Type 1 diabetes is a chronic condition where the body’s immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas.
Insulin is a hormone that helps regulate blood sugar. Without it, blood sugar levels can get dangerously high. Type 1 is usually diagnosed in childhood or early adulthood, and people with it must rely on insulin for the rest of their lives.
Managing Type 1 diabetes means carefully balancing insulin, food, exercise, and stress to keep blood sugar levels within a healthy range. It can be a lot to handle, but with the right support and education, it’s possible to live a full and healthy life.
Early diagnosis is essential in type 1 diabetes.
It is extremely important for prompt recognition and diagnosis in order to manage the disease effectively and minimize the acute and potentially life threatening complications of untreated type 1diabetes.
The role of the Certified Diabetes Care and Education Specialist (CDCES) in a newly diagnosed type 1 diabetic is pertinent in the management of type 1 dm, especially in the early stages of diagnosis.
This article explores the critical role the CDCES plays in supporting the type 1 diabetic from diagnosis, through the learning curve of insulin management, to the ongoing care with advanced and ever changing technologies.
It may be difficult to recognize the initial symptoms leading to diagnosis, as some are common symptoms of other disorders or can happen for various reasons, unrelated to diabetes.
Common symptoms of type 1 diabetes include:
Frequent urination
Excessive thirst and hunger
Weight loss despite normal or increased eating
Fatigue and irritability
Blurred vision
Fruity smelling breath
Early recognition is crucial to avoid the potential risk of diabetic ketoacidosis (DKA).
DKA is a serious and potentially life-threatening complication of diabetes, most often seen in people with Type 1 diabetes. It occurs when the body doesn’t have enough insulin to use glucose for energy, so it starts breaking down fat for fuel instead.
This process produces acidic compounds called ketones, which build up in the blood, making it more acidic. Symptoms of DKA include excessive thirst, frequent urination, nausea, vomiting, abdominal pain, rapid breathing, and a fruity-smelling breath.
DKA requires immediate medical treatment, typically involving insulin and fluids to restore balance, as it can lead to coma or death if not addressed promptly.
Healthcare intervention is pertinent in the early diagnosis and treatment of type 1 diabetes.
The healthcare provider will do a series of blood tests to confirm diagnosis; these usually include a fasting glucose, A1C, and C-Peptide.
Being diagnosed with type 1 diabetes can be a very emotional experience for the person diagnosed as well as family members and loved ones. It often elicits a great amount of different emotions as the diagnosis and required lifestyle adjustments sink in.
The support of a CDCES is crucial at this time for the successful outcome of this diagnosis.
As a CDCES, I have worked with several clients newly diagnosed and their response is always that they were so happy they started off their journey with diabetes with the support and close care they received.
Research shows that when the newly diagnosed type 1 is able to see a CDCES shortly after diagnosis, their outcomes are more positive. Some key findings show that when working with a CDCES, the newly diagnosed type 1 has:
Improved glycemic control
Reduction of diabetes distress and anxiety
Better adherence to diabetes management
Improved quality of life
Enhanced technology use
Prevention of acute complications
These several new aspects of health management can be daunting; especially without the support of a CDCES!
Learning the complexities of insulins, the various types, how they work, how to inject, determining dosage etc can be extremely overwhelming. Working with a CDCES enables the newly diagnosed diabetic to learn new and complex ideas with close, personalized support.
I offer my clients unlimited communication when they sign up for one of my packages, as I feel the ability to ask questions in real-time, as they are living this new experience, is of utmost importance for gaining a deep understanding of their health management.
Type 1 diabetics require insulin replacement due to their body’s inability to produce it. There are several types of insulin (rapid-acting, long-acting, etc.) and they play different roles in glucose control.
Another important aspect of managing type 1 diabetes is understanding carbohydrate counting. It is crucial to know how to count carbohydrates, as this is used in determining the amount of insulin needed per dose.
The insulin-to-carbohydrate ratio is the ratio that determines how much insulin is needed to cover a specific amount of carbohydrates consumed in a meal or snack.
For example, a common starting point might be 1 unit of insulin for every 15 grams of carbs, but this ratio can vary from person to person based on factors like age, height, weight, activity level, and insulin sensitivity.
Calculating this ratio correctly helps prevent blood sugar spikes (hyperglycemia) after eating and ensures that the body has enough insulin to process the carbs efficiently. Adjusting the insulin-to-carb ratio based on individual needs is an important skill for achieving better glucose control.
This can seem very complex, but as a CDCES, I make these adjustments daily for my clients and more importantly, teach them how to make adjustments on their own.
Insulin dosing can be quite complex and it is crucial there is a good understanding of it prior to starting, as insulin can cause severe lows, or be ineffective in correcting highs if not used correctly.
