All cells in the human body needs glucose to function normally and the blood sugar levels are usually controlled by the hormone insulin . If the body lacks insulin or the body's cells become resistant to insulin , blood sugar levels will increase dramatically due to accumulation . This is what happens when a person suffers from diabetes ( diabetes mellitus ) .
Diabetes is a disease characterized by long-term blood sugar levels are above normal
Diabetes sufferers in Indonesia
In 2013, people with diabetes in Indonesia is estimated at 8.5 million people aged 20-79 years (quoted from the International Diabetes Federation). But less than 50% of them were aware of it.
Southeast Asia is one of the areas with the highest prevalence of diabetes type 1. There are about 111,500 children under 15 years of diabetes type 1 with an estimated 18,000 new cases each year.
Any Type of Diabetes?
The main types of this disease is diabetes type 1 and type 2. People with type 1 diabetes is very dependent on insulin. This type is also sometimes known as diabetes 'teenager' due primarily affects patients under the age of 40 years, especially in adolescence.
Pancreas organ in the body type 1 diabetics do not produce insulin, so patients must receive insulin injections every day. Insulin is very important because it serves to control blood sugar levels. Blood sugar levels that are too high can result in serious damage to the body organs.
In addition to injecting insulin, people with type 1 diabetes should also keep your blood sugar levels to remain balanced. For example, with a healthy diet, regular exercise, and regular blood tests.
Symptoms Common in Diabetes
Symptoms of diabetes vary. Among them:
What Causes The occurrence of Type 1 Diabetes?
- Often feel thirsty.
- Frequent fatigue.
- Frequent urination, especially at night.
- Reduced muscle mass (in people with Type 1 diabetes).
- Weight loss (in patients with Type 1 diabetes).
The main cause of diabetes is closely linked to the hormone insulin. Type 1 diabetes is caused by the body's inability to produce insulin. This hormone serves to move glucose from the blood into cells that will process it into energy. The pancreas in type 1 diabetic patients are not able to produce insulin the body needs.
Without insulin, the body's cells will process the fat and muscles into energy, causing weight loss. This can lead to an acute condition called diabetic ketoacidosis in patients with type 1 diabetes, which is when the blood becomes too acidic and dehydrates dangerous.
Diabetes type 1 is called the autoimmune condition, the immune system attacks cells in the pancreas because they thought they harm the body.
Measures Treatment for Type 1 Diabetes
Diabetes can not be cured and can only be controlled. Early diagnosis of diabetes is very important so that treatment can be done immediately. With early detection, the blood sugar levels of diabetics can be controlled. Treatment of diabetes aims to keep blood sugar levels and control the symptoms to avoid complications that may occur.
Body type 1 diabetics do not produce insulin anymore so they must receive insulin supply from outside the body on a regular basis. They are also required to learn to adjust supply of insulin with food intake, blood sugar levels, and activities undertaken. This adjustment process must be gradual. Some types of insulin that can be used, including:
Getting treatment for diabetics can use a combination of the types of insulin at the top.
- Long-acting insulin that can last one day.
- Short-acting insulin that can last up to eight hours.
- Rapid-acting insulin that does not last long, but reacted quickly.
Transplantation of pancreatic cells that produce insulin (islet cells) may also be able to help some people with diabetes type 1. In this process, islet cells from those taken from deceased donors will be entered into the pancreas of diabetics 1.
Islet transplantation is effective to reduce the risk of severe hypoglycemia. Hypoglycemia is a condition where blood sugar levels fall too low. This condition is as dangerous as blood sugar levels are too high. But although there are countries that have implemented islet transplantation, many diabetics are reluctant to go through because the risks are quite high.
Brought to Diabetes Complications
Kagar high blood glucose can cause damage to blood vessels, nerves, and organs. Therefore, diabetes can lead to complications if not controlled properly. Increased blood sugar levels are not significant and does not trigger the symptoms can lead to long-term impact.
