managing Diabetes

Unlike many health conditions, diabetes is  managed  mostly by you, with support from your health care team:

• Primary care doctor
• Foot doctor
• Registered dietitian nutritionist
• Diabetes educator

Also ask your family, teachers, and other important people in your life for help and support. Managing diabetes can be challenging, but everything you do to improve your health is worth it!

If you have type 1 diabetes, you’ll need to take insulin shots (or wear an insulin pump) every day. Insulin is needed to manage your blood sugar levels and give your body energy. You can’t take insulin as a pill. That’s because the acid in your stomach would destroy it before it could get into your bloodstream. Your doctor will work with you to figure out the most effective type and dosage of insulin for you.

You’ll also need to  do regular blood sugar checks . Ask your doctor how often you should check it and what your target blood sugar levels should be. Keeping your blood sugar levels as close to target as possible will help you prevent or delay diabetes-related  complications .

Stress is a part of life, but it can make managing diabetes harder. Both managing your blood sugar levels and dealing with daily diabetes care can be tougher to do. Regular physical activity, getting enough sleep, and exercises to relax can help. Talk to your doctor and diabetes educator about these and other ways you can manage stress.

Healthy lifestyle habits are really important too:

• Making  healthy food choices
• Being  physically active
• Controlling your  blood pressure
• Controlling your  cholesterol

Make regular appointments with your health care team. They’ll help you stay on track with your treatment plan and offer new ideas and strategies if needed.

Hypoglycemia and Diabetic Ketoacidosis

These 2 conditions are common complications of diabetes, and you’ll need to know how to handle them. Meet with your doctor for step-by-step instructions. You may want to bring a family member with you to the appointment so they learn the steps too.

Hypoglycemia  (low blood sugar) can happen quickly and needs to be  treated  quickly. It’s most often caused by:

• Too much insulin.
• Waiting too long for a meal or snack.
• Not eating enough.
• Getting extra physical activity.

Talk to your doctor if you have low blood sugar several times a week. Your treatment plan may need to be changed.

Diabetic ketoacidosis  (DKA) is a serious complication of diabetes that can be life-threatening. DKA develops when you don’t have enough insulin to let blood sugar into your cells. Very high blood sugar and low insulin levels lead to DKA. The two most common causes are illness and missing insulin shots. Talk with your doctor and make sure you understand how you can prevent and treat DKA.

Get Diabetes Education

Meeting with a diabetes educator is a great way to get support and guidance, including how to:

• Develop and stick to a healthy eating and activity plan
• Test your blood sugar and keep a record of the results
• Recognize the signs of high or low blood sugar and what to do about it
• Give yourself insulin by syringe, pen, or pump
• Monitor your feet, skin, and eyes to catch problems early
• Buy diabetes supplies and store them properly
• Manage stress and deal with daily diabetes care

Ask your doctor about  diabetes self-management education and support services and to recommend a diabetes educator. You can also search this nationwide directory  for a list of programs in your community.

Get Support

Tap into online diabetes communities for encouragement, insights, and support. Check out the American Diabetes Association’s Community page and JDRF’s TypeOneNation . Both are great ways to connect with others who share your experience.

• Type 1 Diabetes Resources and Support from JDRF
• Living With Diabetes
• Just Diagnosed With Type 1 Diabetes
• Learn About Diabetic Ketoacidosis
• 4 Ways To Take Insulin
• Making the Leap From Type 1 Teen to Adult

To receive updates about diabetes topics, enter your email address:

• Diabetes Home
• State, Local, and National Partner Diabetes Programs
• National Diabetes Prevention Program
• Native Diabetes Wellness Program
• Chronic Kidney Disease
• Vision Health Initiative
• Heart Disease and Stroke
• Overweight & Obesity

Exit Notification / Disclaimer Policy

• The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
• Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
• You will be subject to the destination website's privacy policy when you follow the link.
• CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

Home — Essay Samples — Nursing & Health — Diabetes — Diabetes: Type 1 and Type 2

Diabetes: Type 1 and Type 2

• Categories: Diabetes

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Words: 440 |

Published: Dec 18, 2018

Words: 440 | Page: 1 | 3 min read

• A fasting plasma glucose test measures your blood glucose after you have gone at least 8 hours without eating.
• An oral glucose tolerance test measures your blood sugar after you have gone at least eight hours without eating and two hours after you drink a glucose-containing beverage
• A random plasma glucose test, your doctor checks your blood sugar without regard to when you ate your last meal. This test, along with an assessment of symptoms Positive test results should be confirmed by repeating the fasting plasma glucose test or the oral glucose tolerance test on a different day. This blood test -- along with other information and test results - can help determine if a person has type 1 diabetes and not another type.

