Newly Diagnosed
If you are here at “First 30 Days” it most likely means you or someone your know and probably love, have been diagnosed with Type 1 diabetes. Let us be the first to say, “We’re sorry,” but we are glad you have found your way here. On this page you’ll find the following: The Basic Basics – what you need to know now The Next Layer – information for beyond the initial diagnosis Teaching Type 1 to others – guides for anyone who needs to be in the know Personal stories – written about diagnosis plus additional support for parents The “Type1Day1” film project – what others wish they had known on their Day 1 Online community + support systems in the Beyond Type 1 community The Basic Basics A Type 1 diagnosis is overwhelming – some say like swimming with sharks. These Basic Basics are just that – the basics you need in the first few days of adjusting Type 1. There’s always more in depth information available, but for now, here are our selections for getting out of the hospital or doctor’s office. Continue reading >>
The Patient With Newly Diagnosed Diabetes
Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Diabetes (Diabetes Mellitus) article more useful, or one of our other health articles. The initial management of someone who has just been diagnosed as having diabetes mellitus can have a big effect on the course of the illness. It is essential to establish a clear understanding of the disease, the benefits of all aspects of management and to allay unnecessary fears and myths quickly. See also the separate Management of Type 1 Diabetes and Management of Type 2 Diabetes articles. Assessment Indications for hospital referral at initial presentation include: Children and young people presenting with suspected diabetes should always be referred urgently, on the same day, for admission to hospital for initiation of insulin therapy. Adults who are clearly unwell, or who have ketones in their urine, or who have a blood glucose level greater than 25.0 mmol/L, should also be referred urgently for admission to hospital on the same day. Those who present with diabetic ketoacidosis or hyperosmolar hyperglycaemic state will require immediate treatment in hospital. Young adults (aged under 30 years) should also be referred to a specialist diabetes team. Clinical examination and investigations Measure height and weight, and calculate body mass index (BMI). Urinalysis: ketones and proteinuria. Arrange midstream specimen of urine (MSU) if protein is present. Identify any long-term complications of diabetes already present: Cardiovascular assessment, including smoking status, blood pressure, lipids and ECG. Examine feet for diabetic complications, including cardiovascular disease, diabetic neuropathy Continue reading >>
Newly Diagnosed T1d
TrialNet partners with the Immune Tolerance Network on the EXTEND study which is aiming to preserve insulin production in people newly diagnosed with type 1 diabetes. Please visit www.extendstudy.org for more information. Continue reading >>
Newly Diagnosed With Type 1
Tweet We know there’s a huge amount to take in when you’re newly diagnosed with type 1 diabetes so we’ve put together this guide to help make sense of it all. Contained within this guide are links to some of our most important guides which help to get you in control of your diabetes from today. Coming to terms with diabetes A diagnosis of type 1 diabetes is usually a big shock and some of us wonder how we’re going to cope with the condition. Diabetes can be a struggle to come to terms with and we each will come to terms with having diabetes in our own way and at own pace. Some of us may adjust quickly, but for many of us it can take years to truly come to terms with this important part of our lives. Read more on coming to terms with a diagnosis of diabetes You may wish to consider joining the Diabetes Forum as this is a great source of support - not only during your diagnosis, but also for when you wish to ask questions and share your experiences. Having diabetes One of the questions which often strikes us around the time of diagnosis is what effect diabetes will have on our daily lives? Will it prevent us from taking part in activities? Will it affect our present or future career? Will we have diabetes for life? Read answers to all of these questions and more in our guide to having diabetes Getting to grips with injections and blood tests Some of us adjust to injections and blood tests better than others. Although in reality, injections and blood tests are a pain for us all. Blood testing guides Blood glucose testing is the main way you will be able to identify what your blood glucose levels are. You will most likely be given a blood glucose meter by your doctor or healthcare team. If you are new to blood glucose testing, the following guides will prove useful. Continue reading >>
Top Ten Tips For People Newly Diagnosed With Type 1 Diabetes
Twitter summary: Top 10 tips for the newly diagnosed with t1 #diabetes – know that it will NOT hold you back Know that type 1 diabetes will NOT hold you back. Type 1 patients have climbed Mount Everest, completed Ironman Triathlons, and competed at the highest levels of professional sports. These include Charlie Kimball – the first driver with diabetes to win a race in the IZOD IndyCar Series, Missy Foy, the only runner with diabetes ever to qualify for Olympic Marathon Trials, Olympic cross-country skier Kris Freeman, ballerina Zippora Karz of the New York City Ballet, NFL quarterback Jay Cutler, NBA small forward Adam Morrison, PGA tour golfer Scott Verplank, LPGA golfers Michelle McGann and Kelli Kuehne, Olympic gold medalist Gary Hall, Jr, tennis legend Arthur Ashe, and many more! Think of glucose readings as information and every day as an experiment - A reading of 210 mg/dl or 45 mg/dl should never be thought of as a grade that reflects the quality of your diabetes management. Your glucose meter is your compass and is one of the best tools at your disposal to help manage the disease. Studies show that testing more often is associated with better diabetes control. Exercise is a critical tool at your disposal! It's important to find forms of exercise you enjoy, whether individually or in a group. Remember that people with diabetes tend to be at higher risk for heart disease and depression, and exercise can help with both (see studies that show how exercise has benefits for both heart disease and depression). Exercise also benefits your diabetes control immediately - even something as simple as five minutes of walking can lower your blood glucose quite dramatically. Many patients are fans of activity trackers (e.g., Fitbit, UP by Jawbone, Nike Fuelband, the Moves Continue reading >>