Healthy and balanced diet and regular exercise is proven to reduce blood sugar levels in diabetics. Quitting smoking also often can reduce the risk of heart disease complications.
Emerging Diabetes in Pregnancy
Diabetes also often affect pregnant women. Women who are pregnant also sometimes have blood sugar levels were very high during pregnancy, so the body can not produce enough insulin to absorb it.
This type of diabetes known as gestational diabetes generally develops in the second trimester and disappears after the baby is born. Diabetes can occur in approximately two out of 100 women who became pregnant. For women with type 1 diabetes, pregnancy may worsen their condition.
People with type 1 diabetes who become pregnant also have a higher risk for complications, especially on the health of the fetus. Because it is very important for people with diabetes who are pregnant to keep blood sugar levels steady.
Symptoms of Type 1 Diabetes
Common symptoms of diabetes are similar to Type 1 and Type 2 are:
While the symptoms of type 1 diabetes are:
- Frequent urination, especially at night.
- Often thirsty.
- Often tired.
The symptoms of type 1 diabetes can develop rapidly within a few weeks or even days. If patients experienced vomiting and breathing in heavy, meaning the condition of diabetes are at a dangerous stage and immediately see a doctor.
- Often feel hungry.
- The itching and yeast infections in the vagina or penis.
- Loss of weight and muscle mass.
- Blurred vision due to changes in shape of the lens in the eye.
- Skin infections.
Blood Sugar Levels Too High (hyperglycaemia)
Blood sugar levels that are too high (hyperglycemia) may occur due to the production of insulin in the body stopped or not enough so there is no insulin to move glucose from the blood into the cells which in turn is processed into energy.
Hyperglycemia symptoms similar to diabetes, but it usually occurs suddenly with a high severity. Among them:
If left untreated, hyperglycemia can cause a serious condition in which the cells of the body will turn to fat and muscles as an alternative energy source. This can lead to diabetic ketoacidosis which then triggers increased levels of acid in the blood and lead to people vomiting, dehydration, loss of consciousness and even death.
- Dry mouth.
- Feel very thirsty.
- Sleepy.
- Blurred vision.
- Frequent urination.
- Dizzy.
Levels Too Low Blood Sugar (Hypoglycemia)
In addition to high blood sugar levels, people with diabetes may also experience blood sugar levels are so low is called hypoglycemia. This condition can be caused by several factors, but mostly because of insulin in the body move glucose from the blood too much.
Most cases of hypoglycemia caused by the side effects of excessive use of insulin. This condition can also occur as a result of forgetting to eat, exercise and physical activity are too heavy, or drink alcohol on an empty stomach.
The symptoms of hypoglycemia are:
it simple way to deal with foods or sugary drinks. If left untreated, hypoglycemia may adversely affect the brain and lead to:
- Heart palpitations.
- Trembling.
- Sweating.
- Quick emotion.
- Limp.
- A tingling sensation on the lips.
- Nausea.
- Hungry.
To deal with the above symptoms, you need an injection of the hormone glucagon which can increase blood sugar levels as soon as possible.
- Rasa daze.
- Blurred vision or double look.
- Slurred speech.
- Loss of consciousness.
The patients with type 1 diabetes who are planning to fast also expected to be always wary because it had a risk of hypoglycaemia. This condition usually occurs in the afternoon before iftar and particularly in elderly diabetics.
If you experience symptoms of hypoglycemia as described above, diabetics are encouraged to immediately break the fast by drinking sugared water, such as syrup or sweet tea, then eat rice as usual.
Soon Search Assistance Medical Assistance
People with diabetes should seek immediate medical help if you experience:
Causes of Type 1 Diabetes
- Breath smell like fruit.
- Nausea or vomiting.
- Loss of appetite.
- Stomach ache.
- High fever.
When eating, your digestive system will destroy the food and deliver nutrients into the blood. Then pancreas is behind the stomach to produce insulin that would move glucose from the blood into body cells which will then convert it into energy.