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Type 1 diabetes (nursing).

Jessica Lucier ; Ruth S. Weinstock ; Chaddie Doerr .

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Last Update: March 3, 2023 .

• Learning Outcome
• Recall the cause of Type 1 diabetes
• Describe the presentation of type 1 diabetes
• List the complications of type 1 diabetes
• Summarize the treatment of type 1 diabetes
• Introduction

Type 1 diabetes mellitus (T1DM) is an autoimmune disease that leads to the destruction of insulin-producing pancreatic beta cells. Insulin is an essential anabolic hormone that exerts multiple effects on glucose, lipid, protein, mineral metabolism, and growth. Importantly, the insulin allows glucose to enter muscle and adipose cells, stimulates the liver to store glucose as glycogen and synthesize fatty acids, stimulates the uptake of amino acids, inhibits the breakdown of fat in adipose tissue, and stimulates the uptake of potassium into cells. People with T1DM require life-long insulin replacement therapy. Without insulin, diabetic ketoacidosis (DKA) develops and is life-threatening. [1] [2]

• Nursing Diagnosis
• Increased thirst and hunger
• Frequent urination
• Blurred vision
• Numbness and tingling
• Wounds healing slowly
• Diaphoresis

In T1DM, there is the immune destruction of the beta cells in the pancreatic islets over months or years, causing an absolute deficiency of insulin. Although the exact etiology of T1DM is still unknown, researchers believe there is a genetic predisposition with a strong link with specific HLA (DR and DQ) alleles, especially DRB103-DQB10201 and DRB 10401-DQB10302H. Multiple other genes contribute to heritability, as well. The risk of developing T1DM with no family history is approximately 0.4%, while the offspring of an affected mother is 1% to 4%, the offspring of an affected father is 3% to 8%, and the offspring of both affected parents is as high as 30%. In monozygotic twins, the risk of developing T1DM in the first ten years of diagnosis of the first twin is 30%, with a lifetime risk of around 65%. [3] [4] [5]

The presence of circulating pancreatic autoantibodies suggests that the individual is at risk for or has developed T1DM. These antibodies include islet cell cytoplasmic antibodies (ICA), antibodies to insulin (IAA), glutamic acid decarboxylase (GAD65), insulinoma-associated 2, or protein tyrosine phosphatase antibodies (IA-2), and zinc transporter8 (ZnT8). The greater the number of detectable antibodies and the higher their titers, the greater the risk of developing T1DM.

In those at risk, it is generally believed that a virus or other environmental factors trigger the autoimmune beta-cell destruction. Some studies have found an increased development of T1DM in children born to a mother with  Coxsackievirus  or another  Enterovirus  during pregnancy. Environmental toxins have also been postulated to play a role. The hygiene hypothesis suggests that improved sanitation relates to the increased development of autoimmune-mediated disorders. It is proposed that reducing childhood exposure to infectious agents leads to the lack of proper immune system development. Dietary factors have also been examined as potential triggers. One study showed an increased development of islet autoimmunity with cow’s milk-protein consumption in study participants with low to moderate-risk HLA-DR genotypes but no significant increased risk in those with a high-risk genotype.

• Risk Factors

T1DM is one of the most frequent chronic diseases in children but can start at any age. There has been a steady increase in the incidence and prevalence of T1DM, representing approximately 5% to 10% of people with diabetes. In the United States, there are an estimated 1.24 million people with T1DM, which is expected to grow to 5 million by 2050. Between 2001 and 2009, there was a 21% increase in the prevalence of T1D in those 20 years of age or younger. The most common age of presentation is between the ages of 4 to 6 and early puberty (10 to 14 years). Worldwide, there is also a considerable geographic variation in incidence. The highest reported incidences are in Finland and other Northern European nations, with rates approximately 400 times greater than those seen in China and Venezuela, where there is the lowest reported incidence. In the United States, the highest rate of T1DM is seen in non-Hispanic whites, affecting both females and males almost equally. [6] [7]

