4.19.3 Lesson: Diabetes, Part I

DIABETES

Part I: Type 1 Diabetes & Gestational Diabetes

Objectives:

G.2 – Students will analyze personal risk factors for diabetes, heart disease, and stroke.

G.5 – Students will identify health-related decisions that contribute to heart disease, stroke, diabetes, and other chronic diseases and conditions.

Diabetes

Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal.  This is also called hyperglycemia.

When you eat your body breaks food down into glucose and sends it into the blood.  Insulin then helps move the glucose from the blood into your cells.  When glucose enters your cells, it is either used as fuel for energy right away or stored for later use.  In a person with diabetes, there is a problem with insulin.  But, not everyone with diabetes has the same problem.

There are different types of diabetes – type 1, type 2, and a condition called gestational diabetes, which happens during pregnancy.  If you have diabetes, your body either doesn’t make enough insulin, it can’t use the insulin it does make very well, or both.

This lesson will cover Type 1 diabetes and gestational diabetes.  Tomorrow’s lesson will cover Type 2 diabetes.

Type 1 Diabetes

In type 1 diabetes, your immune system mistakenly destroys the cells in your pancreas that make insulin.  Your body treats these cells as invaders and destroys them.  This can happen over a few weeks, months, or years.

When enough beta cells are destroyed, your pancreas makes little or no insulin.  Because the pancreas does not make insulin, the insulin needs to be replaced.  People with type 1 diabetes take insulin by injection with a syringe, an insulin pen, or an insulin pump.  Insulin does not come in a pill.  Without insulin, your blood glucose rises and is higher than normal, which is called hyperglycemia.

Type 1 diabetes affects about 5% of people in the United States with diabetes.  In the past, type 1 diabetes was called juvenile diabetes or insulin-dependent diabetes.  It is usually first diagnosed in young people but it can occur at any age.  Type 1 diabetes is much less common than type 2 diabetes.

Scientists aren’t sure what causes type 1 diabetes.  It is not contagious and it is not caused by eating sugar.  Research is under way to find the exact causes of type 1 diabetes and how it might be prevented.

Diabetes can affect how you feel each day.  If your blood glucose level is too high or too low (hypoglycemia), you may not feel well.  Keeping your blood glucose in a target range will help you feel your best.

People with type 1 diabetes must take insulin several times a day to keep their blood glucose under control. You also need to check blood glucose regularly and use the information to adjust the amount of insulin you are taking.

Treatments

The two goals of diabetes treatment are to make sure you feel well day-to-day and to prevent or delay long-term health problems.  The best way to reach those goals is by:

• Taking insulin
• Planning your meals—choosing what, how much, and when to eat
• Being physically active

Risk Factors

Some known risk factors for type 1 diabetes include:

• Family history.  Anyone with a parent or sibling with type 1 diabetes has a slightly increased risk of developing the condition.
• Genetics.  The presence of certain genes indicates an increased risk of developing type 1 diabetes.
• Geography.  The incidence of type 1 diabetes tends to increase as you travel away from the equator.  People living in Finland and Sardinia have the highest incidence of type 1 diabetes — about two to three times higher than rates in the United States and 400 times the incidence among people living in Venezuela.
• Age. Although type 1 diabetes can appear at any age, it appears at two noticeable peaks.  The first peak occurs in children between 4 and 7 years old, and the second is in children between 10 and 14 years old.

Many other possible risk factors for type 1 diabetes have been investigated, though none have been proved.  Some other possible risk factors include:

•         Exposure to certain viruses, such as the Epstein-Barr virus, Coxsackie virus, mumps virus and cytomegalovirus

•         Early exposure to cow’s milk

•         Low vitamin D levels

•         Drinking water that contains nitrates

•         Early (before 4 months) or late (after 7 months) introduction of cereal and gluten into a baby’s diet

•         Having a mother who had preeclampsia during pregnancy

•         Being born with jaundice

Gestational Diabetes

Gestational diabetes develops during pregnancy (gestation).  Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose).  Gestational diabetes causes high blood sugar that can affect pregnancy and the unborn baby’s health.

Any pregnancy complication is concerning, but there’s good news. Expectant moms can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication.  Controlling blood sugar can prevent a difficult birth and keep the mother and baby healthy.

In gestational diabetes, blood sugar usually returns to normal soon after delivery.  But if a woman had gestational diabetes, she is at risk for developing type 2 diabetes.

Risk Factors

Any woman can develop gestational diabetes, but some women are at greater risk.  Risk factors for gestational diabetes include:

•         Age greater than 25.  Women older than age 25 are more likely to develop gestational diabetes.

•         Family or personal health history.  The risk of developing gestational diabetes increases if the woman has pre-diabetes — slightly elevated blood sugar that may be a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes.  She is also more likely to develop gestational diabetes if she had it during a previous pregnancy, delivered a baby who weighed more than 9 pounds (4.1 kilograms), or had an unexplained stillbirth.

•         Excess weight.  A woman is more likely to develop gestational diabetes if she is significantly overweight with a body mass index (BMI) of 30 or higher.

•         Nonwhite race.  For reasons that aren’t clear, women who are black, Hispanic, American Indian, or Asian are more likely to develop gestational diabetes.

As in the previous lessons in this module, you will identify and list your risk factors for diabetes and answer questions related to your own risk factors.