Insulin therapy in type 1 diabetes pdf oms,s gravendeel 5 mei 2015,symptoms of hypoglycemia vs diabetes - Try Out

Type 1 diabetes mellitus (sometimes called insulin-dependent diabetes) is a chronic disease that occurs when the pancreas produces little or no insulin.
In 2011 the International Diabetes Federation estimated more than 350 million people worldwide suffered from diabetes and expected an increase to more than 550 million people by 2030. Insulin replacement by needle injection and subcutaneous pumps has had a huge impact on extending the lives of millions of patients with diabetes. Pancreas transplantation has resulted in insulin independence in most patients during the first year after transplant, but it is also associated with a risk of complications from surgery, as well as long-term immunosuppression treatments. Another option is transplanting just the cells in the pancreas that produce insulin, which is much less invasive as procedures go (injection of cells under portal vein under local anesthesia).
Gene therapy on the other hand looks to insert a properly functioning version of the insulin producing gene back into your own cells. Work in this area over the last decade has produce some very promising results in reprogramming liver, gut, and pancreatic cells into insulin producing cells. Callejas D, Mann CJ, Ayuso E, Lage R, Grifoll I, Roca C, Andaluz A, Ruiz-de Gopegui R, Montane J, Munoz S, Ferre T, Haurigot V, Zhou S, Ruberte J, Mingozzi F, High K, Garcia F, Bosch F. The major advantage of carb counting is that it gives flexibility to eat a meal or snack when ever you wish and gives a freedom to choose any food you like. The carbohydrate content of a meal is quantitatively a determining factor of the mealtime insulin doses. Initially carbohydrate counting and insulin dose calculation may sound like a difficult task. The good news is that the technology for the management of type 1 diabetes is moving fast and is making living with type 1 diabetes a lot easier.
At ACE diets we can help you to learn the differences between carbohydrate counting and general diabetes control. Effective diabetes management requires regular blood sugar testing to check the levels of glucose in the blood.
Blood glucose meters, diabetes test strips and insulin delivery equipment are an integral part of insulin therapy and become a part of the normal routine. Type 1 diabetes is caused by a loss or malfunction of the insulin producing cells, called pancreatic beta cells.
It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes. There are many different insulins for many different situations and lifestyles, and there are more than 20 types of insulin sold in the United States. Insulin may be taken by means of a shot (often several times a day), or infused through catheter (a small needle) attached to an insulin pump.
It is important for anyone with diabetes to be careful about the type, timing and amount of food they eat.
Lastly, it is important to note that individuals that receive a pancreas or islet transplant must take immunosuppressive medications as long as the pancreas or islets are functioning.
In type 1 diabetes the pancreas no longer produces insulin (or at least not a significant amount) therefore the primary type 1 diabetes treatment consists of giving the body insulin as closely as we can to the way the body would do it naturally. There is no one right way to manage diabetes, since many different types of insulin treatment can successfully control blood sugar levels.  The type of insulin treatment varies from person to person, and can depend on many individual factors – including age and life style.
Many type 1 diabetics have what is called a ‘honeymoon’ period for the first few months (or even year) after being diagnosed. Over time, people with type 1 diabetes usually learn to adjust their own insulin dose, although you will need help from time to time.
There are a few types of insulin, which can be used alone or in combination in order to treat type 1 diabetes. There are two general types of insulin treatment plans: intensive insulin treatment and standard (conventional) insulin treatment. Intensive insulin treatment — Intensive insulin treatment is best for keeping blood sugar in tight control. Intensive insulin therapy is recommended for most people with type 1 diabetes because it gives you the best chance for successful blood sugar control, and it is best to start it as soon as possible.
The drawback to intensive insulin control is that you might experience a higher rate of low blood sugars (hypoglycemia) and it is about 3 times as expensive as standard insulin treatment. Intensive insulin therapy usually entails a long acting insulin (like glargine or detemir) that is used as a basal insulin, and an additional rapid insulin (lispro, aspart, or glusine) every time you eat.
