Type 1 diabetes (T1D) is a chronic, life-threatening disease that can strike anyone at any age and at any time. It occurs when the body's immune system attacks and destroys the cells in the pancreas that make insulin. T1D can be passed on genetically, but can also affect those without a hereditary link. Although most people are diagnosed as children, it is not just a child's disease, and in fact, 20 per cent of people with T1D are diagnosed as adults.
Each day, 50 people across the country are diagnosed with T1D. More than 300,000 Canadians currently suffer from the disease.
Below are accounts from three individuals who are challenged on a daily basis by a disease that preoccupies their thoughts 24/7.
Kenadie, 11, from Toronto, ON
When I was first diagnosed, I had no idea what was happening. I was at the theatre with my mom and had to go to the bathroom many times, which was not normal. My mom has T1D and after using her blood glucose tester, it showed that I likely had the disease. After visiting my doctor, it was confirmed.
I was scared at the beginning, but I felt better after I was taught how to manage my diabetes. Every day, I check my blood sugar level seven or more times, and my mom checks three times during the night. Afterwards, I have to either eat specific foods or give myself an insulin injection. I used to have around nine needles per day, but now I have an insulin pump which is easier and less painful.
When I'm at school playing at recess, I sometimes have to go inside because my blood sugar levels are too high or too low, or someone needs to change my pump site (where the catheter enters the body). I often have to miss recess to do this. During class, if my levels are not right, I have to go to my emergency drawer that has tools, snacks and juice to help manage my sugars. I have to walk up and interrupt the class. I hate doing this, but I have no choice.
T1D is hard to live with, but I would tell people with it to never give up. Never say that you can't do things others can. That will not get you anywhere. Be brave. You have a difficult disease, but you can get through it if you take care of yourself each day.
Aryssah, 26, from Calgary, AB
I was diagnosed with T1D when I was 19 years old. This was at the end of my first year of university. While most people are diagnosed as children, I was already an adult. I had a set lifestyle, and things changed overnight.
You need to start as early as you can after diagnosis to avoid other complications.
I now had to keep an eye on what I was eating, think of my blood sugar levels prior to playing soccer and other activities, and be careful when going out for food with friends.
I am now in my mid-20s and my disease is managed as best it can be. Given that I was diagnosed at such a late age, I am still running into new and challenging situations. For instance, I was seasick last year and I became so dehydrated that I fell into a diabetic emergency. It was scary because I had no idea such a health problem could happen (and so quickly) and I feel that for many adults diagnosed with T1D, there is still a learning curve.
For those with T1D diagnosed at a young age, it is not until you become an adult that you understand the repercussions of not taking care of yourself. You need to start as early as you can after diagnosis to prolong your time and avoid other disease-related complications. Take care of your health and make this a priority both for you and those you love.
George, 56, from Kitchener, ON
I was diagnosed with T1D when I was six years old and this year marks my 50th anniversary with the disease. While the past half century has not been easy, I have learned to manage my condition effectively and have always viewed this as me having the opportunity to be healthier than most people.
I was told that I would not likely live to be 60 years old. My reaction was that I want to beat that statistic.
Although T1D is easier to cope with as an adult, it can still disrupt my day. At work, you can run into problems if you have a meeting which runs late and you have not eaten. You get distracted because you're concerned that your blood sugar might be spiking or dipping. You are mentally unable to be at your best and may be preoccupied while important decisions are being made with your colleagues.
Eating socially is also a challenge. When attending an event and being served a meal you didn't prepare, you have to figure out the carbs and sugars in the food. I often go to restaurants and have to coordinate my insulin injection around when I think the meal will be served. If there is a delay with the meal, which often happens, your body can get confused and a major event can occur. You have to be prepared.
In my experience, the only way for a person to live healthy and happy with T1D is to own the disease. Be responsible and be vigilant. When I was in my early teens, I was told that I would not likely live to be 60 years old. My reaction was that I want to beat that statistic, and by the way I have managed my disease over the past 50 years, I know I will.
You're not alone
For those impacted by T1D, don't suffer in silence. Visit the Juvenile Diabetes Research Foundation (JDRF) Canada's website www.jdrf.ca for up-to-date information and resources.
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Commonly referred to as Juvenile Diabetes, because it’s often diagnosed in childhood. However, it can also be diagnosed in adults. Type 1 diabetics have a pancreas that produces little or no insulin, which requires insulin management through medication that is usually injected.
