What is Type 1 Diabetes?

Diabetes (medically known as diabetes mellitus) is the name given to disorders in which the body has trouble regulating blood glucose, or blood sugar, levels. There are two major types of diabetes: type 1 diabetes and type 2 diabetes. Type 1 diabetes, also called juvenile diabetes or insulin-dependent diabetes, is a disorder of the body's immune system. That is, its system for protecting itself from viruses, bacteria or any "foreign" substances. Type 1 diabetes diagnosed in adults over 30 may be Latent Autoimmune Diabetes in Adults (LADA), sometimes known as Type 1.5 diabetes. LADA is often misdiagnosed as type 2 diabetes because of age; however people with LADA do not have insulin resistance like those with type 2. LADA is characterized by age, a lack of family history of type 2 diabetes, a gradual increase in insulin requirements, positive antibodies, and decreasing ability to make insulin as indicated by a low C-peptide.


Type 1 diabetes occurs when the body's immune system attacks and destroys certain cells in the pancreas, an organ about the size of a hand that is located behind the lower part of the stomach. Beta cells normally produce insulin, a hormone that helps the body move the glucose contained in food into cells throughout the body, which use it for energy. But when the beta cells are destroyed, no insulin can be produced, and the glucose stays in the blood instead, where it can be very harmful to all the organ systems of the body.
For this reason, people with type 1 diabetes must take insulin in order to stay alive. This means undergoing multiple injections daily, or having insulin delivered through an insulin pump, and testing their blood sugar by pricking their fingers for blood six or more times a day. People with diabetes must also carefully balance their food intake and their exercise to regulate their blood sugar levels, in an attempt to avoid hypoglycemic (low blood sugar) and hyperglycemic (high blood sugar) reactions, which can be life threatening.

The warning signs and symptoms of type 1 diabetes include extreme thirst; frequent urination; drowsiness or lethargy; sugar in urine; sudden vision changes; increased appetite; sudden weight loss; fruity, sweet, or wine-like odor on breath; heavy, labored breathing; stupor; and unconsciousness.

Type 1 diabetes is generally diagnosed in children, teenagers, or young adults. Scientists do not yet know exactly what causes type 1 diabetes, but they believe that autoimmune, genetic, and environmental factors are involved.

Exercise and Type 1 Diabetes

This is some information that the American Diabetes Association has made available for diabetics to be aware of exercise and diabetes management.

All levels of physical activity, including leisure activities, recreational sports, and competitive professional performance, can be performed by people with type 1 diabetes who do not have complications and are in good blood glucose control. The ability to adjust the therapeutic regimen (insulin and medical nutrition therapy) to allow safe participation and high performance has recently been recognized as an important management strategy in these individuals. In particular, the important role played by the patient in collecting self-monitored blood glucose data of the response to physical activity and then using these data to improve performance and enhance safety is now fully accepted.

Hypoglycemia, which can occur during, immediately after, or many hours after physical activity, can be avoided. This requires that the patient has both an adequate knowledge of the metabolic and hormonal responses to physical activity and well-tuned self-management skills. The increasing use of intensive insulin therapy has provided patients with the flexibility to make appropriate insulin dose adjustments for various activities. The rigid recommendation to use carbohydrate supplementation, calculated from the planned intensity and duration of physical activity, without regard to glycemic level at the start of physical activity, the previously measured metabolic response to physical activity, and the patient’s insulin therapy, is no longer appropriate. Such an approach not infrequently neutralizes the beneficial glycemic lowering effects of physical activity in patients with type 1 diabetes.

General guidelines that may prove helpful in regulating the glycemic response to physical activity can be summarized as follows:

1. Metabolic control before physical activity
   
   • Avoid physical activity if fasting glucose levels are >250 mg/dl and ketosis is present, and use caution if glucose levels are >300 mg/dl and no ketosis is present.
   • Ingest added carbohydrate if glucose levels are <100 mg/dl.
2. Blood glucose monitoring before and after physical activity
   
   • Identify when changes in insulin or food intake are necessary.
   • Learn the glycemic response to different physical activity conditions.
3. Food intake
   
   • Consume added carbohydrate as needed to avoid hypoglycemia.
   • Carbohydrate-based foods should be readily available during and after physical activity.