The Diabetes Media Foundation is a 501(c)(3) tax-exempt nonprofit media organization devoted to informing, educating, and generating community around living a healthy life with diabetes.
Type 1 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood. Researchers are testing ways to delay or prevent the onset of Type 1 diabetes, a disease that requires intensive, lifelong management.
Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. For other people, these serious warning symptoms may be the first signs of type 1 diabetes. Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Because type 1 diabetes can start quickly and the symptoms can be severe, people who have just been diagnosed may need to stay in the hospital.
If you have just been diagnosed with type 1 diabetes, you may need to have a checkup each week until you have good control over your blood sugar.
By testing your blood sugar level, you can learn which foods and activities raise or lower your blood sugar level the most. The American Diabetes Association and the American Dietetic Association have information for planning healthy, balanced meals. Checking your blood sugar level yourself and writing down the results tells you how well you are managing your diabetes.
Get a foot exam at least twice a year with your doctor, and learn whether you have nerve damage. With type 1 diabetes, you are also at risk of developing conditions such as hearing loss, gum disease, or yeast infections (in women). The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. About type 1 diabetes Around 2.6 million people in the UK have been diagnosed with diabetes.
People with this form of diabetes require injections of insulin every day to control the glucose levels in their blood, or they will die.
Type 1 diabetes accounts for approximately 5% of all cases of diabetes and it is estimated that 78 000 children develop type 1 diabetes every year.
This solution is not ideal however, as it still typically means a reduced lifespan, intensive disease management, and a high likelihood of developing debilitating complications. Considered a highly effective therapy inducing sustained insulin independence or reduced insulin requirements in most patients. A group in Spain last month reported they replaced two genes to cure a dog of type 1 diabetes using a similar approach.


Treatment of Diabetes and Long-term Survival Following Insulin and Glucokinase Gene Therapy.
For people with Type 1 Diabetes, blood glucose control is best achieved by matching rapid acting insulin dose directly to the amount of carbohydrate consumed; this method is called Carbohydrate Counting. Find your individual “correction factor” – extra units of insulin to correct a high blood glucose level that is above your personal targets. However, you will gradually become more familiar with the process and it will eventually become second nature. If you are using insulin pump therapy, you are probably already using the bolus calculators built into most pumps. The randomized and non-randomized studies have shown the efficiency of Insulin Pump Therapy across all age groups.
We are experts in advising people with multiple daily injection therapy (MDI) as well as those on insulin pump therapy (CSII).
As Wikipedia notes: Patients with Type 1 diabetes depend on external insulin for their survival because the hormone is no longer produced internally. The usual schedule for checking blood glucose through fingersticks and administering insulin is before all meals, and at bedtime. The program will cover the latest developments in kidney transplantation presented by experts in the fields of transplant surgery, nephology, and pathology.
Damage to beta cells results in an absence or insufficient production of insulin produced by the body. Type 1 diabetes an autoimmune disease in which the body views the beta cells (insulin producing cells found in the islets of the pancreas) as a foreign substance, so the patient's immune system attacks the islets and kills them. People with diabetes also need to monitor their bloodsugars carefully through frequent finger prick glucose testing.
The advantages over pancreas transplantation are that it does not require a major operation and the procedure has a small complication rate. Insulin requirements are relatively lower during this time, and when it ends patients insulin needs rise dramatically.
Changes in weight, diet, health conditions (including pregnancy), activity level, emotional states, and work can affect the amount of insulin you need to take in order to control your blood sugar.
Most people with type 1 diabetes meet with a doctor or nurse every three to four months, and review blood sugar levels and insulin doses at these visits, helping to fine-tune diabetes control.
You will need to take 3 or more insulin shots per day or use an insulin pump, and you will need to check your blood sugar frequently.
However, this regimen will be successful only if you are fully committed to it and you have good understanding of the regimen—this means checking your sugars 4 or more times a day. Visiting your doctor is very important so you can monitor any long-term problems from diabetes.