In the initial outpatient visit, obtaining a complete medical, surgical, social, and family history is important. History of prior diabetes education, including monitoring of blood glucose and ketones, proper administration of insulin, recognition/treatment of hypoglycemia, education on nutrition, sick-day rules, and foot care, should also be obtained. Particular attention should be paid to prior treatment, current medication, and history of acute (hypoglycemia including severe episodes and episodes of DKA) and chronic (skin disorders, dental problems, retinopathy, macular edema, neuropathy, kidney disease, cardiovascular disease, peripheral arterial disease, stroke, foot ulcers) diabetic-related complications.

Clinicians should measure height, weight, and blood pressure. The thyroid should be palpated, as patients with T1DM are at increased risk of developing autoimmune thyroid disease. The skin should be examined, especially at insulin injection or infusion sites. If lipodystrophy is evident, they should be educated on the importance of varying injection sites. The heart, chest, and abdomen should also be examined. A foot exam examines pedal pulses, deformities, pre-ulcerative lesions, ulcerations, calluses, and onychomycosis. It is also important to test vibratory and protective sensations with a 10-g monofilament exam to look for peripheral neuropathy. A screen for depression (for example, PHQ-2/PHQ-9) is also recommended annually.

HbA1c is recommended every 3 to 6 months. The HbA1c reflects glycemic control over the previous 2 to 3 months. There should also be a yearly lipid profile, liver function tests, spot urine albumin to creatinine ratio, serum creatinine, GFR, and TSH. These tests could be repeated more frequently if the previous results were abnormal. It is also important to remember that patients with T1DM are at an increased risk of developing other autoimmune diseases, such as autoimmune thyroid disease, primary adrenal insufficiency, celiac disease, and vitiligo. Screening for these disorders should be considered when appropriate. [8] [9] [10]

• Medical Management

All patients with T1DM require insulin therapy. Multiple daily insulin injections (MDI) using a basal/bolus insulin regimen or continuous subcutaneous insulin infusion through an insulin pump are the preferred treatment. The patient’s weight in kilograms is multiplied by 0.5 to 0.6 units to calculate the initial total daily insulin dose (TDD) in an adult. In general, 40% to 50% of the total daily dose comprises the patient’s long-acting insulin needs. The other half approximates the daily short-acting insulin that needs to be given before or with meals. Dosing is modified based on many factors, including diet and physical activity. Adjustments can also be made based on self-monitoring of blood glucose or continuous glucose monitoring results. When possible, patients should be taught carbohydrate counting and instructed to use an insulin-to-carbohydrate ratio that approximates the grams of carbohydrates that will be covered by one unit of insulin. A carbohydrate-consistent diet is helpful if carbohydrate counting is not realistic due to poor numeracy or other reasons. Patients should be taught which foods contain carbohydrates and benefit from meeting with a dietician. It is also recommended to calculate a correction factor, which can be initially estimated using the formula 1800 divided by the TDD. This estimates the fall in blood glucose for every 1 unit of insulin given. This number will need to be adjusted per subsequent glucose monitoring results. [11] [12]

It is important to note that insulin requirements vary across the lifespan and under specific circumstances. For example, larger insulin doses are normally required during puberty, pregnancy, when steroids are given, and with the development of obesity. Individuals need less insulin when they are engaged in aerobic exercise and during the “honeymoon period.” The honeymoon period occurs soon after diagnosis when there is a temporary recovery of beta-cell function.

Multiple types of insulin can be used for diabetes management. Rapid-acting insulin (lispro, aspart, glulisine) will generally have an onset in 10 to 30 minutes, peak in 30 to 90 minutes, and have a duration of 3- to 5 hours. Insulin aspart injection is more rapidly acting. Short-acting insulin (regular insulin) has an onset in 30 minutes to 1 hour and peaks in 2 to 4 hours with a duration of 6 to 8 hours. Intermediate insulin (NPH, NPL) will have an onset in 1.5 to 4 hours, peaks around 4 to 10 hours, and with a duration of 12 to 18 hours. Long-acting insulin is often given once a day (glargine, degludec) or 1 to 2 times daily (detemir). Glargine does not have a peak and lasts approximately 20 to 24 hours. U-300 glargine lasts more than 24 hours, and degludec has a longer duration of action, up to 42 hours. When MDI is used, the patient will ideally use rapid insulin with each meal and for hyperglycemic correction and long-acting basal insulin. If using insulin pump therapy, a continuous infusion of rapid-acting insulin will be used.