But the pancreas belongs to type 1 diabetics can not produce insulin which controls blood sugar levels so that glucose can not be moved from the blood to the body's cells.
Type 1 diabetes is an autoimmune condition. In general, the human immune system works to fight and destroy anything that is considered to be foreign or dangerous. In the case of type 1 diabetes, the immune system has mistakenly attacks the cells in the pancreas and insulin production stops. This is because the immune system thinks the pancreas cells that harm the body.
Triggers the immune system reaction against the cells of the pancreas is not known for certain, but there are few studies that suspect the cause is probably due to hereditary factors or viral infection.
A person's risk of developing this disease would be a little higher if there is a nuclear family (mother, father, or sibling) who suffer from type 1 diabetes, while those who do not have families who suffer from type 1 diabetes have a very small risk.
Diagnosis of Type 1 Diabetes
Early diagnosis of diabetes is very important so that treatment can be done immediately. If you experience symptoms of diabetes, it is advisable to consult a doctor as soon as possible.
Urine Test for Determining Blood Glucose and Glucose Content
Regular doctor will ask you to undergo a urine test and a blood test. Your urine sample will be tested to check the content of glucose. Normal urine contains no glucose (diabetes), but the substance will accumulate and flow to the kidneys and urine if you are suffering from diabetes. Doctors also usually will check whether there is the content of ketones (compounds that indicate diabetes type 1) in your urine.
If there is glucose in the urine, you will normally be advised to undergo a blood test to confirm the diagnosis of diabetes. Your blood samples are generally taken twice, namely glucose fasting and two hours after a meal.
Blood samples for fasting glucose test will be done in the morning after you fast for a maximum of 12 hours. You will then be given a drink containing sugar that has been determined.
Exactly two hours later, a blood sample is taken you will come back for a glucose test in order to evaluate the activity of insulin in the body.
Treatment of Type 1 Diabetes
Diabetes can not be cured. Treatment of diabetes aims to keep blood sugar levels and control the symptoms to avoid complications that may occur.
Step Treatment with Insulin
Pancreas organ in the body type 1 diabetics do not produce insulin, so patients must receive insulin supply from outside every day. Insulin is very important because it serves to balance blood sugar levels. Levels that are too high and the low could result in serious damage to organs. There are several types of insulin that can be used. Among them:
Treatment for people with diabetes may use a combination of the types of insulin at the top.
- Rapid acting insulin whose effects do not last long, but reacted quickly.
- Short-acting insulin whose effects can last up to eight hours.
- Long acting insulin whose effects can last up to a day.
Insulin by injection
Administration of insulin by injection is the most common. This method is chosen because if taken in tablet form, insulin will be digested in the stomach as food and could not get into the blood.
In the early stages of use, the doctor will usually help you to inject insulin. Then you will be taught how to inject insulin and store and dispose of needles safely.
There are two methods typically used to give insulin injections, namely through a needle and syringe or pen. Diabetics generally requires two injections per day. The doctor or nurse also teaches how to use the usually close friends or family.
Insulin pump therapyMonitoring Blood Sugar Levels
Another alternative is to inject insulin with insulin pump. Tools insulin container is small. Complete small tube with a needle on the end will connect the pump to your body. The needle is usually inserted into the body through the stomach, but there also were put through the hips, thighs, buttocks, or arms.
These pumps will deliver insulin into the bloodstream at a dosage that can be set so you do not need to make insulin injections again. But you still have to be vigilant and monitor blood sugar carefully to ensure you receive the right dose of insulin.
Insulin pumps are very practical and can be used by people with type 1 diabetes adults, adolescents and children (with adult supervision). But not everyone is fit to use it. These pumps are usually recommended for diabetics who experience frequent hypoglycemia (low blood sugar). This tool is also not widely used in Indonesia because the price is expensive.
Keeping blood sugar levels to remain balanced
The main goal of diabetes treatment is to maintain blood glucose balance. You can do this with insulin treatment and diet, but to ensure normal blood sugar levels, you need checking blood sugar levels regularly. Some of the factors that can affect your blood sugar levels are:
- Stress.