What I Wish I’d Known When My Child Was Diagnosed With Type 1 Diabetes
Oh, the things I would tell myself if I could go back seventeen years to the time of my daughter’s Type 1 diabetes diagnosis and have a good talk with me. That might not do me much good now, but it might do you a whole lot of good. So here, parent/caretaker new to this life with Type 1 diabetes, is my letter back to me, helping me see what I could not then, pointing out some things that – I hope – might make this road smoother for you. Dear Scared, Confused, Nervous, Determined Parent/Caretaker of a Child With Diabetes, This is me, speaking to you from the future. I’ve seen you go through a lot and I’ve helped you figure some things out. I’m back to share them with you so the road through life can be smoother. I’m good that way. And Deloreans work! So, here goes: 1) It’s okay to cry. But only for a while. Yes, you’ve been dealt a trauma that is nearly unfathomable to just about the rest of the world. Remember how you felt the first time you walked out of that pharmacy with the pile of filled prescriptions in your arms? Overwhelmed and oh-so-very-sad. But in time it’s important to move on from those tears. If you find you are still crying regularly a good six months into this, find someone to talk to. Consider a small dose of personal therapy. Because this is your new life; your “new normal.” And anything you can do to accept it and be good with it is only going to help your child do just that. 2) The internet is only good for some stuff. Like, finding friends. And programs. And cool blogs and digital magazines to read. If you are using Google or Facebook to find out things like “what should my son’s carb ratio be,” or “how many times a night should I be checking?” do what Bob Newhart said in this skit. STOP IT. You have a medical team. Continue reading >>
Newly Diagnosed: Doctors Answer Type 1 Diabetes Faqs
When your child is diagnosed with type 1 diabetes, it can feel like you have hundreds if not thousands of questions. The good news is that doctors have heard most of them before and can easily provide answers that will ease your mind. Here, doctors give the FAQs they hear most and share their responses. Q: What caused my child to get type 1 diabetes? A: “As a physician and type 1 diabetic myself, I understand the fears and concerns of parents for their newly-diagnosed children. Most people’s first question is what caused the diabetes in the first place. The truth is we don’t know for sure. Type 1 diabetes is considered an auto-immune disease where our immune system mistakenly begins attacking the insulin-producing (beta) cells of our pancreas. How could our immune system get so mixed up? One common theory is that the outer shell of a specific common cold virus looks very similar to the shell surrounding our beta cells in the pancreas. As our body eradicates this cold virus, our immune system may erroneously think our pancreatic beta cells must be more bad guys. From that time, it could take several weeks or even months before we begin developing the typical symptoms of diabetes. It wasn’t the basket of Halloween candy or the extra dessert — instead, it may have been a simple case of mistaken identity.” — Durant Abernethy, M.D., pediatrics physician at High Country Health Care in Frisco, Colo. Q: As a parent, did I do anything to cause the diabetes? A: “No! Parents can feel a lot of guilt if their child develops diabetes, and it’s important for you to realize and understand that you did not do anything to cause this disease. You are, however, one of the most important resources for helping prevent your children from developing some of the complications Continue reading >>
Home-based Vs Inpatient Education For Children Newly Diagnosed With Type 1 Diabetes
Abstract Initial management of children diagnosed with type 1 diabetes (T1D) varies worldwide with sparse high quality evidence regarding the impact of different models of care. To compare the inpatient model of care with a hybrid home-based alternative, examining metabolic and psychosocial outcomes, diabetes knowledge, length of stay, and patient satisfaction. Subjects and Methods The study design was a randomized-controlled trial. Inclusion criteria were: newly diagnosed T1D, aged 3 to 16 years, living within approximately 1 hour of the hospital, English-speaking, access to transport, absence of significant medical or psychosocial comorbidity. Patients were randomized to standard care with a 5 to 6 day initial inpatient stay or discharge after 2 days for home-based management. All patients received practical skills training in the first 48 hours. The intervention group was visited twice/day by a nurse for 2 days to assist with injections, then a multi-disciplinary team made 3 home visits over 2 weeks to complete education. Patients were followed up for 12 months. Clinical outcomes included HbA1c, hypoglycemia, and diabetes-related readmissions. Surveys measured patient satisfaction, diabetes knowledge, family impact, and quality of life. Fifty patients were recruited, 25 to each group. There were no differences in medical or psychosocial outcomes or diabetes knowledge. Average length of admission was 1.9 days shorter for the intervention group. Families indicated that with hindsight, most would choose home- over hospital-based management. With adequate support, children newly diagnosed with T1D can be safely managed at home following practical skills training. Continue reading >>
Insulin Regimens For Newly Diagnosed Children With Type 1 Diabetes Mellitus In Australia And New Zealand: A Survey Of Current Practice.
