Type 1 Diabetes - Pennington Biomedical Research Center

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Type 1 Diabetes
Pennington Biomedical Research Center
Division of Education
Types of Diabetes
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Type 1 Diabetes mellitus (DM)
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Type 2 Diabetes mellitus (DM)
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Gestational Diabetes
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Type 1: Overview
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Usually diagnosed in children and young adults.
Previously known as “juvenile diabetes”.
In this type of diabetes, the body does not produce insulin.
Insulin is required in order for the body to properly use sugar,
in the form of glucose.
Sugar is the basic fuel for the cells in the body.
Insulin’s role is to take the sugar from the blood and carry it into cells
where it can be used to provide energy for the body to work.
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About Insulin
Insulin is a hormone made from
beta cells inside of the pancreas.
 With each meal consumed, beta
cells release insulin in order to
help the body use or store the
blood glucose it gets from foods.
 With Type 1 Diabetes; however,
the pancreas no longer makes
insulin.
 These beta cells have been
destroyed for some reason and
insulin shots are thus required
in order for the body to use the
glucose coming from meals.
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More on Insulin
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Insulin cannot be taken in pill form.
If it were to be consumed orally, it would break down during digestion
just like normal proteins in your food.
Insulin must be injected into the fat under your skin in order for
it to get into your bloodstream.
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Characteristics of Insulin
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There are three characteristics of insulin:
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Onset is the length of time before insulin reaches
the bloodstream and begins lowering blood glucose.
Peaktime is the time during which insulin is at
maximum strength in terms of lowering blood
glucose.
Duration is how insulin continues to lower blood glucose.
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The Basics of Insulin: 4 Types
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Rapid-acting insulin
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Regular or short-acting insulin
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Intermediate-acting insulin
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Long-acting insulin
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Rapid-acting Insulin
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Examples: insulin lispro or insulin aspart
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Onset:
Peaktime:
Duration:
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Begins to work at about 5 minutes
Peak is about 1 hour
Continues to work for about 2-4 hours
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Regular or Short-acting Insulin
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Onset:
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Peaktime:
Duration:
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Reaches the bloodstream within 30 minutes
after injection.
Peaks anywhere from 2-3 hours after injection.
Effective for approximately 3-6 hours.
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Intermediate-acting Insulin
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Onset:
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Peaktime:
Duration:
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Reaches the blood stream about 2 to 4 hours
after injection.
Peaks 4-12 hours later.
Effective for about 12 to 18 hours.
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Long-acting Insulin
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Onset:
Reaches the bloodstream 6-10 hours after injection
Duration: Usually effective for 20-24 hours
There is also a very long-acting insulin, known as glargine insulin, which
starts to lower blood glucose levels, on average, 1 hour after injection
and keeps working evenly for 24 hours after injection.
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Premixed Insulin
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Premixed insulin is also an option for individuals with Type 1 Diabetes.
It is helpful for individuals who have trouble drawing up insulin out of two
bottles or have difficulty in reading the correct directions and dosages.
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Fine-Tuning Your Blood Glucose
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There are many factors that influence your blood glucose levels,
including:
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What you eat
How much and when you exercise
Where you inject your insulin
When you take your insulin injections
Illness
Stress
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Information on Storage of Insulin
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Manufacturers do recommend storing insulin in
the refrigerator; however, injecting cold insulin
sometimes makes the injection more painful.
You can store insulin in use at room temperature.
Insulin stored at room temperature will last for 1
month.
If purchasing several bottles at once, store your
supply in the refrigerator for a longer shelf life.
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Information on Storage of Insulin
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Do not store insulin near extreme heat or
extreme cold.
Never store in the freezer, direct sunlight, or in
the glove compartment of a car.
Check expiration date- especially important if you
have had the bottle for a while
Make sure the insulin looks normal before you
draw it into the syringe
If there is any discoloration, particles, “frosting”,
or crystals in the solution, do not use it. Return
the unopened bottle to your pharmacy and
exchange and/or refund it.
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Conditions that can arise from
Type 1 DM
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Hypoglycemia
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Hyperglycemia
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Ketoacidosis
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Hypoglycemia
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A condition arising due to low blood glucose
Happens from time to time in everyone with diabetes
Sometimes referred to as an “insulin reaction”
Must be treated before immediately before symptoms worsen
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Hypoglycemia: The Symptoms
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Shakiness
Dizziness
Sweating
Hunger
Headache
Pale skin color
Sudden moodiness or behavior
changes, such as crying for no
apparent reason
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Clumsy or jerky movements
Seizure
Difficulty paying attention,
or confusion
Tingling sensations around
the mouth
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How to Know When Your Blood
Sugar is Low?
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Part of managing diabetes is to check your blood
glucose often.
Ask your doctor how often you should check your
blood sugar and what your levels should be.
Results from checking your level will indicate
whether it is low or not.
It is important to follow your blood glucose
monitoring schedule.
It is also important to check any time that you feel
your blood sugar might be low and treat accordingly.
The basic rule is: “When in doubt, treat.”
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How to Treat Hypoglycemia?
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The quickest way to raise your blood glucose and treat
hypoglycemia is with some form of sugar. Either of the following
would work:
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3 glucose tablets*
½ cup of fruit juice
5-6 pieces of hard candy
* Tablets can be purchased at your local drug store
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How to Treat Hypoglycemia?
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Once you have checked your blood glucose and
treated the hypoglycemia, wait 15-20 minutes and
check again.
If blood glucose is still low and symptoms have
not went away, repeat the treatment.
