Dear Doctors: My fiance, who is 24 years old, was just diagnosed with Type 1 diabetes. Isn’t that something that gets discovered when you’re a child? I can tell he’s not paying close attention to blood sugar control. It’s almost like he’s in denial. What can happen if he doesn’t start being more careful?
Dear Reader: When someone has Type 1 diabetes, it means their body is producing very little insulin or none at all. Insulin is a hormone produced by specialized cells in the pancreas known as islet cells. It is crucial to the metabolic pathway that moves glucose out of the bloodstream and into the cells, where it is used for energy. Without insulin, glucose builds up in the bloodstream. This causes a wide range of health problems, both short- and long-term.
You are correct that Type 1 diabetes is most often diagnosed during childhood or adolescence. In the younger years, it often first appears between ages 4 and 7. A second diagnostic window occurs during adolescence, between ages 10 and 14. However, it is possible for the disease to develop at any point during someone’s lifetime.
The causes of Type 1 diabetes are not yet fully understood, and at this time there is no cure. Instead, the disease must be managed with the use of insulin and other medications, proper diet, regular exercise and lifestyle changes.
Uncontrolled blood sugar is a real danger to health. It can cause both short- and long-term damage to organs, tissues and cells throughout the body. This includes the nerves, kidneys, blood vessels, heart and eyes. That makes it important for anyone living with the disease to take their condition seriously. They need to use every tool at their disposal to keep their blood glucose levels within the normal range and as steady as possible.
High blood sugar activates inflammatory pathways that damage the interior lining of the blood vessels and lead to a buildup of plaque. This puts people living with diabetes at increased risk of developing heart disease and atherosclerosis, which is narrowing of the arteries, and thus of having a heart attack or stroke. That same inflammation also harms the extensive networks of capillaries, which carry oxygen and nutrients to tissues throughout the body. As these tiny blood vessels begin to fail, damage to the nerves, kidneys and retinas in the eyes can occur.
Poor blood flow in both the large and small vessels slows wound healing, can lead to neuropathy and can damage the feet. Otherwise minor injuries, such as a scrape or a blister, can escalate to become a dangerous wound. People with diabetes must also be vigilant about fungal and bacterial infections.
Although worrisome, it’s not unusual for someone newly diagnosed with Type 1 diabetes to get overwhelmed. People often need time to adjust to their new health status, both mentally and emotionally. They also have to learn to navigate the complex logistics of living with the disease. You can urge your fiance to check in with his health care provider, and perhaps also seek counseling and professional emotional support during this difficult transition.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
