How to treat type 1 diabetes with proper nutrition
To date, all doctors can confidently say that this is one of the most common diseases of the pancreas.
Even though the causes and symptoms of the disease have been studied today, the treatment of type 1 diabetes still raises questions among experts, and today the disease is recognized as incurable.
Read the article to learn how to help the body fight disease and which treatment is most effective.
Modern treatment
In the last few decades, little has changed in treating type 1 diabetes.
The only way to fight the disease is supportive insulin therapy, as well as strict dietary rules and lifestyle controls.
However, several modern methods can make life easier for the patient, the development of which continues to this day.
An insulin pump is an increasingly popular device in many countries around the world.
This device is attached to a belt and allows you to regulate the injection of insulin into the abdomen at a specific time. The advantage of the device is that there is no need to constantly monitor the injection time. However, the pump is expensive and has a complex system that is difficult to master;
Recently, transplantation of the pancreas and islets of Langerhans has been actively developing. To date, it is not possible to resolve the diagnosis of just one patient in this way - sometime after the procedure, insulin injections must be resorted to again.
How to completely cure type 1 diabetes?
Many worry about the question - is it possible to cure type 1 diabetes? Unfortunately, today this disease is incurable. Doctors are actively developing the drug.
The emphasis is on the possibility of transplantation or implantation of an artificial pancreas, and genetic therapy. However, the most effective drugs are insulin injections and metformin tablets for patients who need a large dose of the hormone.
Since it is impossible to get rid of the disease, all responsibility for health rests entirely with the patient, and his physical condition depends entirely on compliance with medical regulations.
Clinical recommendations
The answer to the question: of how to treat type 1 diabetes mellitus is constant replacement therapy.
The dose of insulin and additional drugs is prescribed depending on the level of glucose in the blood and the presence of ketoacidosis, side effects.
In the first phase of therapy, short-acting insulin was selected to assess its effect on the body. Thereafter, long-acting insulin is prescribed individually.
In addition to injections that support pancreatic function, medications are prescribed to alleviate side effects. There are many vitamins, lipotropic drugs, steroids, enzymes, and analgesics.
Standard treatment for type 1 diabetes includes medication and insulin therapy.
Injections of the drug are injected with a special syringe into a layer of subcutaneous fat (abdomen, thighs, or buttocks).
According to its effect, the drug is isolated into three types:
- It is short-lived - it is almost always given before a meal. The duration of the drug is from 4 to 6 hours;
- Medium or medium action - duration of the drug from 10 to 18 hours;
- Long-acting insulin - duration of this insulin from 24 to 36 hours.
Injections depend on food intake. As a rule, 40% of the daily intake is given after bedtime, 30% before lunch, and 30% before the last meal.
Patients frequently receive multiple injection regimens tailored to their individual needs. Crafted by the physician, these schemes account for the patient's lifestyle and comprise a strategic blend of injections with varying durations to ensure effective management.
Diabetic nutrition is one of the most important aspects of maintenance therapy.
The pancreas reacts sharply to food, so attacks, and even insulin, can be avoided by following the main recommendations:
- Restricting the intake of quick-digesting carbs like pastries, candies, and flour-based products is crucial.
- Opt for frequent, smaller meals to evenly distribute the workload on your pancreas throughout the day.
- The menu should contain products that have a lipotropic effect - seafood and fish, cottage cheese, eggs, as well as plant fiber;
- The rules should be followed: the diet should be 20% carbohydrates, the rest of the protein and fat.
The goal of therapy
According to statistics, the life expectancy of this disease is significantly lower than average. Almost half of the patients die approximately 30-40 years after diagnosis.
The goal of maintenance therapy is to normalize the work of the pancreas to prolong a person's life and improve his quality. To do this, you must follow the prescriptions of a doctor who uses a protocol for the treatment of type 1 diabetes, think carefully about the menu, give injections on time, and avoid strong stress.
You have to remember that type 1 diabetes is a serious disease, the treatment of which will play one of the most important roles in life as it has a powerful impact on all aspects of human life.
If you adhere to competent therapy, you can significantly reduce the risk of complications, and slow down the severity of the disease for a long time.
Type 1 diabetes mellitus (insulin-dependent) - symptoms of the disease, probable causes, methods of treatment: insulin therapy, pump, other drugs, diet and sports, survival prognosis
Discover the essence of type 1 diabetes versus type 2, delve into its origins, classification, symptoms, and clinical presentations, and explore its stages, potential complications, diagnostic approaches, unique treatment modalities, preventive measures, and prognosis through this comprehensive article.