Abstract AIM: There is no consensus on the optimal insulin treatment for children newly diagnosed with type 1 diabetes mellitus (T1DM). The aims of this study were (i) to describe the insulin regimens used at diagnosis by patient age and geographical region and (ii) to explore differences between and within Australia (AU) and New Zealand (NZ) with regards to other aspects of patient management and education. METHODS: An online survey of medical professionals caring for children with T1DM in AU and NZ was undertaken. Questions included clinic demographics, insulin regimen/dosing choices and patient education. RESULTS: Of 110 clinicians identified, 100 responded (91%). The majority of those in AU (69%, P < 0.0001) favour multiple daily injections (MDI) for all ages. In NZ, for patients < 10 years old, (twice daily (BD)) BD therapy was favoured (75%, P < 0.0001), with MDI dominant for ages ≥ 10 years (82%, P < 0.0001). Insulin pump therapy was never considered at diagnosis in NZ, but 38% of clinicians in AU considered using pumps at diagnosis in patients <2 years, but rarely in patients aged 2 and over (16%). Differences in clinician choices were also seen in relation to starting insulin dose. CONCLUSION: This is the first study to examine current clinical practice with regards to children newly diagnosed with T1DM. Practice varies across Australasia by clinician and region. This lack of consensus is likely driven by ongoing debates in the current paediatric diabetes evidence base as well as by differences in clinician/centre preference, variations in resourcing and their interpretations of the influence of various patient factors. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians). Continue reading >>
Free Kit For Children Newly Diagnosed With Type 1 Diabetes
Is your child newly diagnosed with Type 1 diabetes? Then you may be interested in a Courage-Wisdom-Hope Kit, providing “help and hugs for families.” To help kids with Type 1 and their loved ones adjust, the kit includes a parent guide, kid’s interactive guide, sibling guide, drawstring bag for a meter and other supplies, and a write-on magnet and pen for keeping track of emergency contacts. While the kit cannot take the place of seeing a health-care provider, it is intended to help fill in some of the blanks. To order your free kit, call (800) DIABETES (342-2383), Monday through Friday, 8:30 AM to 8:00 PM ET, or order the kit online. This blog entry was written by Senior Digital Editor Diane Fennell. Continue reading >>
Autoantigen Vaccination In Human Type 1 Newly Diagnosed Diabetes Mellitus
Objective: This proposal is a pilot study to investigate the safety and the immunologic mechanisms of human insulin B-chain in incomplete Freund’s adjuvant (IFA) in humans. The ultimate goal of the intervention is to prevent or delay further loss of beta cell mass after the clinical onset of Type 1 diabetes mellitus. Immunization with autoantigens in different autoimmune diseases appears to be a new, effective approach to treatment in humans and animals alike. Rationale: Insulin has been implicated as being a key autoantigen in autoimmune diabetes. Reintroduction of autoantigen in autoimmune disease can generate protective antigen-specific cell mediated immunity. Several animal data suggest that the Th1/Th2 balance plays a crucial role in the pathogenesis of the disease. Insulin B-chain in IFA has been shown to reduce IFN-gamma (Th1) expression and reduce insulitis. Our preliminary animal data show that insulin B-chain in IFA reduces the diabetes incidence in NOD scid/scid model and prevents insulitis. Our preliminary human studies show extreme Th1 bias in invariant V alpha 24 Jalpha Q+ T-cells of patients with Type 1 diabetes further supporting Th1/Th2 paradigm in human diabetes. This cellular marker can be used along with humoral (IAA, GAD65Ab and IA2Ab and heterophile AB) and metabolic markers (FFIR) to predict development of diabetes in humans, an existing prerequisite for prevention. Significance: This adjuvant enhanced autoantigen vaccine is a novel approach in human diabetes. It is aimed to stop or slow down the ongoing autoimmunity against pancreatic beta cells at the clinical onset of the disease by immune modulation. At the onset, 15-40% of the beta cells is still intact. Arrest of autoimmune destruction of these beta cells would lead to prolonged or lifelon Continue reading >>
Type 1 Diabetes Diagnosis
