Diabetes Cheatsheet for Family and Friends

Do you struggle to explain your type 1 diabetes to your friends and family? Or maybe you are just tired of explaining it again and again, and again? Here is a quick rundown of some of the basics that you can share with your nearest and dearest.

It’s often left up to us to educate our nearest and dearest about type 1 diabetes and I really struggled with this for a long time, for two reasons:

  1. I was trying to process this news myself and

  2. I just couldn’t get my head around it.

I was so relieved when my husband-to-be asked where he could get more information about diabetes. He was the first person I met who asked me where they could get more information and not ask me the questions I really didn’t have answers to.

This cheat sheet for family and friends was first published as part of RealityCheck.org’s Type 1 Starter Kit and republished with permission as part of Diabetes Ireland’s Type 1 Diabetes Starter Kit 2012.

http://t1dn.org.au/our-stuff/all-about-type-1-resources/cheat-sheet/

https://www.diabetes.ie/wp-content/uploads/2014/11/T1-Starter-Kit.pdf


Cheatsheet For Family & Friends

Someone you love (or like) has just been diagnosed with Type 1 Diabetes and no doubt, you have questions and want to know how you can support this person. But before you fire all those questions remember that they have just been dealt with a life blow and may be struggling to understand this condition themselves as well as trying to adapt to this new life filled with injections and other sharp objects. So here is a basic rundown of some of the questions you might have.


TYPE 1 DIABETES IS:

  • An autoimmune disease

  • The type of diabetes that people associate with children BUT you can get it at any age.

  • Chronic – it does not go away as you get older

  • Treated with insulin every time you eat.

  • Often a HUGE lifestyle change and a big deal

  • 50% genetic and 50% environmental

  • Sometimes a very challenging adjustment and is difficult to cope with emotionally

TYPE 1 DIABETES IS NOT:

  • Caused by anything you ate

  • Related in any way to obesity or any lifestyle factors

  • Strongly genetic – even if a mother has diabetes there’s only a 4% chance her child will develop diabetes, if father has diabetes it’s a 7% chance.

  • Cured by taking insulin

  • Easy to manage – it’s very complex

  • A sentence to stop living, travelling, playing sport, drinking and having fun (you can still do all those things)

SOME COMMON QUESTIONS

Have they got too much sugar or not enough?

Both! A person with Type 1 diabetes produces no insulin. This means they have to keep glucose levels “normal” by injecting insulin, carefully balance what they eat, how much exercise they do and other factors to keep the amount of sugar in their blood stable.

Finding that “just right” balance is really, really hard.

At times, a person will have not enough sugar and URGENTLY need some. At other times they will have too much sugar and not feel too great and need to top up on insulin. It’s not easy!

Will they have fits or pass out? What do I do?

If they are unconscious call an ambulance. Never try to give food or drink to someone who is unconscious, instead call 999.

Lay them on their side and call an ambulance. NEVER try to make them drink or eat when unconscious.

A person who has had a hypo should not be left alone. They should NOT be sent alone to a sick bay or sent home from work or school immediately after a hypo. At least 15-30 minutes is required for the blood sugars to return to normal.

Some common early warning signals of a ‘hypo’ include:

  • Sweating

  • Trembling

  • Hunger

  • Headache

  • Tiredness or Weakness

  • Tingling around the lips and mouth

  • Difficulty concentrating

  • Paleness

With more severe hypoglycaemia, or without treatment, it is possible that the person may progress to more severe symptoms, such as:

  • Confusion

  • Behaviour changes

  • Slurred speech

  • Marked drowsiness

  • And eventually unconsciousness

If in doubt whether a person is having a hypo, and they are conscious, give sugar – you can do no harm. Where possible do a blood glucose test. A result BELOW 4.0 indicates a hypo.

Hypos should be treated promptly.

The treatment is to give quick acting sugar of any kind.

If conscious, give any of these:

  • glucose tablets (3-5)

  • sugar (2-3 teaspoons)

  • jelly beans or jelly baby sweets (7)

  • sugary soft drink - not diet (1/2 can)

Symptoms should disappear in 10 -15 minutes. If not, give more sugar and check the blood glucose level.



MORE ABOUT DIABETES

What is diabetes?

Diabetes is a lifelong, chronic, and sometimes fatal condition where the body has difficulty turning food into fuel.

The reason for this is a lack of, or not enough insulin - a hormone produced by a gland called the pancreas (forever known from this point forward as “stupid Pancreas”).

When you eat starchy foods, they break down into glucose. The glucose hangs out in your blood stream until insulin comes along to convert it to fuel/energy. Insulin controls the level of glucose in the blood by helping glucose go from the bloodstream into your body’s cells.

If the insulin can’t do this it leads to glucose building up in your bloodstream making your feel very unwell.

The common factor in ALL types of diabetes is the need to keep blood glucose in the normal range. This will help reduce the likelihood of long-term health problems or ‘complications’.

The treatments that exist today are not a cure. Diabetes is a chronic illness. Until a cure is found, treatment must continue throughout a person’s lifetime.

