Understanding and Managing Diabetes: Key Symptoms and Treatments

Overview of Type 1 Diabetes

Type 1 diabetes is an autoimmune disorder where the body's immune system attacks and destroys insulin-producing cells in the pancreas called beta cells. As these cells are eliminated, insulin production drops, leading to a lifelong dependency on insulin therapy. The exact cause remains unclear, but genetic factors and environmental triggers are believed to play roles. The immune response involves immune cells called CD4 and CD8 T cells that identify and destroy the beta cells after they are marked by antibodies.

Progression of the Disease

Before symptoms manifest, individuals typically experience a pre-diabetes phase characterized by increased pancreatic effort to regulate blood sugar. During this stage, markers such as GAD, ICA, and IAA antibodies appear, indicating immune activity against beta cells. When beta cell mass declines below 25%, insulin production becomes insufficient, resulting in overt diabetes and elevated blood glucose levels.

Signs and Symptoms

Symptoms vary but commonly include frequent urination, especially at night, unintended weight loss, intense thirst, persistent hunger, blurred vision, fatigue, nausea, vomiting, and infections of the skin, bladder, or vagina. The hallmark signs are the "3 P’s": polyuria (excessive urination), polydipsia (thirst), and polyphagia (hunger). High blood sugar levels cause dehydration and hunger sensations, prompting more urination to eliminate excess glucose.

Managing Type 1 Diabetes

Following diagnosis, lifelong insulin therapy is essential. Typically, patients start with a dose of 0.4 to 1.0 units per kilogram of body weight daily. Insulin can be administered as long, intermediate, short, or rapid-acting forms, with regimens often involving basal-bolus schedules. For example, dividing the total daily dose equally between long-acting insulin for baseline coverage and rapid-acting insulin at mealtimes helps maintain blood sugar control.

Calculating Insulin Dosage

For a patient weighing 60 kg and needing 0.5 units per kg: the daily dose is 30 units.

Half is long-acting (15 units), and the remaining half is divided into three bolus doses of about 5 units before each meal.

Insulin Administration Tips

Inject at a 90-degree angle, counting to 10 before removing the needle.

Use common sites like the abdomen, thighs, arms, and buttocks; rotate within the site to ensure proper absorption and prevent skin issues.

Avoid daily site changes across different body parts due to differing absorption rates.

Proper Insulin Storage

Refrigerate unopened insulin for prolonged storage.

Once in use, insulin can be kept at room temperature for up to one month.

Avoid exposure to excessive heat.

Potential Side Effects

Hypoglycemia (low blood sugar), usually from excessive insulin or inadequate food intake.

Weight gain.

Skin issues at injection sites from improper rotation.