- The frequency and intensity of exercise.
- Other diseases such as colds or coughs.
- Taking the other drugs.
- Consumption of liquor.
- Changes in the amount of hormones during menstruation.
Examination of their own blood sugar levels can be done through a simple blood test with a small prick on the finger. This test is generally recommended for people with diabetes. You may need to do as much as four times or more a day. Type of insulin medication that you live will affect the frequency of tests required. The doctor will also explain about the ideal blood sugar levels.
Normal blood glucose dose is:
- 80-100 mg / dL before meals.
- 80-144 mg / dL after meals (checked exactly two hours after eating).
Milligrams / deciliter (mg / dL) is a unit of blood sugar levels that are used in general in Indonesia. You should therefore be careful and make sure the unit first time to purchase a blood glucose test.
Examination of blood sugar levels regularly
In addition to self-monitoring is done every day, you are recommended to undergo blood sugar levels every 2-6 months. This process will show balance your blood sugar levels as well as the effectiveness of your treatment type.
Other investigations are HbA1c tests. These checks are different from the fasting glucose test and after meals that show the blood glucose concentration when measured alone. These tests will illustrate the control of blood glucose concentration within two to three months.
When the body is processing glucose, glucose in the blood is automatically attaches itself to hemoglobin. The higher the blood sugar levels, the more hemoglobin linked with glucose and this is called a hemoglobin HbA1c. HbA1c test measures the amount of hemoglobin that contains glucose. Figures HbA1c indicates high blood sugar levels are high so that your treatment may need to be changed.
Hyperglycemia (Blood Sugar is Too High)
Blood sugar levels that are too high (hyperglycemia) can occur for several reasons, such as eating too much, deteriorating health conditions, or insulin dose is lacking. Adjustment of diet or insulin dose will be needed people with diabetes who have hyperglycemia. The doctor can also help you to find the best compromise.
Untreated hyperglycemia can lead to serious complications. The body will process the fat and muscles as an alternative energy source as well as increasing acid levels in the blood (diabetic ketoacidosis).
Diabetic ketoacidosis is very dangerous and can lead to the patient is dehydrated, vomiting, loss of consciousness and even death. Therefore, patients with diabetes who have hyperglycemia should be treated in the hospital. Patients also usually be given a drip to add body fluids, such as saline and potassium.
Hypoglycemia (Blood Sugar is Too Low)
When your blood sugar is too low, you will experience hypoglycemia. This condition can occur in all people with diabetes, but generally occurs in people with type 1 diabetes.
Some of the symptoms of mild hypoglycemia was limp, shivering and hungry. This condition can be overcome by eating foods or sugary drinks, such as carbonated beverages (not the type of diet), sugar, or raisins. Pure glucose in tablet or liquid form can also be consumed to overcome hypoglycemia quickly.
Severe hypoglycemia will lead diabetics to feel dazed, sleepy, even loss of consciousness. Diabetics who experience this condition should be given an injection of glucagon (a hormone that can raise blood sugar levels quickly) directly on the muscle or vein. Doctors usually will teach injection process on your family or close friends.
Loss of consciousness due to hypoglycemia means the possibility of hypoglycemia may recur again a few hours later. Therefore, rest and make sure there are accompanying you. Do not forget to eat sweet foods or drinks when you're sober.
But you will need medical help as soon as possible and glucagon injections again if you still feel drowsy or unconscious for 10 minutes after receiving an injection of glucagon first in the muscles.
Handling the Islet Transplantation
Islet transplantation may also be able to help some people with diabetes type 1. In this process, the islet cells obtained from a donor who had died and transplanted into the pancreas of patients with type 1 diabetes islet cells is the type of pancreatic cells that produce insulin.
Reducing Risk Through Other Treatments
People with type 1 diabetes have a higher risk of complications, such as heart disease, stroke, and kidney disease. Therefore your doctor will probably suggest the following drugs to reduce the risk:
Complications of Type 1 Diabetes
- Statins to reduce high cholesterol levels.
