The Disease:

1. The Disease: • Type 1 diabetes is an auto-immune condition in which the immune system is activated to destroy the cells in the pancreas which produce insulin. We do not know what causes this auto-immune reaction, but we do know that it is not caused by poor diet and lack of activity. At this stage, nothing can be done to prevent or cure type 1 diabetes but scientists are working on finding a cure for the future. • Type 1 diabetes: • Occurs when the pancreas does not produce insulin • Represents 10–15 per cent of all cases of diabetes • Is one of the most common chronic childhood conditions • Onset is usually abrupt and symptoms are obvious • Symptoms can include • Excessive thirst • Excessive urination • unexplained weight loss • Weakness • Fatigue • Blurred vision

2. Managing Type 1 Diabetes • There are a range of way that Type 1 Diabetes can be managed; • Administering insulin • Monitoring blood glucose levels • Eating well • Keeping active • Ensuring good mental health • How to get ‘insulin in’? • Type 1 diabetes is managed with insulin injections several times a day or the use of an insulin pump. In the meantime you can live an enjoyable life by learning about the condition and effectively managing it. While your lifestyle choices didn’t cause type 1 diabetes, the choices you make now can minimise many of the complications associated with diabetes.

3. Managing Type 1 Diabetes • Checking blood glucose levels • Blood glucose monitoring is a valuable diabetes self management tool, which enables you to check your own blood glucose levels as often as you need to. • Testing your blood glucose levels will help you to: • Better understand the relationship between your blood glucose levels and the exercise you do, the food you eat, other medication you may take and other lifestyle influences such as travel, stress and illness • Find out immediately if your blood glucose levels are too high (hyperglycaemia) or too low (hypoglycaemia). • When someone with Diabetes Type 1 should test their blood glucose levels and how often depends on each individual; however, possible times to test are: • Before breakfast (fasting) • Before lunch/dinner • Two hours after a meal • Before bed • Before rigorous exercise • When you are feeling unwell

4. Managing Type 1 Diabetes In Australia Blood glucose levels are measured in millimoles per litre of blood (mmol/L). The 'normal' range for blood glucose is about 4 to 6 mmol/L (fasting). In the States Blood glucose levels are measured in milligrams per decilitreof blood (mg/dl). The 'normal' range for blood glucose is about 72 to 108 mmol/L (fasting). To convert measurements from different countries the following can be useful; mmol/l to mg/dl= multiply by 18 mg/dl to mmol/l= divide by 18

5. Managing Type 1 Diabetes • What to eat? • Managing blood glucose levels for a person with type 1 diabetes requires matching the amount of insulin to the carbohydrate in the foods eaten. Individuals with type 1 diabetes need to know how to plan their food, insulin and activity to best manage their blood glucose levels. • To help manage diabetes, meals need to be: • Regular and spread evenly throughout the day • Lower in fat, particularly saturated fat • Based on high fibre carbohydrate foods such as wholegrain breads and cereals, beans, lentils, vegetables and fruits. • .

6. Managing Type 1 Diabetes • What to eat? Carbohydrates • Carbohydrate foods are the best energy source for the body. When they are digested they break down to form glucose in the bloodstream. Insulin takes the glucose out of the blood and deposits it into the muscles, liver and other cells in the body where it is used to provide energy. A regular carbohydrate intake is required to provide our body and brain with instant energy. Most foods contain carbohydrate and also provide us with fibre, vitamins and minerals. Very low carbohydrate diets are not recommended for people with diabetes. • If a person suffering from diabetes eats regular meals and spreads carbohydrate foods evenly throughout the day, they will be able to maintain energy levels without causing large rises in their blood glucose levels. All carbohydrate foods are digested to produce glucose but they do so at different rates – some slow, some fast. The glycemic index or GI is a way of describing how a carbohydrate containing food affects blood glucose levels. The type of carbohydrate eaten by someone with Diabetes is very important as some can cause higher blood glucose after eating. The best combination is to eat moderate amounts of carbohydrate and include high fibre foods that also have a low GI.

9. References: http://www.diabetesaustralia.com.au/ http://www.glycemicindex.com/about.php http://en.mte.cz/conversion.php?mmol=6&mg=&count_it=1 http://www.okloseweight.co.uk/common-low-gi-foods-chart.html