Blood glucose readings should be monitored throughout the day. Patients should check their blood glucose pre-meals, 2 to 3 hours post meals (when adjusting prandial dosing), before bedtime, and when they suspect hypoglycemia. It is beneficial to check a 2 am to 3 am glucose reading if the morning glucose value is high to determine the underlying cause of hyperglycemia. It is important to educate patients about the symptoms of hypoglycemia, which include diaphoresis, tachycardia, lightheadedness, confusion, visual changes, and tremors. 15 to 20 g of glucose should be given orally for blood glucose levels below 70 mg/dl. Patients should then recheck their blood glucose 15 minutes later and consume a snack once the value has normalized to prevent a recurrence. Glucagon should be prescribed for emergency use when patients have a severe hypoglycemic episode and are unable to consume carbohydrates by mouth.

Continuous glucose monitors (CGM) are extremely useful tools for people with T1DM. Sensors are inserted into the subcutaneous tissue and measure interstitial glucose levels, which are transmitted to a receiver and displayed in real time. One can examine trends and use alarms to prevent serious hypoglycemia episodes. There are continuous glucose monitoring systems (CGMs) that transmit glucose readings every 5 minutes and can alarm the patients if readings are too high or too low or if there is a rapid change in glucose value (thresholds set by the patient). These CGMs can communicate with insulin pumps. Readings from certain CGM sensors can be transmitted to smartphones and can be shared with relatives, friends, or caregivers. Other sensors communicate with insulin pumps, providing a hybrid artificial pancreas. Another CGM is a less expensive option worn for ten days at a time. This “flash” CGM records glucose readings every 15 minutes, does not have an alarm feature and uses a “reader” (a device the user scans over the site of sensor placement) to visualize recent glucose readings and trends. All these devices make it easier to monitor glucose values throughout the day. Users examine trends and are provided with vital information to guide insulin therapy and food intake to help avoid wide glycemic variation.

In addition to insulin therapy, diet, and physical activity, individuals with T1DM should generally have an annual eye exam by an eye care specialist. Those with foot deformities, neuropathy, a history of foot ulcers, or peripheral arterial disease should see a podiatrist, be educated in proper foot care/footwear, and be evaluated for orthotics if necessary. Other specialists, such as psychologists, nephrologists, and cardiologists, may also be needed.

More advances in T1DM management can be expected soon. “Closed-loop” systems are anticipated in which CGMs directly communicate with insulin pumps and automatically direct insulin infusion rates. Research is also being conducted on islet cell transplantation. Individuals who receive islet-cell transplantation require immunosuppressive therapy, and many islets do not have a long lifespan. Encapsulated islets unrecognizable by the immune system would obviate the need for immunosuppressive therapy and are a promising future therapy. These and other research initiatives give hope to the increasing number of youth and adults with T1DM that a cure is in their future.

• Nursing Management
• Monitor blood sugar and use a sliding scale to treat high levels of glucose
• Educate patient about diabetes
• Examine feet and skin and teach patient foot care
• Educate the patient on foot protection
• Monitor vitals
• Teach the patient about insulin self-injections and how to perform fingersticks
• Encourage annual visits to the dentist, ophthalmologist, cardiologist, and neurologist
• Teach the patient about hypoglycemia and how to manage it
• Teach the patient about nutrition and the importance of exercise
• Urge the patient not to smoke and to abstain from alcohol
• Outcome Identification

Type 1 DM is associated with high morbidity and mortality. Close to 50% of patients will develop a serious complication over their lifetime. Some will lose eyesight, and others will develop end-stage renal disease. The prognosis is good for those who make it past the first 20 years. However, the disease has no cure, and with time, the patient may develop premature coronary artery disease, neuropathy, foot ulcers, and vision loss.

Maintaining euglycemia for a lifetime is associated with severe anxiety and depression; for many patients with type 1 diabetes, the quality of life is poor.

• Coordination of Care

Type 1 diabetes is a systemic disorder with diverse presentations and very high morbidity; for this reason, the condition is best managed by an interprofessional team of healthcare professionals.

