Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Type I diabetes is a disease of the insulin-producing cells of the pancreas that results in the inability of the body to metabolize nutrients normally. Type I diabetes is caused by a lack of insulin. Insulin is a hormone produced by special cells in the pancreas called beta cells. In most individuals with type I diabetes, beta cells are destroyed by the body’s own natural defense system, the immune system. Researchers do not know what causes the body to attack its own beta cells. Without insulin, the body is unable to normally use carbohydrates from the diet for energy. The result is a buildup of sugars in the bloodstream called glucose. Type I iabetes may develop in other patients as a result of certain diseases, such as cystic fibrosis or hemochromatosis Type I diabetes may also result from surgical removal of the pancreas or severe inflammation of the pancreas. Type I diabetes is slightly more common in men than women and has a peak age of onset at 12–15 years. Most cases are diagnosed before 30 years of age. It is more common in Caucasians of European descent than in other ethnic groups. There are currently more than 300,000 individuals in the United States with type I diabetes. There currently is no cure for diabetes, except under special circumstances, in which patients receive a pancreas transplant operation. It is generally reserved for only those few patients with advanced
kidney disease, who are receiving a simultaneous kidney transplant.

Living With Your Diagnosis
Symptoms of type I diabetes include frequent urination (especially at night), excessive thirst, increased hunger, rapid weight loss, and extreme fatigue. Blurry vision, slow-healing sores in the skin, or numbness in the hands or feet may develop. Type I diabetes may lead to decreased vision and blindness. Kidney failure requiring dialysis may occur. Nerve damage may also occur. These complications generally happen after many years of type I diabetes, especially if poorly controlled. Patients with type I diabetes are also at increased risk of coronary heart disease and peripheral vascular disease.

The best treatment for type I diabetes involves a team approach of medical professionals who specialize in the care of diabetes, including a registered dietician, a certified diabetes educator, and a physician. The dietician will establish a meal plan with predictable quantities of carbohydrates and calories eaten at specific times of the day. The diabetes educator will teach insulin administration techniques, home blood glucose monitoring, and the treatment of high and low blood sugars. The physician will take a complete medical history, perform a physical examination, and prescribe insulin. Longterm studies have proven that individuals who undergo intensive insulin therapy using multiple injections of insulin a day, or an insulin pump, are able to achieve better control of their blood sugar levels and have fewer complications from their diabetes. Additional members of the health care team that may be consulted include an exercise physiologist, a psychologist, a podiatrist, a nephrologist, and an ophthalmologist.Hypoglycemia, or low blood sugar, is the most common side effect of diabetes treatment. Occasionally a severe hypoglycemic reaction may occur in which the patient becomes unconscious or has a seizure. Other possible side effects from treatment include fat atrophy at the insulin injection site, leading to poor insulin absorption over time. Very rarely an allergic reaction to insulin may occur.

The DOs
• Follow your diet, eating regular meals at regular times.
• Learn how exercise and food affects your blood sugar levels.
• Take your insulin as prescribed & Monitor your blood sugar levels at home.
• Obtain an annual eye examination by an ophthalmologist if you have had type I diabetes for more than 5 years.
• Obtain annual urine testing for protein.
• Obtain a hemoglobin A1c blood test every 3–6 months as an indicator of your long-term blood sugar control.
• Instruct family members in the use of glucagons administration in the case of low blood sugar emergencies.

The DON’Ts
• Don’t skip doses of your insulin, especially when you are sick.
• Don’t run out of your insulin.
• Don’t drink excessive amounts of alcohol because this may lead to unpredictable low blood sugar reactions.
• Don’t forget that exercise will lower your blood sugar level.
When to Call Your Doctor
• If you have a fever or nausea and vomiting and are unable to keep down any solids or liquids.
• You are having high or low blood sugars that you cannot explain.
• You are overdue for your eye examination or urine protein test.

American Diabetes Association
National Institute of Diabetes and Digestive and Kidney Diseases