- ACE inhibitor drugs, such as enalapril, lisinopril or ramipril, if there is an indication of diabetic kidney disease. Progression of the disease is characterized by the protein albumin in the urine can be controlled if treated immediately.
- Low-dose aspirin to prevent stroke.
High blood sugar levels can damage blood vessels, nerves, and organs. Therefore diabetes can lead to complications if not properly controlled. Increased blood sugar levels are not significant and does not trigger the symptoms can lead to long-term impact.
Type 1 diabetes and complications Retinopathy
Diabetes can damage blood vessels in the retina (retinopathy). The blood vessels can be blocked, leaky or grow randomly and thus block the light to reach the retina. These complications can lead to blindness if left unchecked.
Your eyes examined regularly every year at the ophthalmologist will assist in detecting early indications that can be addressed immediately. Keeping blood sugar levels will also reduce your risk.
Diabetic retinopathy is detected early can be treated with laser surgery, but this treatment only aims to maintain eyesight and still no cure.
Type 1 Diabetes and Complications Nerve damage (neuropathy)
Excess blood sugar can damage the tiny blood vessels and nerves. This can cause a tingling or burning sensation usually starts from the tip of the fingers and toes, and then spreads to other body parts. The nerve damage or neuropathy that attack the digestive system can cause nausea, vomiting, diarrhea, or constipation.
Type 1 Diabetes and Complications Foot Problems
Something unusual late we are aware, is the damage to the nerves or inhibition of blood flow in the legs can increase the risk of health complications in the legs. If left unchecked, cuts and minor scrapes on the feet of people with diabetes can develop into a serious infection.
Patients who have suffered nerve damage should consult their feet every day and consult on perceived changes to the physician. Complications in the feet that you should watch are:
Complications of Type 1 Diabetes and Heart Disease and Stroke
- Wounds that do not heal.
- Skin that feels hot to the touch.
- Your feet checked by a doctor regularly every year.
Diabetics have five times higher risk of developing heart disease or stroke. Blood sugar levels are not balanced and left long enough will increase the risk of atherosclerosis, the narrowing of blood vessels that usually occurs as a result of the accumulation of cholesterol. This complication has the following risks:
Complications of Type 1 diabetes and kidney disease (nephropathy)
- Obstructing blood flow to the heart and cause an attack of angina (wind seated). Angina attacks indicated the presence of chest pain that feels oppressive.
- Causing a heart attack or stroke because it increases the risk of blood vessel blockage in the heart or brain.
Kidneys have millions of fine blood vessels that filter wastes from the blood. If the fine blood vessels are blocked or leaking, your kidneys will decrease performance.
Severe damage to the kidneys can lead to kidney failure. If you are experiencing kidney failure, you will need dialysis (dialysis) or a kidney transplant.
Type 1 diabetes and complications of Sexual Dysfunction
Diabetes can damage the small blood vessels and nerves. Therefore, the diabetic men (especially those who smoke) may experience erectile dysfunction. These disorders can usually be solved with drugs.
Diabetics can also experience female sexual dysfunction disorders, such as:
People with diabetes are women who experience vaginal fluid deficiency or pain during intercourse can use lubricants or gels .
- Decreased sexual satisfaction
- Lack of sex drive
- Failed to reach orgasm
- Pain during intercourse
- Vaginal dryness
Type 1 diabetes and complications of miscarriage and birth of the Dead
High blood sugar levels can be harmful to mother and baby. The risk of miscarriage and stillbirth increases if diabetic pregnant women is not handled carefully. Blood sugar levels are not maintained properly in early pregnancy the mother may also increase the risk of birth defects .
Pregnant women with diabetes are encouraged to regularly check the condition of their diabetes to the hospital or clinic . This will facilitate the regular consultation the doctor to monitor blood sugar levels of the mother and controlling the insulin dose should be given .
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