I've seen diabetes in dogs and cats in practice as a veterinary technician and it's actually very common. The animals we treated had symptoms similiar to Type 2 diabetics in humans. They presented with symptoms of drinking alot and peeing alot, and most would present overweight. We would test their blood and urine, much like in people and test for glucose and ketones. We then put these animals with a high blood glucose level on insulin twice a day, and also put them on a strict diet, usually a prescription veterinary diet with high fiber and low carbs, and usually low calorie as well.
Up until last year that is what I knew of diabetes not even realizing there were 2 types. I learned about Type 1 very quickly as Hannah was diagnosed with something I knew little about, but knew enough about to sense her symptoms were diabetic related and acted quickly on my instincts.
So first of all.....
What is diabetes?
It is a condition, whether it be type 1 or type 2, which the body cannot use the sugar, from food that is eaten. The body doesn't make(type 1)
or properly use (type 2) a natural hormone produced in the pancreas, called insulin. When you eat, the carbs in your food are broken down into a type of sugar, called glucose, which your body uses for energy. Insulin helps cells throughout the body absorb the sugar from the bloodstream.
If you have diabetes, your body cannot use the sugar, either because it doesnt' make insulin (type 1) or the insulin it makes doesn't work right (type 2).
Since the sugar is not absorbed into the body, it goes into the urine and leaves the body. The cells of the body are not able to use the sugar and begin to starve. Insulin must be given to lower the sugar in the blood and the body is then able to use the sugar for energy.
The two types of diabetes
Type 1 --is also called juvenile onset or insulin dependant diabetes.
With Type 1 diabetes:
* the pancreas stops making insulin. They do not know exactly why this happens, but it an autoimmmune process, the immune system makes a mistake and destroys the insulin making cells in the pancreas, usually diagnosed in children.
* insulin must be given to treat
Insulin is a protein; if taken by mouth it would be digested and therefore not effective. Therefore people with type 1 require insulin injections daily.
Type 2--is also called adult onset or non insulin dependant diabetes
With Type 2 diabetes:
* the pancreas produces insulin, but the insulin doesn't work properly in the body. They are resistant to the insulin they do make. Often people with Type 2 can control their blood sugars with oral medication, exercise and diet changes. A combination of these 3 can help the pancreas make more insulin and help it work better in the body.
If the pancreas still cannot keep up with the high insulin demands, insulin injections may be needed.
* there are risk factors for type 2 that people can control, unlike type 1, which is an autoimmune attack on the pancreas keeping it from producing insulin at all.
These high risk lifestyle factors associated with type 2, include inactivity, and a high fat, high sugar diet. A person can reverse a type 2 diagnosis, by changing their diet and exercise but with type 1, it is an immune response and is not reversable, and insulin injections are needed for a lifetime.
Causes of Type 1
Type 1 sometimes runs in families, however, the majority of people diagnosed have no close relative with type 1 diabetes. It is NOT caused by eating or drinking too much sugar. Sometimes an illness where the immune system is surpressed, such a a cold or the flu can make the symptoms of diabetes more obvious. There is nothing you can do to stop Type 1 diabetes from developing.
People with type 1 develop anitbodies to the insulin producing cells in the pancreas. These antibodies signal that those cells are being destroyed. They do not know why these antibodies appear. They do know that replacing insulin usually produced in the body with insulin injections will help the body use food for energy and stay healthy.
What are carbohydrates ?
Carbohydrates (carbs) are a component of food. Starch and sugar are carbohydrates. Starch is in breads, pasta, cereals, potatoes, beans, and peas. Natural sugars are in fruits, milk and vegatables. Added sugars are in desserts, candy, jams, and syrups. All carbs eaten are converted to a type of sugar in the blood called glucose. Glucose supplies your body with energy. Your body needs insulin to use this energy.
With type 1 diabetes it invloves carb counting, in type 2 it involves limiting sugar and fat in the diet which helps the insulin they do produce work more efficiantly in the body.
Carb counting is a process of adding up the carbohydrate content of a meal or snack, and using that total with a insulin ratio (a dose prescribed by a doctor) to calculate the insulin dose for each meal or snack. Because there is no insulin being produced at all in the body, type 1 diabetics have to be precise in gaining control of their blood sugars and what they eat vs how much insulin they get. Carbs are the main source of high blood sugars in type 1 diabetics.
For all people, including type 1 or 2 diabetics, a healthy diet is important. Avoiding sugar/carbs and too many empty calories is just a healthy way to live. With Type 1 however, since they need insulin for everything they eat to keep their blood sugar in range, the carbs in sweets and things with alot of fat and sugar, should be avoided if possible, however cookies, candy, cake, etc are all calculated into their insulin vs carbs ratio before they even consume the carbs or sugars, and they are covered with an insulin injection based on the carbs in the item.
There are sugar free cookies and candy, and things that can be made without sugar using a sugar substitute, but the carbs involved in all, are still high at about 20-30 grams,(based on size) which also would raise a type 1's blood sugar drasticly even without the added sugar involved. Calculating carbs vs insulin is what keeps a type 1 diabetics blood sugar under control. Both types need frequent blood glucose testing, but with type 1, it is about every 3 hours, after the rapid acting insulin in the blood is no longer effective. Testing is right away in the morning, at every meal or snack at bedtime, and sometimes during the night.
Type 1 Insulin:
Lantus, basil insulin:
a long acting insulin that is given once a day, at the same time every day, and is meant to meet the metabolic needs of the body, helping keep blood sugars steady over 24 hrs.
Novalog, bolus insulin:
is given whenever carbs are eaten and lasts in the body about 3 hrs. The blood sugar will start to rise within 10 minutes, of eating and short acting insulin is needed at this time to allow the body to use the glucose for energy and bring the sugar back down to target range. The meal bolus is described as units of insulin per total grams of carbs. Meal boluses vary from person to person, and may even vary meal to meal at different times of the day. The basic guideline in treating type 1 is to cover all carbs all the of the time with the meal bolus ( which is the carbs vs insulin ratio determined for each person).
Correction bolus:
using the Novalog, a correction bolus is needed when the blood sugar is high at a time when it's not expected-- in the morning, before meals, or overnight. It is a predetermined scale to give a extra dose of insulin to bring the blood sugar back into target range, also may include a meal dose added to the correction.
Are you overwhelmed yet?
I hope that I have given you a better understanding of diabetes and what we as Hannah's parents and Hannah have to deal with daily. Insulin is not a cure, only a treatment to keep her body going every day. Some days are a stuggle, but every day we a just thankful for having Hannah with us.
Letters will be going out in October sometime, so stay tuned for our upcoming JDRF Walk to Cure Diabetes (Juvenile Diabetes Research Foundation) we will be participating in this year at the Mall of America, on February 27, 2010.
We have a team started called "Hannah's Hopeful Hearts". To register to walk with us and help to raise money for a cure go to-- www.jdrf.org, and type in Hannah Emery or our team name and we'd be honored if you join us in the walk.
The walk lasts about an hour and includes over 15,000 people fighting for a cure.
If you can't be there to walk, please consider a donation to the JDRF, for team Hannah's Hopeful Hearts, and that can be done, either online or it can be mailed to us and we will personally deliver it on walk day. No fundraising is necessary to walk, but if you raise $100 for JDRF and walk with us you will recieve a t-shirt.
Questions email me: ssbh.emery4@hotmail.com
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