Type 2 diabetes is a chronic condition that almost always develops in adulthood — which is why it’s sometimes referred to as adult-onset diabetes. "About 90 per cent of diabetics are Type 2, meaning that their ability to produce adequate levels of insulin is highly compromised and they have significant levels of insulin resistance,” says Dr. Barry Sears, president of the Inflammation Research Foundation. "The combination leads to significant increases in a variety of additional disorders — in particular heart disease and Alzheimer’s — in addition to the standard problems of loss of vision, increased amputation, and kidney failure."
Insulin is a hormone. It’s produced by the islet cells of the pancreas, and its role is to regulate glucose levels in the blood. The pancreas secretes insulin into the bloodstream, where it works to allow sugar to enter the cells and lowers the level of sugar in your bloodstream. As blood sugar drops, the secretion of insulin from the pancreas does too. While both types of diabetes involve insulin and the functioning of the pancreas, there are key differences in their causes and treatments.
Symptoms of type 1 diabetes include the emergence of bedwetting in children, frequent thirst, frequent urination, unintended weight loss, extreme hunger, blurred vision, and fatigue.
With type 2 diabetes, the condition can exist for years before diagnosis. But many of the symptoms are the same as with type 1: blurred vision, unexplained weight loss, excess thirst and urination, fatigue. Also watch for sores or infections that are slow to heal, as type 2 diabetes can affect your ability to heal and fight infection. As well, areas of darkened skin (acanthosis nigrican) in creased areas like the armpits and neck are a sign of insulin resistance.
A variety of factors may contribute to the development of type 1 diabetes, according to the Mayo Clinic, including possible genetics and exposure to certain viruses. Risk factors for the disease include family history and young age, with peaks in outset occurring between ages 4 and 7 and ages 10 and 14.
With type 2 diabetes, the risk factors include having excess fatty tissue, carrying fat around the abdomen, having a family history of diabetes, being inactive, having polycystic ovary syndrome, and getting older. As well, people of black, Asian, Hispanic, and Aboriginal backgrounds are at higher risk of developing type 2 diabetes, though it’s not known why.
Interestingly, the incidence of type 1 diabetes increases as you travel away from the equator, according to the Mayo Clinic, leading some researchers to think it could develop more readily in winter than summer. The highest incidences of type 1 diabetes are found in Finland and Sardinia, for example, where rates are about double or triple those in the U.S. and 400 times those in Venezuela.
It’s unknown exactly what causes type 1 diabetes, but in those with the condition, the immune system attacks the insulin-producing cells of the pancreas. In type 2 diabetes, the islet cells are still functioning as they should, to release insulin — the problem instead is that the pancreas doesn’t produce enough insulin, the body becomes resistant to the insulin, or both. But while we know about some contributing factors, it’s also not known exactly what causes type 2 diabetes.
Type 1 and type 2 diabetes can both have serious effects on your health if not managed. Diabetes can affect your eyes, heart, blood vessels, nerves, and kidneys, though keeping your blood sugar levels well managed does a lot to mitigate these effects. Nerve damage can manifest in loss of feeling or pain, usually beginning in the feet or hands. It could cause gastrointestinal problems or erectile dysfunction. Damage to the blood vessels in the kidneys can lead to kidney failure or kidney disease. Eye problems are also seen in some diabetics, and problems in pregnancy are also a risk.
Prevention of type 2 diabetes can be done in part through dietary choices, and making sure you get enough magnesium may be one of them. "Magnesium plays a pivotal role in the secretion and function of insulin,” Dean says. “Without it, Type 2 diabetes is inevitable.” Measurable magnesium deficiencies is common with the condition, she says, and related to many of the related complications.
Managing stress and anxiety can also help to keep your overall health steady, including possibly staving off type 2 diabetes. "The connection between stress, obesity and diabetes cannot be overlooked,” Dean says. "The stress chemical cortisol signals a metabolic shutdown that makes losing weight almost impossible. Magnesium can neutralize the effects of stress and is known as the anti-stress mineral.” And of course, if you do have diabetes, it’s easier to manage your condition if you aren’t overwhelmed.
There is no cure for type 1 diabetes, though the disease is manageable and treatment has advanced considerably in recent decades. Those with type 1 diabetes must take insulin for the duration of their lives; the physician works with the patient to find the best insulin and dose for blood sugar maintenance. Other medications may be required for related conditions. Not all type 2 diabetics require insulin therapy, but some do. For both types, regular exercise and a healthy diet, along with weight control, can also help keep glucose levels consistent.
For some type 2 diabetics, bariatric surgery may be an option to lose weight and control the disease. However, the surgery does involve serious risks that should be discussed with your physician.
If you suspect you or a family member has type 1 or type 2 diabetes, it’s important to seek medical help as soon as possible. It may be helpful to keep track of your symptoms leading up to the appointment, and go in with a list of your medications and general information about your diet and exercise routines.
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