Type 1 Diabetes Facts

By Richard Morell

When a family faces the diagnosis of Type 1 Diabetes Mellitus (T1D) in a child or adolescent, the learning curve for the management of the illness can be overwhelming.  T1D, also referred to as “Childhood Onset” or “Insulin Dependent” Diabetes, appears to arise from the development of an autoimmune disorder where the body attacks the insulin-producing “beta cells” in the pancreas.  Oftentimes, this autoimmune response is triggered by the existence of some other viral or bacterial infection.  The body in effect goes to work on the invading toxin, but in the process misidentifies the beta cells as invasive and goes to work destroying them.

Insulin works to regulate the levels of glucose in the bloodstream.  Glucose supplies the life energy to the tissues and organs, but insulin is required to be able to effect the transfer of the glucose into the tissues to feed them.  When the beta cells are destroyed, and no insulin is being produced, the glucose overloads the bloodstream thereby creating other problems related especially to hydration, excretion and circulation.  Diabetes affects the heart, the kidneys and the liver.  Excessive thirst and frequent urination are two of the symptoms signaling T1D’s onset.  Once T1D develops, it is a chronic condition that can never be outgrown.

Because the body no longer produces insulin, the supply needs to come from an external source.  Hence, insulin shots need to be administered twice a day, or an insulin pump needs to be used and blood glucose monitored through the use of blood pricks several times a day to ensure that the blood sugar level stays within reasonable limits.  According to the website for the Juvenile Diabetes Research Foundation (www.jdrf.org), the optimal blood sugar levels are 70-110 mg/dL before meals, and 100-140 mg/dL at bedtime, though these are rough guides and some individuals’ needs might vary.

While organizations such as the Diabetes Research Institute are working to find a cure for the disease, individuals must be proactive in managing the malady.  Attending to personal insulin requirements presents many challenges for kids, parents and schools alike.  New York State publishes a 123-page booklet called Children with Diabetes, downloadable from the NYS Department of Health website at www.health.ny.gov/publications/0944.pdf.  This booklet provides a platform of approaches that children, family members, educators and school health personnel can work on together to support the children and teenagers who must manage their insulin levels constantly.

Three things that the booklet urges folks to keep in mind are:

• Management is a 24/7 job.
• Diabetes emergencies can happen at any time with no rhyme or reason, and even perfect monitoring and following of instructions may not prevent an episode.
• Not every individual will have the same needs; some will need to monitor their food more, while others will need to place their focus on frequency issues or exercise requirements.

Research into the care for the disease has continued apace, and it has improved quite extensively over the past decade.  Currently, biologists and medical researchers are studying the progression of the disease in the hopes that a cure can be found that will interrupt and hopefully reverse the body’s autoimmune misrecognitions of the beta cells.

By Richard