Type 1 Diabetes (T1D) is an autoimmune disease characterised by the body's inability to produce the hormone insulin. Insulin is the 'key' that allows the cells in our body to use any sugar (glucose) in our blood for energy. Without insulin available, the concentration of glucose builds up in our blood and leads to the nasty symptoms of hyperglycaemia, including ketoacidosis.
Our cells constantly need energy, all day every day. Even if we were to lay in the same position doing nothing all day, the body still requires energy to function properly. When we eat carbohydrates, the sugars from these foods enter our blood stream and are used by the cells for this exact reason. In non-diabetics, an organ in the body called the pancreas will secrete the hormone insulin from cells known as B-islet cells. The insulin secreted allows the cells to utilise the glucose dumped into the blood and prevents the concentration from building up too high. In those with T1D, the pancreas becomes partially incompetent. Those with T1D are unable to produce any insulin, which is where the problems arise.
Normally, the body will maintain a stable blood glucose by secreting insulin which allows the glucose to leave the blood; much like a filtration system. In T1D, insulin must be injected into the body directly as the pancreas is no longer able to produce it.
A simple solution to this 'no insulin' drama would be to just cut the carbs completely and live a life of lettuce and cheese. Unfortunately the inconvenience doesn't end here. The liver is constantly secreting glucose into the blood stream, alongside the extra glucose from the foods you eat. Without a constant supply of insulin, blood glucose will continue to rise as the glucose cannot be used.
To summarise, insulin is required to be present in the blood at all times to ensure than glucose from both the liver and the foods you eat is used by the cells for energy and doesn't start to build up to dangerously high concentrations in the blood. Type 1 Diabetics must therefore inject each time they eat food with carohydrates (bolus) and supply their own 'background' insulin which covers the glucose dumped by the liver (basal). A lot of effort.
What is Type 1 Diabetes?
What causes Type 1 Diabetes?
Environmental & Genetic factors
Life with T1D.
The first thing you'll be told upon diagnosis is that you'll be required to take insulin injections for the remainder of your life. Sounds horrid, and in all honestly it is. The thought of plunging a needle into you several times a day isn't exactly the most appealing prospect in the world. The insulin injections you take are divided into bolus & basal insulin.
Bolus insulin is a 'rapid acting' insulin used to lower your blood glucose quickly. This is usually administered when you eat carbohydrates or are correcting an elevated blood glucose.
Basal insulin is 'background insulin'. This is usually given in either one dose or two (one morning one evening). This insulin works throughout the day to keep your blood glucose levels stable between meals.
Blood glucose monitoring
Life with T1D.
Blood glucose monitoring is a really important chore when you're diabetic. Non-diabetics have the luxury of their own body working the see saw between insulin and blood glucose. Unfortunately for us we have to do all the hard work ourselves.
It's important to test your blood glucose several times a day in order to keep your levels within a target range. A normal persons blood glucose is between 4.0 mmol/mol and 7.0 mmol/mol. Testing your blood glucose regularly is key to maintaining good control over your diabetes. It allows you to see how sensitive you are to both basal and bolus insulin, how your blood glucose reacts to certain activities and most importantly, to make sure you treat a current or impending hypoglyceamia/hyperglycaemia.