See more at: http://www.diabetes.ca/about-diabetes/types-of-diabetes#sthash.LpHMlIEp.dpuf

THE TYPES

Type 1 or Insulin Dependent Diabetes Mellitus (IDDM) or formerly Juvenile Diabetes

Type 1 diabetes is where the pancreas stops producing insulin. Those affected require daily insulin injections to survive.

Approximately 16,000 Irish people have Type 1 Diabetes. The cause of Type 1 Diabetes is not totally understood. However, it is believed that people have a genetic predisposition to developing diabetes combined with a trigger factor such as a virus then causes the body’s own immune system to incorrectly identify the insulin producing cells as foreign and destroy them. Type 1 diabetes can be diagnosed at any age.

Type 2 Diabetes

Type 2 diabetes is the most common type. My (non scientific, non-medical) description; Type 2 diabetes happens when your insulin has developed a dementia. It's old and tired and not quite sure what it's supposed to do. So, sometimes it works and sometimes it has to put twice as much effort in to work. To me, it's like the insulin has dementia - sometimes it's sharp and works well and other times it just can't figure out what to do.

The treatment options for type 2 diabetes include managing physical activity, meal planning, may also require medications and/or insulin to control blood sugar more effectively. It can be a series of trial and error to find the right treatment plan for a person with type 2 diabetes.

Risk Factors for Type 2 Diabetes (from IDF):

There are 10, that's TEN risk factors for type 2 diabetes. Not just the two/three that we ALWAYS hear about.

  • Family history of diabetes

  • Increasing age

  • High blood pressure

  • Ethnicity

  • Impaired glucose tolerance (IGT)*

  • Overweight

  • Unhealthy diet

  • Physical inactivity

  • History of gestational diabetes

  • Poor nutrition during pregnancy

  • Impaired glucose tolerance (IGT) is a category of higher than normal blood glucose, but below the threshold for diagnosing diabetes.

Gestational Diabetes

The hormonal changes in a woman’s body during pregnancy sometimes cause insulin resistance and again the pancreas fails to respond adequately, blood glucose levels rise. All pregnant women are tested for gestational diabetes.

GDM usually disappears after pregnancy but women with GDM and their children are at an increased risk of developing type 2 diabetes later in life. Approximately half of women with a history of GDM go on to develop type 2 diabetes within five to ten years after delivery.

LADA (latent autoimmune diabetes in adults) or Type 1.5

My (non scientific, non-medical) description; LADA is very much like type 1 diabetes but it tends to occur in older adults. It is very often mistaken for type 2 diabetes. It's a slower destruction of the insulin making cells. Maybe it's something to do with the "Terminator" being older and slower moving!?! So the symptoms present over a longer period than they would for a person with type 1 diabetes.

LADA is also known as slow-onset type 1 diabetes and type 1.5 diabetes. Like other forms of type 1 diabetes, people with LADA require insulin injections to normalise their blood glucose levels.

For the more medical explanation of LADA click here. Symptoms are very similar to those of type 1 diabetes.

Other Types.

There are other, much rarer forms of diabetes that are monogenic, meaning a change in only one gene is responsible for the condition. There are two types of conditions in this category: Maturity Onset Diabetes of the Young (MODY) and Neonatal Diabetes Mellitus (NDM).



Managing Type 1 Diabetes is a complex question of balance.

Type 1 Diabetes is treated with multiple daily insulin doses, healthy eating, regular exercise and constant monitoring of blood sugar levels through taking small samples of blood from the fingertips.

Low blood sugars (hypoglycaemia or hypo)

Initially the your nervous system responds, with symptoms such as sweating, shaking, rapid heartbeat and pallor. The brain, which relies heavily on glucose to operate properly, can also be affected, leading to tiredness, trouble concentrating, mood and behaviour changes and eventually possible coma. Treatment of mild hypoglycaemia involves consumption of sugary food or drink followed by something more substantial such as bread. If a mild hypo is left untreated, the blood sugar level will continue to fall, starving the rest of the body of glucose and energy and leading to serious episodes such as blacking out. In most cases, the early symptoms can be recognised and treated without further problems.

High blood Sugars (hyperglycaemia)

High blood glucose level causes you to feel fatigued, dehydrated and ill. The kidneys filtering the blood collect more glucose than usual. This glucose must be removed from the body. You pass a lot of urine. You need more water, get thirsty and drink a lot.

People with Type 1 diabetes are generally able to treat hyperglycaemia by increasing the amount of insulin at their next injection or having an extra insulin injection. Usually, symptoms of hyperglycaemia are initially relatively mild. If a person becomes ill or omits their insulin dose, the body is unable to process glucose normally.

A complex balancing act!

There are a large number of factors which influence blood glucose levels: 42 have been documented by DiaTribe. They include the amount and type of food you eat, the amount and type of insulin you inject, all forms of exercise, drinking alcohol, and taking prescribed and recreational drugs. However, many less tangible factors are also involved, often relating to the interaction of hormones in the body, such as those produced during periods of stress, anxiety and menstruation. A reliable but unpredictable part of everyday life for most people!