Your doctor will choose the best type of insulin for you and will tell you at what time of day to use it. This helps you adjust your insulin doses to specific meals or activities to prevent blood sugar from becoming too high or too low. People with type 1 diabetes must take special steps before, during, and after physical activity or exercise.
Usually, you prick your finger with a small needle called a lancet to get a tiny drop of blood. This is very important when you already have nerve or blood vessel damage or foot problems. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. The only draw backs to this therapy are the shortage of high-quality donor cells, long-term graft failure, and the risks associated with long term immunosuppression.
I first heard of a group out in BC working on this using gut endocrine stem cells (cells in the lining of your gut that reproduce to form various cell types) back in the early 2000’s. Although the technology requires more testing before human clinical trials can be started, the continued advancements in this technology provide hope for those searching for a cure to diabetes.
If you are on  MDI therapy there are now several blood glucose meters available with a built in mealtime (bolus) insulin calculator for calculating suggested insulin doses which means that it eliminates the need for you to make any mathematical calculations when estimating your mealtime insulin dose. However, to make most of the technology, you also need to know about carbohydrates, how to monitor your blood glucose regularly, how to re-address insulin to carb ratios and about correction factors, how to re-address the adequacy of your background basal rate and use correct strategies for high and low blood glucose.
Guidelines also call for a check 2 hours after the meal to ensure that the meal has been covered effectively. A person with diabetes may experience long term complications if tight blood sugar control is not maintained; likewise, control that is too tight may result in severe hypoglycemic (low blood sugar) reactions. Whole organ pancreas transplant is a major operation and can be associated with complications, such as bleeding, infection, inflammation of the pancreas and clots in the blood vessels around the pancreas.
Nevertheless, islet transplantation can be associated with bleeding, clotting of blood vessels in the liver, or damage to the gall bladder. Standard insulin treatment is an older regimen, although it may still be recommended for selected patients.
This is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. Some types of insulin may be mixed together in an injection to get the best blood glucose control. You and your doctor should set a target goal for your blood sugar level at different times during the day.
The affected limb may need to be amputated if these skin ulcers do not heal or become larger, deeper, or infected. It can develop at any age, but usually affects people before the age of 40, and most commonly during childhood. The idea being that these cells would be able to detect blood glucose levels and then produce insulin responsively. For example, 1 unit of rapid acting insulin may be appropriate for every 10g of carbohydrate in a meal.
Once you have worked out and programmed the information into the meter along with your insulin-to-carbohydrate ratio and correction factors, the rest is then calculated by the meter. Using fasting tests help you learn about your individual background insulin requirements over 24-hour period and allow programming of your pump to your individual needs. On average, I test my blood sugar 5-6 times per day but some days that number may go as high as 9 or 10. The replacement insulin is administered by injection using a syringe or an insulin pump, which delivers the insulin under the skin. With type 1 diabetes, an infection or another trigger causes the body to mistakenly attack the cells in the pancreas that make insulin. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. The group eventually started the company EnGene that now works on a multitude of gene therapy and protein delivery solutions. Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada. Center of Animal Biotechnology and Gene Therapy, Universitat Autonoma de Barcelona, Bellaterra, Barcelona, Spain.


This ratio is individualized from patient to patient, and it may even vary for the same patient at different times of the day.
It is also important to make full use of the extra features available on your pump, such as temporary basal rates and multi wave and square wave boluses.
The success rate (long-term insulin independence) with pancreas transplantation was initially low, but increased dramatically in the 1980s. The tendency to develop autoimmune diseases, including type 1 diabetes, can be passed down through families.
However, the body needs insulin to absorb glucose from the bloodstream and circulate it to the various cells of the body. Now, its hard for me to imagine having to rely on insulin injections to manage my diabetes. Any duplication or distribution of the information contained herein is strictly prohibited.
Patients will also have to take into account pre-meal blood glucose level and give a correction dose if blood glucose is above the target range.
By the 1990s, more than 1000 pancreas transplants a year were being done worldwide, the majority in the U.S.