What is type 1 diabetes?
Type 1 diabetes is a severe hormonal pathology caused by a lack of insulin, a hormone of the pancreas. This substance is of a protein nature, a peptide or short protein consisting of several amino acids. Its function is to process glucose that enters the body through the digestive system.
The hormone is produced by Langerhans cells. Some of these cells, also called beta cells, produce insulin, and some are the hormone glucagon, which is an insulin antagonist.
The disease has no age restrictions, debutants in adolescents, young people in their thirties, and older patients. Type 1 diabetes is most commonly diagnosed in Scandinavian countries.
In the last twenty years, a significant increase in pathology has been recorded in the Russian Federation. If all forms of diabetes make up about 10% of somatic pathology, then the insulin-dependent version occupies that 10% already within the disease itself.
Differences between diabetes 1 and diabetes 2
There are two main types of diabetes in medical practice: the first and the second. There is also gestational diabetes that can develop during pregnancy. Sometimes the symptoms of type 1 and 2 diabetes appear in one patient at a time. But, as a rule, diseases of different natures have their own characteristic features, which are presented in the table.
Causes of disease
To date, the exact etiology of insulin-dependent diabetes has not been determined, research is ongoing. Modern diabetology considers the most likely cause of the development of type 1 diabetes - heredity in combination with external harmful factors.
Genetic predisposition
Genetic data on the composition, structure, and function of proteins are passed from parents to children. If a dad or mom is diagnosed with insulin-dependent diabetes, the information at the gene level is passed straight to the child. In this case, new combinations of genes that predispose to a milder or more severe course of the disease may appear.
For example, proteins of the human HL leukocyte system can cause autoimmune changes in a child’s body, and an environmentally unfavorable external environment can cause a viral lesion of pancreatic cells.
In other words, the human leukocyte antigen may be the major gene for the risk of type 1 diabetes. This is confirmed by studies by doctors from the EU and the US, where exactly the autoimmune type of the disease is most common.
But there are many other genes of similar risk, their genetic testing helps to establish the etiology of the disease and identify the main directions of treatment and prevention of the disease.
Autoimmune processes
The essence of autoimmune reactions in type 1 diabetes is the destruction of T cells of the cellular immune system of the pancreas.
How and when such a pathological process begins is still not clear, so type 1 diabetes mellitus is diagnosed already in the phase of almost complete extermination of Langerhans beta cells.
The only way for a patient to survive in such a situation is through lifelong insulin replacement therapy.
Genetic tests show that sometimes insulin itself can be the key to an immune attack. But why the human immune system perceives insulin as a foreign protein is not yet clear. Something similar happens in the body with systemic collagenosis, for example, lupus erythematosus.
Negative environmental impact
The atmosphere that surrounds a person is a source of a huge amount of pollution, microbes and viruses live in it. Soil containing toxins is a matrix for environmentally unreliable food.
Many diabetologists directly link the autoimmune destruction of beta cells to the environmental situation around the patient. Moreover, it can be a major cause of pathology and can worsen the course of a previously diagnosed disease.
Type 1 diabetes really depends on external influences. This is confirmed by the fact that in identical twins with exactly the same genetic code, who live in different areas of ecological purity, the disease occurs in only 30% of cases.
infections
Neither bacteria nor viruses can cause insulin-dependent diabetes mellitus on their own. But infections of any genesis weaken the immune system, resulting in the development of type 1 diabetes, which confirms a direct link between them.
Moreover, type 1 diabetes occurs most often during epidemics of influenza, SARS, and colds. The effect of Coxsackie B virus, cytomegalovirus, adenovirus, rubella, and mumps on pancreatic cells has been demonstrated in the laboratory.
Antibodies to Langerhans beta cells are detected with the same frequency in acute pancreatitis and rubella. To develop an antiviral vaccine against diabetes 1, scientists are trying to take advantage of this addiction.
Baby feeding
The eating habits of a breastfeeding mother can influence the likelihood of type 1 diabetes in her child. Consistent intake of vitamin D by the mother translates to reduced disease risk, even in the presence of a hereditary predisposition. Conversely, artificial feeding or premature introduction of cow's milk to the infant can elevate the risk.
Injuries, removal of the pancreas
Inflammation of the pancreas, swelling, injuries - damage insulin-producing cells, causing diabetes. The same process occurs with the surgical removal of organs when insulin deficiency is complete.
