Type 1 diabetes (T1DM) is an autoimmune condition where the immune system destroys the cells of the pancreas that make insulin. Without insulin the body is not able to clear sugar from the blood, and so prior to the discovery of injectable insulin type I diabetes was almost always fatal. Thankfully, we now have multiple types of injectable insulin which allows people living with Type I diabetes to live perfectly normal lives. There are even notable athletes like Brett Stewart and Steve Renouf who have managed their type I diabetes while forging successful NRL careers.
People with Type I diabetes work with a range of health care professionals to develop an appropriate insulin regime, diet, and lifestyle to maintain their blood sugar within a normal range (typically 4-8mmol/l).
The healthcare team usually includes:• GP
• Endocrinologist
• Diabetes Educator
• Dietitian.
What are the treatment goals with Type 1 Diabetes?
One of the primary goals with T1DM management is to prevent hyperglycaemia (high blood sugar) and hypoglycaemia (low blood sugar) as each of these have their own risks. Hypoglycaemia typically results from excessive insulin, or inadequate carbohydrate intake. This can be a medical emergency as if it drops low enough it can result in coma, and even death.
Hyperglycaemia typically isn’t a medical emergency unless it is for a long time or particularly high. However, over time even moderately high blood sugar can cause serious problems. This is largely because sugar is a comparatively large molecule in our body and so when in high concentrations it can cause damage to small blood vessels, like those in the eyes, feet and kidneys.
Chronic hyperglycaemia can cause:
• Kidney disease
• increased risk of heart attack and stroke
• limb amputations and blindness.
• Nerve damage
• Diabetic Ketoacidosis
It can be a bit of a balancing act keeping blood sugar from being too high or too low and therefore it is important that people living with T1DM engage with a multi-disciplinary healthcare team.
How can our Dietitians help?
The foods that we eat are an important part of managing blood sugar levels in conjunction with an appropriate insulin regime.
Accredited Practising Dietitians (APDs) work with clients with T1DM to:
• Understand what foods contain carbohydrates
• Understand how to count carbohydrates
• Choose appropriate carbohydrates
• Develop an individualised nutrition approach to best support long-term health
Developing an appropriate nutrition plan with one of our dietitians is an essential part of managing T1DM, because of this Diabetes Australia recommends that everyone with T1DM sees and APD. Seeing an APD is key, because one diet does not fit all, particularly not those living with T1DM.