The high level of glucose in the blood can cause damage to the vascular system in the heart, liver, kidneys, eyes and nervous system. The correction factor is again individualized to each patient and it may vary at different times of the day. This disease can occur at any age, but more often its development began in childhood.Diabetes type 1 is a disorder of the immune system. Antibodies were supposed to fortify the body from bacteria and viruses even attacking pancreatic and destroys insulin-producing cells (beta cells). As a result, the pancreas can no longer produce insulin for the body.Treatment of diabetes type 1 in the form of regular insulin injections, because the sufferer is no longer able to produce insulin.
However, the amount produced can not meet the body’s need or because body cells do not respond to insulin properly (insulin resistance). Insulin resistance is the most common cause of diabetes type 2.People who are overweight have a greater risk of developing diabetes type 2, as obesity can cause insulin-resistant conditions. Insulin resistance causes blood sugar (glucose) increases, because although the pancreas work harder to produce the hormone insulin still not be able to keep blood sugar within normal levels.Although diabetes can not be cured, people with diabetes can still live a healthy and normal if handled appropriately. This type of diabetes is often difficult to detect because of the hormonal activity is high in pregnant women.
The high level of glucose in pregnancy will affect the baby because glucose also becomes circulated through the placenta and the baby in the womb. Regular consultation with a doctor is needed to diabetes can be detected early.Gestational diabetes usually resolves after giving birth. But having gestational diabetes during pregnancy makes the woman has a high risk of developing type 2 diabetes in the future. Most people think that diabetes is just one disease that occurs due to high sugar levels in the blood.
In the meantime, have not found a medicine that can cure diabetes with certainty, so it can only be prevented and controlled. It can cause you to vomit, breathe faster than usual and have breath that smells of ketones (like pear drops or nail varnish).
However, sometimes we do not realize how important the function of the eye until there is a problem or health problems in the eye.
Diabetic ketoacidosis is a medical emergency and can be fatal if you aren’t treated in hospital immediately. However, the way in which type 1 diabetes first starts isn’t fully understood at present, but it's possible it may be caused by a virus or run in families.
Your GP will arrange for you to have a sample of blood taken from your arm to test for glucose.
You will usually inject yourself before meals, using either a small needle or a pen-type syringe with replaceable cartridges. These may be appropriate if you find it difficult to control your blood glucose with regular injections, despite careful monitoring. Ask your doctor or diabetes specialist nurse for advice on which type and method is best for you.
Smoking is unhealthy for everyone, but it's especially important to stop if you have diabetes because you already have an increased risk of developing circulatory problems and cardiovascular disease.
These are four to five day intensive courses that help you learn how to adjust your insulin dose. This involves regularly taking a pinprick of blood from the side of your fingertip and putting a drop on a testing strip. HbA1C is a protein that is produced when you have high blood glucose levels over a long period of time. The HbA1C test is done by taking blood from a vein in your arm or sometimes a drop of blood from a fingerprick. If you don’t monitor your condition regularly and your blood glucose levels get low, you may become very unwell. It can also be caused if you miss a meal, don’t eat enough foods containing carbohydrate or if you take part in physical activity without eating enough to compensate for it. Another cause can be drinking too much alcohol or drinking alcohol without eating beforehand. You may need to make changes to your meals if you work shifts, or if food isn't readily available. Also, you won’t be allowed to hold a heavy goods vehicle (HGV) licence or be a pilot.
You will need to contact the Driver and Vehicle Licensing Agency (DVLA) to inform them about your condition.
The DVLA will contact your doctor for more information about how your condition is managed and whether you have any complications that might make you unsafe to drive. Carry diabetes identification and a letter from your doctor, and check with the airline you're flying with before you go. Within these groups there are different types of insulin that work at different speeds and for different lengths of time in your body.
These should be injected about 15 to 30 minutes before meals and can last up to eight hours. You will learn to adjust your insulin dose yourself day-to-day so that your blood glucose levels stay stable.




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