After you feel better, continue eating your
regular meals and snacks as planned to keep blood
glucose levels up.
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Treatment should be immediate!
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It is very important to treat hypoglycemia quickly.
There is the potential of it getting worse if
untreated, causing you to pass out.
If you pass out, you will need immediate
treatment, such as an injection of glucagon or
emergency treatment at the hospital.
Glucagon raises blood glucose. Like insulin, it too is
injected. Your doctor can prescribe it to you and
teach you to use it when needed.
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Hypoglycemia: Precautions!
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If you pass out from hypoglycemia, people should:
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NOT inject insulin
NOT give you food or fluids.
NOT put their hands in your mouth
Inject glucagon
Call for emergency help
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Hyperglycemia
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A technical term for high blood glucose
Can be a serious problem if you don’t treat it
Hyperglycemia can happen when the body has too little, or not
enough insulin or when the body can’t use insulin properly.
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Hyperglycemia: The Symptoms
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High blood glucose
High levels of sugar in the urine
Frequent urination
Increased thirst
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What Could Cause Hyperglycemia?
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Eating more than planned
Exercising less than planned
Stress of an illness, such as the cold or flu
Other stresses, such as family conflicts or
dating problems
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How to Treat Hyperglycemia?
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Often, you can lower your blood glucose level by exercising.
However, if your blood glucose level is above 240 mg/dl, check your
urine for ketones.
If there are ketones present, Do Not Exercise!
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How to Treat Hyperglycemia?
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Also, cutting down on the amount of food
you eat may help.
If exercise and changes in diet do not help,
talk with your doctor about possibly
changing the amount of insulin or the timing
of when you take it.
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So, What are Ketones?
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Ketones are acids that build up in the blood.
They appear in the urine when the body doesn’t have enough insulin.
They can poison the body.
They are also an indicator that your diabetes is getting out of control
or that you are getting sick.
They are present in high amounts in a condition known as: Ketoacidosis.
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Ketoacidosis
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Results from a failure to treat hyperglycemia
Rarely occurs in individuals with type 2 diabetes
It is a serious condition that can lead to diabetic coma
or even death.
Treatment for this condition usually takes place in the
hospital.
You can prevent this by learning the warning signs and
by checking blood and urine regularly.
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Ketoacidosis: Warning Signs
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Thirst or a very dry mouth
Frequent urination
High blood glucose (sugar)
levels
High levels of ketones in the
urine
Constantly feeling tired
Dry or flushed skin
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Nausea, vomiting,
or abdominal pain
A hard time breathing
(short, deep breaths)
Fruity odor on breath
A hard time paying
attention or confusion
Possible Causes of Ketoacidosis?
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Not getting enough insulin. Maybe you didn’t inject
enough or perhaps your body could need more insulin
than usual because of illness. Without sufficient
insulin, your body begins to break down fat for
energy.
2.
Not enough food. When people are sick, they often
do not feel like eating. High ketones may result. This
may also occur someone misses a meal.
3.
An insulin reaction (low blood glucose). When blood
glucose levels fall too low, the body must use fat to
get energy. If testing shows high ketones in the
morning, its likely that the person may have had an
insulin reaction while asleep.
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Ketoacidosis: The bottom line
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Ketoacidosis is dangerous and serious.
If you have any of the mentioned symptoms, contact your
health care provider immediately or go to the nearest
emergency room of your local hospital.
Another important note is that you never want to
exercise when your urine test shows ketones and your
blood glucose is high. High ketones and high blood glucose
can mean that your diabetes is out of control.
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Importance of Monitoring Blood
Glucose
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For those with diabetes, keeping blood glucose levels as close to normal
as possible is very important.
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Keeping blood glucose in your target range can help prevent or delay the
start of diabetes complications, such as:
 Nerve, eye, kidney, or blood vessel damage.
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Who Should Check?
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Experts believe that anyone with diabetes can benefit from checking
their blood glucose.
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The American Diabetes Association recommends blood glucose checks
if you have diabetes and are:
• Taking insulin or diabetes pills
• On intensive insulin therapy
• Pregnant
• Having a hard time controlling your blood glucose levels
• Having severe low blood glucose levels or ketones from
high blood glucose levels
• Having low blood glucose levels without usual warning signs
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Division of Education
Phillip Brantley, PhD, Director
Pennington Biomedical Research Center
Claude Bouchard, PhD, Executive Director
Heli J. Roy, PhD, RD
Shanna Lundy, BS
Beth Kalicki
Edited : October 2009
About Our Company
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The Pennington Biomedical Research Center is a world-renowned nutrition research center.
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Mission:
To promote healthier lives through research and education in nutrition and preventive medicine.
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The Pennington Center has several research areas, including:
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Clinical Obesity Research
Experimental Obesity
Functional Foods
Health and Performance Enhancement
Nutrition and Chronic Diseases
Nutrition and the Brain
Dementia, Alzheimer’s and healthy aging
Diet, exercise, weight loss and weight loss maintenance
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The research fostered in these areas can have a profound impact on healthy living and on the prevention of common chronic
diseases, such as heart disease, cancer, diabetes, hypertension and osteoporosis.
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The Division of Education provides education and information to the scientific community and the public about research findings,
training programs and research areas, and coordinates educational events for the public on various health issues.
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We invite people of all ages and backgrounds to participate in the exciting research studies being conducted at the
Pennington Center in Baton Rouge, Louisiana. If you would like to take part, visit the clinical trials web page at www.pbrc.edu or call
(225) 763-3000.
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Sites
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All diabetes-related information is from the American Diabetes Association.
Available at: http://www.diabetes.org
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