Because diabetes is associated with an increased risk of macrovascular disease, the benefit of physical activity in improving known risk factors for atherosclerosis is to be highly valued. This is particularly true in that physical activity can improve the lipoprotein profile, reduce blood pressure, and improve cardiovascular fitness. However, it must also be appreciated that several studies have failed to show an independent effect of physical activity training on improving glycemic control as measured by the A1C test in patients with type 1 diabetes. Indeed, these studies have been valuable in changing the focus for physical activity in diabetes from glucose control to that of an important life behavior with multiple benefits. The challenge is to develop strategies that allow individuals with type 1 diabetes to participate in activities that are consistent with their lifestyle and culture in a safe and enjoyable manner.

In general, the principles recommended for dealing with physical activity in adults with type 1 diabetes, free of complications, apply to children, with the caveat that children may be prone to greater variability in blood glucose levels. In children, particular attention needs to be paid to balancing glycemic control with the normalcy of play, and for this the assistance of parents, teachers, and athletic coaches may be necessary. In the case of adolescents, hormonal changes can contribute to the difficulty in controlling blood glucose levels. Despite these added problems, it is clear that with careful instructions in self-management and the treatment of hypoglycemia, physical activity can be a safe and rewarding experience for the great majority of children and adolescents with type 1 diabetes.

                 

7 Advantages (Blessings) and Disadvantages (Burdens) of My Life With Diabetes

These are the 7 advantages and disadvantages of diabetes according to my personal experience:

ADVANTAGES:

1.       Made me realize that I needed overall discipline in my life.
2.       I eat the way everyone is “supposed” to eat (food group portions).
3.       To be organized.
4.       Being responsible for getting what I need (insulin, food, syringes, testing supplies).
5.       Allowed me to open up to people that were going to be around me and that needed to know what diabetes is and how it affects me personally.
6.       I am under constant medical supervision.
7.       Allowed me to be aware of others in similar conditions and give advice.

DISADVANTAGES:

1.       Not being able to eat candy or sweets as much as I would like to.
2.       Extra things to carry around (insulin, syringes, glucose meter, testing strips).
3.       Health risks from High Glucose levels in the blood (Hyperglycemia).
4.       Health risks from Low Glucose levels in the blood (Hypoglycemia).
5.       The memory of my grandfather dying from diabetes complications.
6.       The frustration of the disease having “No Cure”.
7.       Constant medical supervision and supplies are very expensive.

I hope these advantages and disadvantages from my experience with type I diabetes give some insight as to what diabetics feel sometimes.

The Discipline That Gave Me Life

Ever since I could remember I wanted to play soccer. I saw the Mexican professional soccer league and I always wanted to know what it felt like to play and get paid at that level. I would go see my favorite team “Pumas” play and practice as well. It was amazing to think that someone would get paid to play soccer. That was what I wanted to do but I had a medical condition that needed to be taken care of first so that I could live and continue to dream.

I was diagnosed with type I diabetes when I was 10 years old and at the time the disease did not make sense to me at all. The first few years I was diagnosed with type I diabetes I was angry. I was upset at the world because I had to deal with this disease. I did not want to follow my doctor’s orders and I would eat all the candy and snacks that I wanted; why not, I was a kid. What I did not know is that I was slowly killing myself by doing that. I was eating what I wanted and felt good at the moment but what I did not know is that I was preventing myself from realizing my dreams.

I had blood glucose levels around 300mg/dL to 500 mg/dL because I ate whatever I wanted to eat. Most of what I ate at that time was not a diet suitable for a type I diabetic. At this point I was feeling the same way as I did right before I was diagnosed because the insulin that I was taking was not enough to lower the glucose levels in my blood. This made me feel tired with no motivation to do anything,  and began to  feel indifferent to my dream of playing soccer.