Type 1 diabetes is a serious disorder with very high morbidity and mortality. Over the long term, the vast majority of patients with this disorder will develop blindness, adverse cardiac events, end-stage renal disease, neuropathy, and in some cases, premature death. Data indicate that those patients who manage to control their blood sugars without developing severe complications tend to have a good quality of life.

The patient must be screened for foot, eye, and eye complications at each visit. Appropriate referrals need to be made before disease occurs in these organs. A diabetic nurse should educate the patient on self-insulin injection and how to perform fingerstick tests for blood glucose level monitoring.

Social workers should be involved in the care to ensure that the patient has adequate support and finances for treatment. Communication with the interprofessional team should be prompt to ensure no patient is denied treatment. With assurance and guidance, many patients with type 1 diabetes can live a good quality of life. [13] [14] [15]

• Health Teaching and Health Promotion

As stated above, patient compliance with their medications, follow-up with specialists, and patient education is critical in preventing complications. At every patient encounter, the pharmacist, nurse, and clinicians should emphasize the importance of blood glucose control, long-term complications, and management goals. The patient should be encouraged to modify their lifestyle to reduce the risk of complications. In addition, all people with diabetes should be made aware of the signs and symptoms of hypoglycemia and ways of managing it. Patients should be educated about available resources and the benefits of joining support groups. A dietitian should educate the patient about foods that can be consumed, and the nurse should educate the patient on blood glucose monitoring at home.

• Risk Management

Call the clinician if:

• Unstable hemodynamics
• No urine output
• Acute vision loss
• Low or high blood sugars
• Presence of ketones in the urine
• Altered mental status
• Discharge Planning

The critical factor in preventing complications is patient compliance with their medications and follow-up with specialists and educators. Patients need to understand their disease, how to monitor glucose, and the importance of medication compliance. At each follow-up visit, the patient needs to be screened for complications to the foot, eyes, and eyes. Appropriate referrals need to be made before disease occurs in these organs. A home care diabetic nurse should educate the patient on self-insulin injection and how to perform fingerstick tests for blood glucose level monitoring.

• Pearls and Other issues

Type 1 diabetes is a serious disorder with very high morbidity and mortality. Over the long term, the vast majority of patients with this disorder will develop blindness, adverse cardiac events, end-stage renal disease, neuropathy, and in some cases, premature death. Data indicate that those patients who manage to control their blood sugars without developing serious complications tend to have a good quality of life.

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Disclosure: Jessica Lucier declares no relevant financial relationships with ineligible companies.

Disclosure: Ruth Weinstock declares no relevant financial relationships with ineligible companies.

Disclosure: Chaddie Doerr declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Lucier J, Weinstock RS, Doerr C. Type 1 Diabetes (Nursing) [Updated 2023 Mar 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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Type 2 Diabetes Essay

Introduction.

Diabetes is a health condition that is developed when sugar level in the blood increases above normal levels. The two major types of diabetes are type 1 diabetes and type 2 diabetes. Type 2 diabetes is more prevalent than type 1 diabetes. This essay discusses some of the most frequently asked questions about type 2 diabetes through a sample dialogue between a patient and a doctor.

Patient: What is type 2 Diabetes and how is it developed?

Doctor: Type 2 diabetes can be described as a complication in the metabolic processes characterized by a relative shortage of insulin and high levels of glucose in the blood (Barnett, 2011). It differs from type 1 diabetes where there is a complete deficiency of insulin caused by destruction of pancreatic islet cells.

In addition, type 2 diabetes is more common in adults unlike type 1 diabetes which is prevalent amongst young people. The typical symptoms of type 2 diabetes include: recurrent urination, excessive thirst, and persistent hunger (Wilson &Mehra, 1997).

Type 2 diabetes is caused by a mixture of lifestyle and hereditary factors. Even though some factors, like nutrition and obesity, are under individual control, others like femininity, old age, and genetics are not. Sedentary lifestyle, poor nutrition and stress are the major causes of Type 2 diabetes.

Particularly, excessive consumption of sugar and fats increases the risk of infection. Genetic factors have been linked to this condition. For instance, research indicates that if one identical twin is infected, there is a 90% probability of the other twin getting infected. Nutritional condition of a mother for the period of fetal growth can as well lead to this condition. Inadequate sleep is associated with Type 2 diabetes since it affects the process of metabolism (Hawley & Zierath, 2008).

