Diagnosis and Reviewing the Basics
After learning of their diagnosis, many people find it hard to accept that they now have type 1 diabetes (T1D) and try different ways of coping with the condition. Denial is a normal reaction. It is so common that it’s accepted as part of the process of dealing with the diagnosis. Initially, this response serves as a way of coping with bad news. It can keep you from getting overwhelmed and depressed and can allow you to accept the news little by little, as you are ready. But the shorter your denial, the better your ultimate care will be. Long-term denial can prevent you from taking care of yourself. Denial may stay around for weeks, months, or even years. It may also come and go depending on what else is happening in your life. Sometimes when we have too much on our plate, it can seem easy to let diabetes care go. However, denial usually adds to our stress, because in the back of our minds we know the damage it could cause.
Questions every person with T1D faces are: How do I manage the disease without it managing me? How do I find the balance that lets me behave responsibly without allowing the disease to own my life? How do I make care a simple fact of life and not a burden? Now that complications are arising, what does that mean in terms of my ability to enjoy life?
Remember: Managing the personal and emotional aspects of T1D is as important as managing the physical aspects. If you are human, you probably control some aspects of the condition better than others. That’s normal. But mastering every aspect of T1D— the physical, the emotional, the social, the professional, and the moral—requires just two things: effort and information.
We’ll provide the information that we hope will help provide the spirit to make the effort to manage, and master, your T1D.
Let’s Review the Basics
What is T1D?
T1D is an autoimmune disease. For reasons we don’t yet understand, your immune system, which is meant to protect you from foreign bodies, such as viruses and bacteria, mistakenly attacks and destroys the beta cells in your pancreas that produce insulin.
Insulin is crucial to life. Without it, glucose cannot move from your bloodstream into the cells of your body to provide them with energy to function. When your pancreas fails to produce insulin, glucose levels in your bloodstream start to rise and your body can’t function properly. Over time this high level of glucose in the blood may damage nerves and blood vessels and the organs they supply.
What causes T1D?
There is an enormous amount of research into what causes T1D, but so far there are no clear answers. Here is what we know:
- Failure of the pancreas is due to damage inflicted by your immune system.
- Something triggered your immune system to attack your beta cells.
- Certain genes put people at a greater risk for developing T1D, but are not the only factors involved.
- While there are no proven environmental triggers, researchers are looking for possible culprits, such as viral infections and toxins within our environment and foods.
Wait a minute—I thought only kids got T1D?
While most people associate T1D with children, it is believed that half of the people diagnosed with T1D are adults. If you have been diagnosed as an adult... you are not alone.
Why do I have it when no one else in my family does?
Although other family members may carry the same “at risk” genes, the overall risk of T1D for multiple family members is generally low. The long-term risk of a brother or sister developing T1D (assuming you are the only one in the family with T1D) is quite low.
How is T1D different from other types of diabetes?
Diabetes mellitus is the medical name given to a group of conditions in which people have too much glucose in their blood. Glucose comes from the food we eat, and is the major source of energy for the body. After we eat, our body breaks food down into glucose and other nutrients, which are then absorbed into the bloodstream from the gastrointestinal tract. The glucose level in the blood rises after a meal, which triggers the pancreas to make insulin and release it into the bloodstream. Insulin works like a key that opens the door to cells and allows the glucose in. In diabetes, the pancreas is unable to produce sufficient amounts of insulin. Without insulin, glucose is unable to get into the cells, so it stays in the bloodstream. As a result, the level of blood glucose remains higher than normal. Poorly managed high blood glucose levels create a number of symptoms and health problems with time.
There are three major types of diabetes: type 1, type 2, and gestational diabetes. All types of diabetes cause blood glucose levels to be higher than normal. However, they do this in different ways.
Type 1 (formerly called “insulin-dependent diabetes” or “juvenile diabetes”) occurs when the person’s immune system recognizes its own tissue as foreign. Evidence of this reaction is the presence of antibodies in the blood. The body attacks and destroys the beta cells in the pancreas that produce insulin. Insulin injections are then needed to control blood glucose levels. The illness and symptoms typically develop quickly (over days or weeks), however the destructive process has been going on for a much longer time. T1D affects only about 10 percent of population living with diabetes.
Type 2 (formerly called “non-insulin-dependent diabetes” or “adult-onset diabetes”) is different. There are two key issues—people with type 2 diabetes do not make enough insulin for their body’s needs, and the cells in their bodies do not properly use the insulin they produce. The cells in the body become resistant to insulin, making a greater amount of insulin necessary to keep the blood glucose level within a normal range. Eventually, the pancreas can wear out from producing extra insulin, and it may start making less and less. Type 2 diabetes is often referred to as a lifestyle disease, but this is not the entire explanation. It can usually be managed by diet, exercise, and oral medication, at least in the first few years following diagnosis. However, type 2 diabetes is a progressive disease, and most people will need to take tablets and/or inject insulin after living with it for a while. Type 2 diabetes is the most common type of diabetes, accounting for about 90 percent of population living with diabetes. It usually develops after the age of 40; however, its incidence is increasing among younger people due to lifestyle. The symptoms of type 2 diabetes are not always obvious, and they can take a long time to develop. It is more common among people who are older, sedentary, overweight/obese, or who have a family history of the disease.
Gestational diabetes is a form of diabetes first detected during pregnancy that goes away after a woman gives birth. Pregnant women produce large amounts of hormones such as estrogen and progesterone, which can cause the body to become resistant to the effects of insulin. By the time a woman reaches the end of the third trimester, her insulin requirements have tripled. If the pancreas is unable to match this increased demand, blood glucose levels start to rise. Women diagnosed with this type of diabetes are at significantly higher risk of developing type 2 diabetes later in life.