Once I realized I was not able to play soccer because I was not taking care of myself, I was determined to get back out on the soccer field. This meant that I had to take care of my diabetes by doing the following:

·         Take my insulin shots at the appropriate times.
·         Eat a reasonable diet of foods low in glucose.
·         Exercise regularly (Easiest part of my new regimen)
·         Get adequate rest

Once I started doing these 4 easy things in my life, I was able to better concentrate in school, able to train better during soccer practice and games: I was able to do more with my life. Once I had control of my diabetes, I was able to have the following accomplishments:

1.       Finished High School and played in the District 1-5A playoffs for soccer.
2.       Played for UTEP men’s soccer club while attending UTEP for a BS in Kinesiology and Sports Medicine (2000) and a MS in Kinesiology and Exercise Physiology (2005).
3.       Became a Licensed massage therapist in 2000.
4.       Started playing professional soccer at the age of 19 with the El Paso Patriots on the USISL A-League.
5.       Played for the Volcanes de Colima in Colima, Mexico (2000) and then promoted to Tecos de Guadalajara team in Guadalajara, Jalisco Mexico (2002).
6.       Became a Personal Trainer on 2005.
7.       Coach with the Premier Panthers Soccer Club.
8.       Director for one of the Recreation Centers in the City of El Paso Parks and Recreation Department.

These are only professional accomplishments that I am very proud of. The four changes I made in my life allowed me to accomplish my dreams and helped me realize personal achievements. Everything that I have done in my life personally and professionally, is due in part to being disciplined and determined to control my diabetes. Once in control of my disease, I was able to do what I wanted to do and the result could not have been any better.

Juvenile Diabetes: The Personal Triumph of a Determined Diabetic Athlete

I have always been a very active individual. I participated in sports and extracurricular activities every opportunity I had.  Growing up, I was one of those kids that would hurry to get home so that I could finish my homework and go out and play or practice soccer with my friends. I was always one of the first kids from the block to come out to play and the last kid to go home.  I loved playing any kind of sport and as long as I was active I was content.


At the age of 11, I no longer felt the desire to go out and play or even go to soccer practice, which I could never get enough of. A very strange thing was happening. I was always tired and sleepy, which was not the norm for me at all.  Every day I felt more and more exhausted even though I had not done any sort of physical activity.  I realized that part of my exhaustion was due to my lack of sleep. I was losing sleep because I was getting up every hour on the hour to go to the restroom. I had never had that problem before and really did not think much of it. I did notice that I developed an unquenchable thirst and of course, the more liquids I drank, the more I needed to go to the restroom.


My mother noticed a change in my energy, constant thirst and increased bathroom trips, and as any mother would, she became worried. After a trip to my pediatrician and a hospital visit for lab work, I was diagnosed with type I diabetes. Little did I know that the burger, fries and soda I had that day was the last meal I would have as a presumed non-diabetic. I did not know, nor did I understand what type I juvenile diabetes was. I began to realize how serious my diagnosis was based on my parents’ reaction to the news and knew it had to be serious enough after I was admitted to the hospital for several days. Being told that I could no longer eat candy, cookies, chips, or anything sweet for that matter, is not something an 11 year old wants to hear.  I remember the doctor saying that if I took care of myself, I would have a 99% chance of living a somewhat normal life, if not, I probably would not see my 21^st birth day.


From that point on I have tried to keep my body in good physical shape with exercise, proper nutrition and physician prescribed medicine (insulin).  I am now 35 years old and have learned that many factors can negatively affect my glucose levels. Forgetting to take my insulin is one obvious factor, (which on occasion has been known to happen) but other factors may not be as obvious. Stress, depression, and even anger can affect glucose levels. Following my doctors’ orders has helped me reach all the goals I have set for myself. Not only did I graduate from high school, I received a Bachelor’s degree in Kinesiology and Sports Medicine, as well as a Masters degree in Kinesiology and Exercise Physiology. My accomplishments were not limited to education but also extended into sports. I participated in my high school’s soccer playoffs my senior year, participated in the National Soccer Club Association (NSCA) with UTEP and played 2 national tournaments. Professionally, I was part of the El Paso (Texas) Patriots Pro Soccer Team. I also played for the Volcanes de Colima in Colima Mexico and was later promoted to first division soccer with Tecos de Guadalajara, also in Mexico.
I am now coaching youth soccer with the Premier Panthers Soccer Club in El Paso and hold the position of director for one the many recreation centers in El Paso’s Parks and Recreation Department.  I could not have reached my goals if I had not taken care of my diabetes properly. Understanding how my body reacted to exercise, food, stress, and other internal and external factors helped me gain control of my type I diabetes. I did not let my disease interfere with my love of soccer nor did I let diabetes prevent me from living a long, full life. I took control of my diabetes and so can you.