Endocrine diseases
The pancreas (its islets of Langerhans cells) refers to the organs of internal secretion. It is affected by similar structures: the pituitary, pineal gland, thyroid, parathyroid glands, adrenal glands, and gonads that produce hormones.
Failure in their work causes an abnormal concentration of hormones in the blood, disrupts insulin synthesis, and causes resistance to it. An example is:
- Itsenko-Cushing syndrome with excessive cortisol;
- acromegaly - hepatic synthesis of growth hormone;
- pancreatic alpha cell tumor - glucagon with excessive glucagon synthesis;
- hyperthyroidism - hyperproduction of hormones that stimulate the thyroid gland.
Preparations
The action of Langerhans beta cells is interfered with when taking certain medications:
- nicotinic acid;
- diuretics;
- psychotropics;
- anti-drug drugs;
- drugs to treat HIV infection;
- pentamidine (they treat pneumonia);
- streptozocin;
- glucocorticoids;
- nitrates, nitrites.
Toxins work similarly: for example, arsenic.
In addition, the development of type 1 diabetes mellitus is influenced by stress, immunodeficiency of various origins, dietary errors, asthenic physicality, alcohol dependence, and nicotine addiction.
Stage of diabetes development 1
The mechanism of the development of insulin-dependent diabetes goes through several stages. Pathological changes are based on insulin deficiency.
The tissues on which it depends are the liver, muscle, and fat. With the insufficient synthesis of hormones, they stop using blood glucose, and hyperglycemia develops - the main sign of diabetes.
Initially, type 1 diabetes does not manifest, antibodies are already produced, but insulin production remains normal, this stage is called latent predisposition.
The blood gradually becomes viscous, the blood circulation is disturbed, the trophic tissue of the lower extremities worsens, and visual acuity is lost. The body's autoimmune attack on beta cells begins, and the initial trigger mechanism is involved. This is the first stage of the disease.
Insulin deficiency causes the breakdown of proteins and lipids that enter the bloodstream, is metabolized in the liver to ketones - a source of energy for brain tissue independent of insulin.
When the sugar level exceeds 10 mmol / l, the kidneys begin to excrete glucose. There is polyuria with glucosuria. Thirst, which requires a large amount of fluid to enter the body, compensates for the situation.
Thus polydipsia is formed. This is the second stage of insulin-dependent diabetes. At this point, 50% of Langerhans' beta cells have already been destroyed.
The rapid development of symptoms occurs in the third stage of the disease when up to 90% of beta cells have died, and insulin injections are necessary.
Classification
Today, endocrinologists-diabetologists distinguish two types of insulin-dependent diabetes: immunologically dependent (in 98% of cases), and idiopathic.
In type 1 diabetes, insulin deficiency is associated with the destruction of pancreatic beta cells due to the body’s autoimmune response. Autoantibodies to insulin are necessarily fixed in the blood that disappear after the complete destruction of the cells of the target organs.
The idiopathic variant implies the absence of any specific antibodies, so its cause is unknown. This form is found in Africa and Asia. Moreover, the pancreas in this case may occasionally regenerate.
symptomatology
The rate of Langerhans beta-cell deformity in each person is individual, but the symptoms of insulin-dependent diabetes depend on it. In adolescents, the process is lightning-fast, and the patient is very life-threatening.
Delayed insulin synthesis can take several years in adulthood without anything manifesting. In both cases, when it comes time for manifestations, the following symptoms are
- typical of type 1 diabetes:
- relentless thirst (polydipsia);
- constant urge to urinate with the release of large amounts of urine (polyuria);
- constant desire to eat (polyphagia).
This is a well-known diabetic triad of symptoms. In addition, patients with type 1 diabetes note:
- nocturnal enuresis (especially in children and the elderly);
- sudden weight loss (up to 15 kg or more in a few months);
- high fatigue;
- dry skin;
- erythema (red spots) on the chin, in the superciliary region;
- long-term treatment of microtrauma;
- exacerbation of fungal diseases;
- muffled, brittle nail plate.
If you ignore such symptoms, ketoacidosis develops in a short time (a metabolic disorder of acid-base balance in the blood with the appearance of ketone bodies that occur when the body stores fat to get the necessary energy).
Excessive, fatal coma, severe stress, emotional overload, infections, surgeries, and injuries can cause a sharp deterioration of the patient's condition in the initial stage of the disease.
Possible complications
Hyperglycemia with insulin-dependent diabetes leads to disorders of all internal organs and increases blood cholesterol. Capillary paralysis causes dermatitis, trophic ulcers, and retinopathy with an outcome of complete blindness.