Some of the more complex topics that need to be well understood include:
Basal vs bolus insulin
Understanding the factors calculating the bolus (ie target, insulin to carb - ICR ratio, and insulin sensitivity factor - ISF)
Managing insulin for meals, exercise, stress, and illness
All of this can be extremely challenging for the newly diagnosed in addition to the emotional load of constantly having to manage insulin doses, after just learning these new and complex ideas, as well as having to learn and understand how food, activity, and insulin all interact.
A CDCES can provide the support needed during this very steep learning curve.
They can also assist in alleviating some of the emotional load that is being navigated at this time.
This can be done by one-on-one education and personalized, flexible, and consistent support they are able to provide that will likely not be available elsewhere.
Diabetes technology is another example of the learning curve type 1 diabetics are faced with at initial diagnosis. Technology is the management of diabetes go hand in hand these days and people with diabetes are getting much better control of their glucose with the use of various technology.
Continuous glucose monitors (CGM’s) are an example of newer technology that is assisting considerably in the effective management of diabetes. They provide real time glucose readings and trends and the ability to make prompt adjustments as needed based off their glucose data.
Insulin pumps, and now closed loop insulin pumps, provide continuous insulin delivery and connect to the CGM to adjust according to the sensor glucose values. This alleviates a lot of the need for manual calculations discussed above and research is showing the great benefits achieved with the use of an insulin pump.
Technology really is essential for the effective management of type 1 diabetes. With the use of technology, we are seeing greater glucose control with fewer fluctuations, reduced risk of severe hypoglycemia or hyperglycemia, and overall improved quality of life with real-time monitoring and more precise insulin delivery.
But… technology is not without its challenges!
This is where I come in as a CDCES.
I teach you how to set up the systems and how to understand the data and interpret the trends correctly.
Many people may start themselves on a CGM and that is great, taking initiative is amazing! But it is so important to use these systems at their full potential. Optimizing pumps and CGM’s is my jam!
I believe it is so important for people wearing an insulin pump to understand their settings and how to optimize their outcomes by adjusting as needed.
As for the CGM, I think everybody should know how to connect to the software and be able to read and understand the data and make adjustments according to their trends. It is enlightening and SO empowering!
When I meet with my clients to discuss the various technology options, we thoroughly discuss so that they are able to make an informed decision; one that will best fit their needs and lifestyle.
Then we do thorough training or follow up retraining if already on the device. Trouble shooting is essential in this training as well as the benefits of fully understanding how to interpret the data.
Having support at initial diagnosis is extremely important, as well as when deciding on the various technology options, but also for ongoing support and long term management.
I offer maintenance packages once we have completed one of the thorough initial packages where we meet more frequently at first and get you to where you need to be in your glucose management.
It is important to have continued education and reassurance and support. Adapting to life with type 1 diabetes can be very difficult and oftentimes new challenges arise throughout this journey.
Working with a CDCES can be very helpful in gaining support in prevention or delaying of long term complications such as neuropathy, retinopathy, and cardiovascular issues. Also, being provided with reminders of regular A1C checks, eye exams, and other preventative measures.
Throughout this journey, type 1’s may experience psychosocial challenges such as burnout, diabetes distress, and other mental health concerns. Having support is pertinent to navigate these difficulties.
As a CDCES, I provide personalized support and education for those at initial diagnoses, ongoing through their journey, and also as a new addition to their support team for those who have had this diagnosis for years.
Having a CDCES available immediately after a Type 1 diabetes diagnosis is crucial for both emotional and practical support. The initial shock of the diagnosis can be overwhelming, and as a CDCES, I play a key role in providing reassurance, addressing concerns, and helping set realistic expectations for managing their condition.
During the first few weeks and months, direct support is invaluable for adjusting insulin doses, reviewing blood sugar trends, and refining overall management strategies.
Personalized education, including one-on-one consultations, helps create tailored plans for food, exercise, and insulin use, which is especially important for addressing the unique needs of children, teens, or adults newly diagnosed.
By working closely with other healthcare professionals, such as endocrinologists and dietitians, I ensure comprehensive care and help individuals feel empowered and supported throughout their diabetes journey.
Have you or a loved one been recently diagnosed with type 1 diabetes? Get in touch for a free call to understand how I can help you manage your insulin doses and support you with the monitors needed. BOOK YOUR FREE CALL.
If you or a loved one has been newly diagnosed with type 1 diabetes, I urge you to seek out a CDCES as part of your healthcare team.
To learn more about working with me, BOOK YOUR FREE CALL.
About the Author
Hi! I’m Beth, a Registered Nurse and Certified Diabetes Educator. I provide diabetes coaching for newly diagnosed people with diabetes and also work with people who have been living with diabetes for some time.
With 1:1 coaching, you will feel Empowered and supported to confidently manage your diabetes effectively - without it controlling your life! I can help you make sure that you feel good, stay in optimal health and take care of your well-being at all times.
First call is on me! Let’s talk.
Comments