Patients with type 1 diabetes (T1D) require exogenous insulin for survival and should be identified as soon as possible to avoid high morbidity due to a delay in insulin treatment. T1D should be suspected in pediatric patients with hyperglycemia, particularly if they are younger than 10 years; the majority of these patients have T1D, regardless of race or ethnicity. Among adolescents and young adults, the ratio of T1D to T2D shifts. In the 2014 Centers for Disease Control and Prevention (CDC) Diabetes Statistics report, the proportions of youth 10-19 years of age with newly diagnosed T1D were: Native Americans, 18%; Asians, 39%; non-Hispanic blacks, 40%; Hispanics, 52%; and non-Hispanic whites, 85% (1). Body mass index was once thought to be suggestive diabetes type, but as obesity rates have risen, patients’ physical characteristics are no longer reliable diagnostic indicators. Among 6222 adult participants in the T1D Exchange, a clinic registry of patients with T1D, 23% were obese (body mass index [BMI] ≥30 kg/m2), and another 35% were overweight. Of 8394 children and adolescents, 14% were obese and 23% were overweight (2). Table 1 offers recommendations for the differential diagnosis of T1D and T2D (3,4). T1D is usually characterized by absolute insulin deficiency and should be confirmed by the presence of autoantibodies to glutamic acid decarboxylase, pancreatic islet β cells (tyrosine phosphatase IA-2), zinc transporter (ZnT8), and/or insulin. Documenting the levels of insulin and C-peptide and the presence or absence of immune markers in addition to the clinical presentation may help establish the correct diagnosis to distinguish between T1D and T2D in children or adults (3). Table 1. Clinical and Laboratory Characteristics Used to Distinguish Type 1 and Type Continue reading >>
Support For Newly-diagnosed Adults
We know this can be a very difficult time in your life, but we’re here to give you the support and information you need. These pages contain information that you will find helpful in getting to grips with the condition, links to find help and support from others living with type 1, and an overview of our research programme and the progress we are making in efforts to cure, treat and prevent type 1. Continue reading >>
New To Type 1 Diabetes? Information For Parents
If you’re like most parents who have just been told your child or teen has type 1 diabetes, it is a complete shock. Only about 10 percent of the time do we find a family history of type 1 diabetes. There is more to learn about what causes, prevents and cures type 1 diabetes. In the meantime, we must all work together to help your child live a long and healthy life. And yes, that is a realistic goal. Research studies show that people with type 1 diabetes who aim to keep their blood glucose levels as close to normal as possible can significantly lower the chances of life-threatening complications related to diabetes. What Goes Wrong The diagnosis of type 1 diabetes was made because your child’s level of glucose (sugar) in the blood was above normal. This indicates that the metabolic system of checks and balances in the body is not working. Insulin is not being produced. Insulin is essential to escort the glucose from the foods we eat into cells of the body where it is critically needed to function properly. As a result, glucose builds up in the bloodstream. Your child may still be producing some insulin at this point, but in type 1 diabetes the pancreas loses all ability to produce insulin.The islet cells in the pancreas that produce insulin are gradually all destroyed, a process that we cannot at this point stop. Injections of insulin or an insulin pump are then needed to survive. Click here for more information on type 1 diabetes research at Joslin. Why Not an Insulin Pill? Insulin can’t be given orally because it is a protein and would be digested instead of getting to the bloodstream where it is needed. Just about all of the commercially available insulins now are genetically engineered as human insulin. Insulin comes in a variety of preparations that differ acc Continue reading >>
Type 1 Diabetes Mellitus Workup
Laboratory Studies Plasma glucose Patients with type 1 diabetes mellitus (DM) typically present with symptoms of uncontrolled hyperglycemia (eg, polyuria, polydipsia, polyphagia). In such cases, the diagnosis of DM can be confirmed with a random (nonfasting) plasma glucose concentration of 200 mg/dL or a fasting plasma glucose concentration of 126 mg/dL (6.99 mmol/L) or higher. [2, 62] A fingerstick glucose test is appropriate in the emergency department (ED) for virtually all patients with diabetes. All fingerstick capillary glucose levels must be confirmed in serum or plasma to make the diagnosis. All other laboratory studies should be selected or omitted on the basis of the individual clinical situation. Intravenous (IV) glucose testing may be considered for possible early detection of subclinical diabetes. Individually measured glucose levels may differ considerably from estimated glucose averages calculated from measured hemoglobin A1c (HbA1c) levels. [64] Therefore, caution is urged when the decision is made to estimate rather than actually measure glucose concentration; the difference between the 2 has a potential impact on decision making. Hemoglobin A HbA
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- Metabolic surgery for treating type 2 diabetes mellitus: Now supported by the world's leading diabetes organizations
