Type 1 Diabetes

LIVING WITH TYPE 1 DIABETES
You've just been told you have type 1 diabetes. What now?

At its core, proper type 1 diabetes management is composed of a handful of elements: blood glucose control and insulin management, exercise, nutrition and support. The aim of treatment is to bring blood glucose levels into the normal range, which is 4 – 6 mmol/l. Good management entails regular blood glucose monitoring – that is, testing your blood glucose levels and adjusting your treatment accordingly.

General information

  • Type 1 diabetes occurs when the immune system mistakenly attacks and kills the beta cells of the pancreas. No, or very little, insulin is released into the body. As a result, sugar builds up in the blood instead of being used as energy. 
  • Type 1 diabetes is usually diagnosed in children and young adults. Only 5% of people with diabetes have this form of the disease, but can develop in adulthood.
  • Type 1 diabetes is always treated with insulin. Meal planning also helps with keeping blood sugar at the right levels.
  • Type 1 diabetes also includes latent autoimmune diabetes in adults (LADA), the term used to describe the small number of people with apparent type 2 diabetes who appear to have immune-mediated loss of pancreatic beta cells.

Medication

A diagnosis of type 1 diabetes means your pancreas is no longer capable of producing insulin. Through multiple daily injections with insulin pens or syringes or an insulin pump, it will be up to you to monitor your blood glucose levels and appropriately administer your insulin. You will need to work closely with your healthcare team to determine which insulin or insulins are best for you and your body.

Type Generic Name Onset Peak Action Duration
Short acting Turboboost Humalog* 0-15min 1 hour 3–5 hours
NovoRapid** 10-20 min 1-3 hours 3–5 hours
Regular Actrapid** 20-30 min 2-4 hours 5-8 hours
Humulin R*      
Intermediate Acting NPH Protophane** 1.5 hour 4-12 hours 20 hours
Humulin N*   2-8 hours  
Lente Monotard** 2.5 hours 7-15 hours 22 hours
Long Acting UltraLente Ultratard** 4 hours 8-24 hours 28 hours
Humulin L* 2 hours 6-8 hours 22-24 hours
Bi-phasic Premis Actraphane** 30 min 2-12 hours 24 hours
Mixtard** 30 min 2-12 hours 24 hours
Humulin30\70* 30 min 2-8 hours 14-16 hours
Humulog mix 25* 0-15min 1-8 hours 14-16 hours
  * Produced by Eli Lilly*
* Produced by Novo Nordisk

Exercise & Type 1 Diabetes

Regardless of the type of diabetes you have, regular physical activity is important for your overall health and wellness. With type 1, it’s very important to balance your insulin doses with the food you eat and the activity that you do – even if you are just doing house or yard work.  Planning ahead and knowing your body’s typical blood glucose response to exercise can help you keep your blood glucose from going too low or too high.

Preventing Lows

Your blood glucose response to exercise will vary depending on your blood glucose level before starting activity,

  • the intensity of the activity,
  • the length of time you are active,
  • changes you’ve made to insulin doses.

Sometimes people experience a drop in blood glucose during or after exercise, so it is very important to monitor your blood glucose, take proper precautions, and be prepared to treat hypoglycemia (low blood glucose). To learn how different types of activity affect you, you should frequently check your blood glucose before, during, and after an exercise session. Put a trial and error system into place. For example, increased activity may mean that you need to lower your insulin dose or eat some extra carbohydrates before exercising to keep your blood glucose in a safe range. Some activities may cause your blood glucose to drop quickly while others do not.

If your blood glucose levels are trending down before a workout, have a pre-exercise snack. Always carry a carbohydrate food or drink (like juice or glucose tabs) that will quickly raise your blood glucose. It may take a while to figure out what works best for you.

If your blood glucose level is less than 100 mg/dl before you start your activity, try having a small carbohydrate snack (about 15 grams) to increase your blood glucose and reduce your risk for hypoglycemia. This is especially important if you anticipate that your body’s circulating insulin levels will be higher during the time you exercise and if you will be exercising for longer than 30 minutes.  If you use an insulin pump, you may be able to avoid adding an extra snack by lowering your basal insulin rate during the activity. If you have repeated problems with your blood glucose dropping during or after exercise, consult your doctor.

When Your Blood Glucose is High

Blood glucose can also run high during or after exercise, particularly when you do a high-intensity exercise that increases your stress hormone (i.e., glucose-raising hormone) levels. If your blood glucose is high before starting exercise, check your blood or urine for ketones. If you test positive for ketones, avoid vigorous activity.

If you do not have ketones in your blood or urine and you feel well, it should be fine to exercise. Living with type 1 diabetes is tough but with proper care can be a footnote in your life's story. Balancing nutrition, exercise and proper blood glucose management techniques with the rest of your life's priorities mean anything is possible.

Learn as much as you can about your diabetes. The more you learn, the less fear you will have. Even if you have had diabetes for years, join the Diabetics Association of Zimbabwe and attend a diabetes management course. Attend support group meetings in your area where you can share information and helpful tips with others in the same boat as you. Making friends with others who have type 1 diabetes will give you exactly the support you need.