Diabetes: Type 1
DescriptionAn in-depth report on the causes, diagnosis, and treatment of type 1 diabetes.
Alternative NamesInsulin-dependent Diabetes Mellitus; Juvenile Diabetes
Glucose (Blood Sugar) Levels
Both hypoglycemia and hyperglycemia are of concern for patients who are receiving insulin. It is important, therefore, to monitor blood glucose levels carefully. In general, patients with type 1 diabetes need to take readings four or more times a day. Patients should aim for the following measurements:
Different goals may be required for specific individuals, including pregnant women, very old and very young people, and those with accompanying serious medical conditions.
Finger-Prick Test. A typical blood sugar test includes the following:
Home monitors are about 10% to 15% less accurate than laboratory monitors are and many do not meet the standards of the American Diabetes Association. Many experts believe, however, that most are accurate enough to indicate when blood sugar is too low.
Some simple procedures may improve accuracy:
Less Invasive or Noninvasive Tests. A number of noninvasive or less painful tests are on the market or under investigation. The following are some examples:
Hemoglobin A1c (HbA1c), or glycated hemoglobin, is measured periodically to determine the average blood-sugar level over the life span of the red blood cell, which is about eight to 10 weeks. In general, measurements suggest the following:
Home tests (DRx, Metrika A1c Now) are available for measuring HbA1c that may allow even better monitoring of glucose levels. Metrika A1c Now is now sold over the counter.
Urine tests are useful for detecting the presence of ketones, which should always be performed during illness or stressful situations, when diabetes is likely to go out of control. The patient should also undergo yearly urine tests for microalbuminuria (small amounts of protein in the urine), a risk factor for future kidney disease.
For patients beginning intensive insulin therapy, experts recommend an eye examination when starting treatments and every three months thereafter up to a year.