What makes diabetes a difficult disease are the physical complications associated with poor control of the blood glucose. These complications are generally divided into short-term complications and long-term complications.
i Short-term complications, which I cover in Chapter 4, are the result of a blood glucose that's either very low or very high. Low blood glucose (called hypoglycemia) can occur in minutes as a result of too much insulin, too much exercise, or too little food, but high blood glucose often takes several hours to develop. Whereas low blood glucose often can be managed at home, severe high blood glucose (called diabetic ketoacidosis) is an emergency that's managed by a doctor in the hospital. Nevertheless, it's important that you understand how it develops in order to prevent it. Chapter 4 describes the signs and symptoms associated with both of these complications and the best ways of handling them.
i Long-term complications, which I cover in Chapter 5, can be devastating. It's much better to prevent them with very careful diabetes management than to try to treat them after they develop. Fortunately, they take 15 or more years to fully develop, and there's time to slow them down if not reverse them if you're aware of them. All long-term complications can be detected in the very earliest stages.
The long-term complications consist of eye disease known as retinopathy, kidney disease known as nephropathy, and nerve disease known as neuropathy. Diabetes is the leading cause of new cases of blindness; new cases of kidney failure requiring dialysis, which cleanses the blood of toxins when the kidneys can no longer do their job; and loss of sensation in the feet as well as other consequences of nerve damage.
Not only does T1DM have short- and long-term physical consequences, but as an autoimmune disease, T1DM also is associated with other autoimmune diseases such as celiac disease, an inflammation of the gastrointestinal tract; thyroid disease; and skin diseases. Chapter 5 explains the importance of checking for those diseases and correcting them, if present.
As you may expect, people with T1DM also have significant psychological and emotional needs. It's important, first of all, to realize that T1DM has been present in some very high achievers. (I name names in Chapter 6.) In addition, T1DM is not only a disease of the particular patient but also a disease of the entire family. All family members are affected in one way or another. In Chapter 6, you find out ways that family members can help themselves and help the patient to maintain his self-esteem and a high quality of life.
If you're the patient with T1DM, the people around you need to know that you have diabetes and how to help you when you can't help yourself. Often people with T1DM try to keep their disease secret, as though it's a blot on their character. T1DM isn't your fault. There will be times when you may need the help of others, and it will be a whole lot easier for them to help you if they know about your condition and what to do in different circumstances. (All this is also true for your child with T1DM.)
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Although nobody gets a parenting manual or bible in the delivery room, it is our duty as parents to try to make our kids as well rounded, happy and confident as possible. It is a lot easier to bring up great kids than it is to try and fix problems caused by bad parenting, when our kids have become adults. Our children are all individuals - they are not our property but people in their own right.