Type 1 Diabetes Background

• Type 1 Diabetes occurs predominantly in children and young adults.
• It is formerly known as juvenile diabetes.
• Five percent of people with diabetes are diagnosed with Type 1.
• Having Type 1 Diabetes means one is unable to produce insulin, which is a hormone that the body is dependent upon for obtaining glucose from the bloodstream. Glucose provides to energy to bodily cells.
• Treatment involves insulin therapy which can allow young children to manage the effects of their condition and live a long life.
• It is caused by the body's immune system's destruction of beta cells in the islet tissue of the pancreas which produce insulin.
• Without proper management this can result in dehydration, weight loss, diabetic ketoacidosis (DKA), the breaking down of fat cells creating ketones. This causes extra glucose and acid buildup.

Dietary Guidelines for Type 1 Diabetics

• Limit abundant amounts of fat and carbohydrates in diet. Carbohydrates should be limited to 45-60 grams per meal.
• A ratio of 55:20:25 of carbs:fats:protein is ideal.
• Limit protein servings to less than six ounces with each meal
• Optimal diet includes maximum nutrition which limits sugar, carbohydrates, and sodium
• Vegetables that contain low amounts of carbohydrates but are plentiful in vitamins, minerals, and fiber are beneficial (ex. beets, carrots, tomatoes)
• Whole grains over refined and whole fruit juice are preferred because they are nutrient dense carbohydrates with fiber that do not raise blood sugar levels
• Eating smaller meals and progressively snacking throughout the day can make your blood sugar easier to monitor and prevent levels from peaking

How Do You Monitor Blood Sugar Daily and Long Term Including A1C

• To monitor blood sugar daily one can use a blood sugar monitor. It is the main tool for evaluating diabetes control along with keeping a log of your results
• The steps for checking your blood sugar with a monitor are: 1. Insert a test strip into the meter, washing hands prior to this 2. Get a drop of blood from the side of your fingertip with the lancing device 3. Touch and hold the edge of the test strip to the drop of blood, and wait for the result. 4. The blood glucose level will appear on the meter's display.
• Blood glucose targets are individualized based on factors such as how long an individual has had diabetes and their life expectancy.
• Target A1C is 7%
• Before a meal preprandial plasma glucose should be 80–130 mg/dl
• 1-2 hours after beginning of the meal (Postprandial plasma glucose) should be less than 180 mg/dl
• A blood sugar monitor should be used two to three times daily to monitor blood glucose levels

Lifestyle and Exercise Information

• Exercise is vital to type 1 diabetes treatment. It helps manage diabetes and prevent long-term complications by controlling blood glucose levels along with the traditional effects of exercise such as lower blood pressure, weight control, muscle growth, stronger bones, and energy gain.
• Prior to starting a new exercise regimen a full physical should be done to determine if an individual is ready to be more active.
• A good balance of aerobic, strength training, and flexibility work is necessary and completing thirty minutes of exercise training.
• If blood glucose level is less than 100 mg/dl before you commence your exercise activity, one should eat a small carbohydrate snack to increase blood glucose and reduce risk of hypoglycemia.
• Do not engage in vigorous in strenuous activity if ketones are found in your urine.

Personal Stories

Jack Fitzpatrick Jack Fitzpatrick, AFL player, living with type 1 diabetes

Jack Fitzpatrick is living proof that you can achieve anything you want when living with diabetes. The 24-year old forward/ruckman for the Melbourne Football Club was diagnosed with type 1 diabetes in June 2012, two weeks shy of his 21st birthday. The two metre tall man dubbed ‘The Fitz’ made his AFL debut in 2011. He believes that living with type 1 diabetes is an “interesting challenge” but that the right attitude and, in his case, playing footy help to lead a normal life. "It gives you something to look forward to and you don't wallow in self-pity,” says the Demons player. He checks his blood glucose levels during every game at quarter time and half time, making sure he doesn’t develop hypoglycaemia (‘hypo’, caused by low blood glucose levels). If left untreated, hypoglycaemia can lead to serious medical problems including loss of consciousness, convulsions or seizures requiring emergency treatment. He often involves his trainers in his diabetes management and jokes that they help keeping him alive. Since changing to a low carb/high fat diet and after a period of adaption, he was able to reduce his insulin intake. He now only injects long-acting insulin at night, instead of having needles at every meal. This has given him greater flexibility in his diabetes management whilst being able to train fully at high intensity, without losing strength. Jack is well aware of being a role-model for young people living with diabetes. “I really enjoy being able to tell them about my story and that with careful management, they will be able to live a completely normal life,” says Jack. Similar to how professional athletes with diabetes, like Jack, work with a team of coaches, dieticians and exercise experts to achieve certain results, we encourage all people with diabetes to see an Accredited Practicing Dietitian in conjunction with their diabetes team for individualized advice. The needs of each individual with diabetes are different.

Sources

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