Whataya know about Type 1 diabetes?

As a long time insulin user I am curious to learn what people (think they) know about Type 1 diabetes. No lengthy responses, please. Just rattle off one or two things that come to mind.

Dead pancreatic beta cells! IIRC they’re killed off by some sort of autoimmune fluke, not related to diet in any way. No beta cells means no insulin secretion.

Long thought to be the case but new research is pointing to some or all of the beta cells being dormant instead of dead.

https://www.diabetesdaily.com/blog/type-1-diabetics-have-sleeping-insulin-cells-251951/

I still give your response an “A.”

There will not be a cure in any of our lifetimes.

“Smart” insulin is a possibility, and perhaps there will even be a vaccine at some point, but no cure.

Only from the experiences shared with me by my mother, who was diagnosed in her early 30’s and died at 78 of complications.

Her vision got progressively worse at a detail level (i.e. reading) but she could still see to drive. Sometimes had “floaters” caused by small blood vessels in her eye bursting.

It may have made her osteoporosis worse than it otherwise would have been. In her last years she was seriously afraid of falling, even on a carpet, because she was sure to break something.

She injected insulin twice a day (if I am remembering correctly) and tested 3 times using urine.

In the last years of her life she had fairly frequent episodes of passing out (I presume it was insulin shock) and had to be revived by my father with some treatment (glucose injection or something? I never saw it in action). I understood that this left her with a terrible sort of hangover and bad taste in her mouth.

She actually died of a problem with her heart that maybe could have been fixed with a pacemaker, but the problem was not diagnosed in time, possibly disguised by the episodes of insulin shock.

On review, this may not be the sort of thing you were looking for.

I have heard something about a surgically-installed insulin pump of some kind, that could be programmed to provide the right amount of insulin at the right times, rather like one’s original pancreas, but I have no particular knowledge of any details.

There are a few companies racing to create an “artificial pancreas” like you are describing that are not yet available but apparently soon to be on the market. The current pumps are all external and as I understand it (I’m not a “pumper”) deliver a basal dose of insulin constantly but mealtimes require a bolus of fast acting insulin which is controlled by the person wearing the pump.

Being type 1 diabetic doesn’t mean you can’t ever eat sugar or sweets. You just have to balance it and adjust insulin, as needs.

I’m most intrigued by the approaches that seek to make an artificial pancreas out of living cells. This will necessarily have to be impervious to the immune system, but it’s possible to encapsulate cells in a matrix that only lets nutrients and insulin through.

People with Type 1 diabetes can still have sweets!

I have a friend whose daughter has Type 1 diabetes, I have learned a lot. The mother of one of Emily’s classmates brought cupcakes for the whole class on her son’s birthday…except for Emily because the mother “knew” diabetics can’t have sugar. :mad:

“Juvenile” diabetes is a misnomer, because the autoimmune form can actually strike at any age. Type I diabetes that begins in one’s 60s runs in my father’s family. His father had it, two of his brothers, and now his oldest nephew have it.

It is sort of curable, for some people in an unusual situation. A few people who are diabetic, and also in need of a kidney transplant have had a combined kidney/pancreas transplant from the same donor. A pancreas transplant in and of itself is much riskier than life on insulin injections, but if you are going to be on anti-rejection drugs anyway for the kidney transplant, you might as well have a new pancreas.

There are some rare chromosome conditions that interfere with the development of the whole endocrine system. People with these conditions are often diabetic, and have hypothyroidism, due to absence or underdevelopment of thyroid and pancreas. They are usually very short from pituitary dwarfism, unless they receive HGH in childhood.

Home glucometers were a huge breakthrough. Up until they were invented, people followed their diets, took their shots, and prayed. If they felt dizzy or shaky, the ER was the only answer. Now with home glucometers, and different kinds of insulin (fast-acting, medium-acting and slow-acting) it’s pretty rare that a blood sugar crisis can’t be handled at home.

Eat to live.

That is kind of true but it is next to impossible to accurately assess the number of carbohydrates in any particular food and perfectly match up a dose of insulin to balance it. A rough guess is what you have to work with. Additionally the information on food product labels is permitted to be off by as much as 20% in either direction.

I’d like to add that 25 carbs of cupcake, 25 carbs of whole wheat bread and 25 carbs of carrot will have nearly the same effect on someone with T1 diabetes. Our bodies start converting carbohydrates into glucose before they are even swallowed.

They’ve been working on this for a lo-o-o-o-ng time!

A friend of mine died a few months ago- so I’ll contribute this:
Low blood sugar is deceptive. Even if you have had the disease for 30 years, you can get confused about what’s happening when your sugar gets low, and that can be deadly. This was a man who always carried sugar with him.

Yup!

Or maybe there will be.

Hell no! You know me :smiley: That was the one thing that kept me up at night when I was diagnosed - will I ever be able to eat bread again? My family’s chicken dumpling soup? All the wonderful carby things I loooove? I don’t WANT to eat only to live!

Nine years later, I know the answer to “can I eat <x>” is “yup.”

A healthy diet for T1D is the same healthy diet for anyone - eat your bread and sweet stuff but don’t live on it. Eat more vegetables. Exercise.

I’d say overall my diet has changed less than 10% pre-T1 and post-T1, and the changes I’ve made are largely the ones I probably would have changed anyway in the natural process of getting older, because I do keep an eye on my health and weight.

(BTW, 2Bits, fun thread. Thanks for starting it.)

It’s a far more complex disease than anyone could ever imagine, and like type 2 diabetes probably has numerous subtypes.

I’ve been to the Banting Museum in London, Ontario. When the museum was dedicated in the late 1980s, the Queen Mother lit a torch that will be extinguished when a cure is found for diabetes. I don’t see that happening any time soon. :frowning:

And no, it’s not because the pharmaceutical industry is deliberately withholding that cure because they make so much money from diabetics. :rolleyes:

https://en.wikipedia.org/wiki/Banting_House

If you are saying a carb is a carb is a carb, this is not entirely accurate. There are simple carbs (a pack of Skittles) and there are more complex carbs (whole wheat pasta). The simple carbs are converted to glucose much quicker and produce unwanted spikes in blood sugars (often followed by equally unwanted rapid drops).

This is why soda and juice should, really, never be consumed by folks with diabetes (or, really, anyone) unless treating a low blood sugar, in which case they work very well.

Good thread topic, 2Bits.
mmm

The science on this is much less settled than many people realize. (I don’t have time to cite anything right now but I’ll plunge ahead anyway with a response.) 5 grams of any sort of carbohydrate will raise my blood sugar about 30 mg/dl in roughly the same amount if time.

Also, as a T1 diabetic any “rapid drops” in BS are the most commonly related to insulin use (exercise can be another cause). What you are describing up there is more typical of people with type 2 diabetes who have some degree of functioning insulin-producing (beta) cells.