The defeat of small vessels often leads to ulcers, dermatitis, and kidney disease. Polyneuropathy develops. Among the most dangerous complications of type 1 diabetes are:
- WHICH
- ONMK;
- ketoacidosis with an outcome in a hyperglycemic coma;
- amputated limb gangrene ( diabetic foot );
- hypoglycemia with insulin therapy, which can be fatal if the glucose is lower than 3.3 mmol / l.
The wrong dose of insulin, overexertion, stress, dietary errors, and alcohol can cause anyone of any genesis. A complication may not kill a person, but it will leave them incapacitated. Therefore, over, a coma requires urgent medical intervention and hospitalization in a specialized hospital.
Diagnosis of diabetes 1
It is difficult to confuse the symptoms of diabetes with something, the diagnosis is not in doubt, but type 1 diabetes mellitus should be distinguished from the second type of disease. Approaches to their treatment are different, but the survey algorithm is general:
- basis - blood test for glucose in the bloodstream (taken on an empty stomach, from a vein or finger), values above 7 mmol / l on an empty stomach and more than 11 mmol / l after a meal, show hyperglycemia;
- analysis of urine for the presence of glucose is mandatory: normal - up to 1.7 mmol / l, pathology - more than 2.8 mmol / l;
- stress tests;
- analysis for glycated hemoglobin, where glucose binds to protein: diagnosis is confirmed in values greater than 6.5%;
- tests for C-peptide (assessment of beta-cell activity): the norm of C-peptide is from 0.8 to 1.9 µg / l (in diabetes the concentration is lower);
- tests for creatinine, urea - assessment of protein metabolism, the state of renal potential;
- ketone bodies in urine, blood;
- indicators of lipid metabolism: total cholesterol, LDL, HDL, if necessary - lipid profile.
The type of diabetes is confirmed by the following research:
- glucose immunity allows conversation about prediabetes;
- antibody to antibody testing confirms beta cell destruction;
- the study of genetic markers makes it possible to predict the risk of pathology.
Treatment features
The goal of treatment for insulin-dependent diabetes mellitus is to alleviate pathological symptoms, prevent complications, and teach self-control. Main methods:
Insulin injection therapy
Today, no drug can regenerate Langerhans beta cells. The only way for a person with type 1 diabetes to survive is insulin therapy. Therefore, every day, according to the individual treatment regimen, the patient is forced to inject himself with the hormone for life.
Replacement therapy involves the use of medium and long-acting insulin, and immediate correction of sugar levels is performed with fast insulins. According to the validity period, they differ:
- average insulin - for 8-16 hours of action;
- extended - up to 26 hours;
- short - designed for 6-8 hours;
- ultra-short 2-4 hours.
Treatment regimens can be:
- a traditional - daily dose of insulin at a certain time (gives a lot of side effects, and complications);
- basic - an injection of a prolonged drug is performed in the morning or evening, and before each meal - a dose of ultra-fast insulin is applied (simulating the natural process of insulin entering the bloodstream).
Injections are given using special syringes, subcutaneously, into the shoulder, thigh, or abdomen. Convenient pencil case. The most dangerous is hyper- or hypoglycemia associated with stress or overload of various natures. Insulin allergy is rare.
Insulin pump
The most modern method of treating type 1 diabetes is an insulin pump. A portable device with a battery significantly improves the quality of life of patients. The device consists of a microprocessor and an insulin reservoir, which is connected to a catheter.
The computer has a special program that regulates the time and dose of insulin in the body. The catheter is fixed at the usual injection site with an auxiliary belt and the device itself - with clip-on clothing.
Only ultrafast insulin is used. Two modes:
- basal, in which the drug continuously enters the body at a certain rate;
- a bonus once you can inject insulin to stop a sudden rise in blood sugar.
The device is not cheap, but it is highly recommended for children, pregnant women, and people with an active lifestyle.
treatment
Drugs that improve the enzymatic abilities of beta cells are sometimes used to treat type 1 diabetes. It:
- oxygenates: Clexane, Cordiamin-Rusfar, Trental, Curantil, Zokor, Actovegin, Methionine, ATP, Cocarboxylase;
- immunomodulators: Immunal, Kagocel, Viferon, Amiksin, Derinat, Timogen, Anaferon, Lizobakt.
Pathogenetic antiviral (Tamiflu) or antibacterial agents (Levofloxacin) are used to treat infections, with a mandatory determination of the pathogen and its sensitivity to antibiotics.
