1. What is type 1 Diabetes

Diabetes mellitus occurs when the body cannot produce insulin, or the body makes insulin but it does not work properly.

There are two main types of diabetes mellitus as well as some other less common forms, and the treatment required for each type of diabetes may differ:

• Type 1 diabetes

• Type 2 diabetes

• Steroid/ medication induced diabetes 

What is insulin?

The pancreas (a small gland behind the stomach) makes something called insulin. Insulin is a hormone made by special cells in the pancreas, called beta cells.

When we eat food, our food gets broken down in the stomach and small intestine. Food with carbohydrates (like sugar and starch) turns into glucose (a type of sugar) which then goes into the bloodstream.

Insulin helps move that glucose from the blood into the body's cells, where it is used for energy - like fuel for the body. Without insulin the glucose can't get into the cells, and the body can't turn food into the energy it needs to grow, heal and stay healthy.

Type 1 diabetes

In type 1 diabetes the body's immune system, which normally helps us to fight infection, starts attacking the beta cells in the pancreas and destroys them. This is the process of an autoimmune disease.

The reason why this happens is not fully understood but we know that it is a result of a person's genes and environmental triggers. The triggers are not completely understood but they may be common things such as viruses that are harmless to most people.

Once the immune system is triggered, the process of beta cell (insulin making cells) destruction in the pancreas begins. The symptoms of diabetes do not happen until approximately 90% of the beta cells are destroyed.

Important for whānau to know

Type 1 diabetes is not caused by eating too much sugar or making bad food choices.

There is nothing whānau could have done to stop this from happening to their tamaiti. It is not anyone's fault.

The following link takes you to a video produced by the Nemours Foundation that helps to explain diabetes in more detail. https://kidshealth.org/en/parents/diabetes-type1-video.html

Treatment of type 1 diabetes

Type 1 diabetes happens because the pancreas no longer makes insulin.

To treat this, tamariki need insulin every day, because their body can't make it any more. Insulin can't be taken as a tablet (it would get broken down in the stomach) so it's given by injection or insulin pump.

There are different types of insulin and different ways of giving it. The treatment plan is tailored to suit your child's needs, and the diabetes team will work closely with whānau to support you.

Your team will also help with learning how to manage:

• Insulin doses

• Food and carbohydrate counting

• Monitoring blood glucose levels

• What to do during illness

• Keeping your tamaiti active and well

How is type 1 diabetes diagnosed?

If your tamaiti shows signs of type 1 diabetes, a simple blood test can check for high glucose (sugar) levels and ketones.

Another test called HbA1c shows how much glucose has been sticking to red blood cells over the past 2-3 months. This helps the team understand what's been happening over time.

If the glucose levels are high and your tamaiti has symptoms, insulin treatment is usually started straight away.

A blood test to check for diabetes auto-antibodies is also usually done. These antibodies appear when the immune system has attacked the beta cells. The test helps confirm the diagnosis and usually takes 1-2 weeks for results.

What is Type 1 Diabetes - an overview. Let's go over the main points we've just covered. Ready?

Think you've got it sorted now?

If you have read through the information above and you feel confident that you understand this module, print off and fill in the evaluation form below (you might need to ask someone to print this off for you) and return to the nurse on your ward. If you have any questions, note them down on this form and your diabetes nurse specialist will discuss them with you.

What is type 1 diabetes: Evaluation

After reading this teaching module and watching the Nemours Foundation video, I feel confident that I understand can describe:

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