Patient: How is type 2 Diabetes transmitted?

Doctor: Type 2 diabetes cannot be transmitted from one individual to another, since it is not caused by micro-organisms that can be spread. Instead, it is a health condition where the body is unable to create sufficient insulin to maintain the blood sugar level.

Nevertheless, a child from diabetic parents is likely to develop the complication due to genetic inheritance. According to Hanas & Fox (2007), there are some genes that may result in diabetes. As in 2011, research showed that there are more than thirty-six genes that increase the risk of type 2 diabetes infection.

These genes represent 10 per cent of the entire hereditary component of the complication. For instance, a gene referred to as TCF7L2 allele, increases the probability of diabetes occurrence by 1.5 times. It is the greatest threat amongst the genetic invariants. Children from diabetic parents are, therefore, likely to get infected since genes are transferrable from parents to the offspring.

Patient: How is type 2 Diabetes treated?

Doctor: The first step in the treatment of type 2 diabetes is consumption of healthy diet. This involves avoiding excessive consumption of foods that contain sugar and fats as they are likely to increase the levels of sugar in the blood. In addition, getting involved in physical activity and losing excessive weight are also important.

These management practices are recommended because they lower insulin resistance and improve the body cells’ response to insulin. Eating healthy food and physical activity also lower the level of sugar in the blood. There are also pills and other medications that can be injected when these lifestyle changes do not regulate the blood sugar (Roper, 2006).

Type2 diabetes pills function in different ways. Some pills work by lowering insulin resistance while some raise the level of insulin in the blood or decrease the rate of food digestion. Even though the non-insulin injected medicines for this condition work in complex ways, essentially, they lower the levels of blood glucose after injection.

Insulin injection treatment basically raises the insulin level in the blood. Another treatment for type 2 diabetes is weight loss surgery that is recommended for obese people. This treatment has been proved effective since most of the patients can maintain regular levels of sugar in their blood after surgery (Codario, 2011).

Multiple prescriptions can be applied in controlling the levels of blood sugar. Actually, combination treatment is a popular remedy for Type 2 diabetes. If a single therapy is not sufficient, a health care provider may prescribe two or more different kinds of pills.

For instance, individuals with type 2 diabetes have high fat levels in the blood and high blood pressure. Therefore, doctors can prescribe medicines for treatment of these conditions at the same time. The kind of medication prescribed depends on the health condition of the patient (Ganz, 2005).

Patient: What are the chances of survival?

Doctor: Diabetes is one of the major causes of deaths in the United States each year. Statistics indicates that it contributes to approximately 100,000 deaths every year. In the United States, there are over 20 million reported cases of diabetes, the majority being Type 2 diabetes. Proper remedy including change of lifestyle and medications is known to improve the health condition of a patient. If properly used together, lifestyle changes and medication can increase the chances of survival of a patient by up to 85 per cent (Rosenthal, 2009).

Barnett, H. (2011). Type 2 diabetes. Oxford: Oxford University Press.

Codario, A. (2011). Type 2 diabetes, pre-diabetes, and the metabolic syndrome. Totowa, N.J: Humana Press.

Ganz, M. (2005). Prevention of Type 2 Diabetes . Chichester: John Wiley & Sons.

Hanas, R., & Fox, C. (2007). Type 2 diabetes in adults of all ages. London: Class Health.

Hawley, A., & Zierath, R. (2008). Physical activity and type 2 diabetes: Therapeutic effects and mechanisms of action. Champaign, IL: Human Kinetics.

Roper, R. (2006). Type 2 diabetes: The adrenal gland disease : the cause of type 2 diabetes and a nutrition program that takes control! . Bloomington, IN: AuthorHouse.

Rosenthal, S. (2009). The Canadian type 2 diabetes sourcebook. Mississauga, Ont: J. Wiley & Sons Canada.

Wilson, L., & Mehra, V. (1997). Managing the patient with type II diabetes . Gaithersburg, Md: Aspen Publishers.

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Bibliography

IvyPanda . "Type 2 Diabetes." February 4, 2019. https://ivypanda.com/essays/type-2-diabetes-2/.

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