If thiazide or corticosteroid intoxication is detected, hemodialysis is used. Experimentally increase the C-peptide with the innovative BHT-3021 vaccine, and use stem cells, however, all drugs are still in the clinical trial phase, and not used in widespread medical practice (there is not enough evidence of safety).
Diet
Another method of treatment is a diet for type 1 diabetes, and the goal is to even out sharp fluctuations in blood sugar levels. The amount of carbohydrates given to food is related to the concentration of insulin in the bloodstream.
Direct carbohydrates are prohibited. But with the compensated form of the disease, there are no strict restrictions, because there is a risk of hypoglycemia.
Recommended products for type 1 diabetes include lettuce, beans, cabbage, parsley, basil, green peas, pasta, grapes, blackberries, dried apricots, nectarines, quinces, apples, citrus fruits, buckwheat, brown rice, low-fat dairy products, dark chocolate.
You should reject products with a high glycemic index: milk chocolate, cornflakes, soda, granola, semolina, white rice, pumpkin, potatoes, carrots, white bread, crackers, apricots, and watermelon.
Gymnastics
Sport is not contraindicated in type 1 diabetes. Dosed physical activity (half an hour a day of aerobic exercise) has a beneficial effect on blood vessels, improves mood, and improves the quality of life of the patient. But physical activity affects blood sugar levels, so glucometer monitoring is mandatory before any exercise. Sport is not contraindicated at the level of 5 to 13 mmol / L. Deviations require adjustment:
- eat sweets or a slice of chocolate with hypoglycemia;
- inject insulin - with hyperglycemia.
People suffering from type 1 diabetes are allowed almost all types of sports, except extreme, and traumatic, which cause difficult difficulties in correction:
- swimming underwater;
- surfing;
- kite flights;
- Mountain climbing;
- Skydiving.
However, sport is excluded for all who do not know how to control the state of hypoglycemia, loss of tactile and sensitivity to pain, high blood pressure, risk of retinal detachment, and nephropathy.
Just control
We are talking about rapid blood glucose testing with a portable glucometer and special test strips. The algorithm of the procedure is simple:
The test strip is inserted into the device, the skin is pierced on the finger with a special excavator, the strip is applied to a drop of blood, and the device immediately shows the result. It is important to monitor the expiration date of the test strips to get reliable data.
Prevention, prognosis
Type 1 diabetes is a chronic pathology; the prevention of this disease has not yet been developed, but adequate therapy and compliance with some rules can maintain a high quality of life and active longevity in patients. It is necessary:
monitor your blood sugar regularly.
occasionally watch for hemoglobin;
carry out insulin therapy strictly according to the doctor's recommendations;
adhere to the chosen diet;
engage in sports per the recommendations of experts;
undergo regular medical examinations.
Under the prohibition of overload of any nature, which can cause a sudden jump in blood sugar. In addition, for type 1 diabetes, you must follow the recommendations that will help you avoid the effects of reduced skin sensitivity:
Do not wear tight shoes.
To avoid injuries during manicures and pedicures, use an ashtray and nail file.
do foot baths daily, lubricate the skin with cream;
monitor the absence of chickens on your hands in cold weather.
treat microtrauma immediately with an antiseptic, bactericidal patch.
Remember that type 1 diabetes is a deadly disease. According to statistics, without timely and adequate therapy, the patient is only two to three years old, and the mortality rate is 100%.
Lack of regular treatment can lead to strokes or gangrene. Experts say that after 40 years of severe pathology, renal failure with a fatal outcome develops. Bad habits significantly worsen the situation.
The chances of survival in old age in patients with type 1 diabetes are 2.5 times lower than in healthy people.
But today, all patients with diabetes have a chance to live a full life for a long time while retaining their professional abilities. Affordable insulin and innovative design guarantee this.
A patient with insulin-dependent diabetes decides for himself how long to live. The main thing is to adhere to all the recommendations of the doctor, to conduct self-monitoring, and not to neglect dose adjustment, and monitoring.
The patient acquires the necessary knowledge about diet and lifestyle in the case of insulin-dependent diabetes at the Diabetes School, where high-class professionals work with him: endocrinologists, cardiologists, immunologists, nutritionists, ophthalmologists, neurologists, and nephrologists.
The success of treatment is determined by the motivation of the patient. In the classroom, doctors discuss the mechanisms of the disease, ways to compensate, complications, the importance of regular monitoring of sugar levels, and proper use of insulin. Patients learn to give injections themselves, food selection rules, and the menu making.
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