Blood Sugar Levels and Insulin Needs
A healthy pancreas produces insulin, a hormone that the body uses to change glucose in the blood into energy. Glucose in the blood comes from the food and drink a person consumes, there are of course medications which lower your blood sugar levels, but with any medication you should be aware of the side effects especially the metformin side effects. A person with type 1 diabetes doesn't produce any insulin. Without insulin, the glucose builds up in the blood, causing high blood sugar, or hyperglycemia.
While insulin allows a person to stay alive, it does not cure diabetes nor does it prevent its eventual and devastating effects, which may include: kidney failure, blindness, nerve damage, amputations, heart attack, stroke, and pregnancy complications.
In people without diabetes, the pancreas maintains a "perfect balance" between food intake and insulin. When a person eats, the pancreas puts out the exact amount of insulin needed to turn the glucose into energy. If the per­son eats a lot, the pancreas puts out a lot of insulin. If the person eats just a little, the pancreas puts out just a little insulin.

Since people with type 1 diabetes can't produce their own insulin, they must put insulin into the blood stream through injections or an insulin pump or use medications like metformin to control the patients blood sugar levels.. If people with type 1 diabetes inject too much insulin (or eat too little) they may have a hypoglycemic reaction. Hypoglyce­mia (low blood sugar) is the most common problem in children with diabetes. It can be very serious and requires imme­diate action.
in reality there is no way to know how much insulin to inject with 100% accuracy. Many factors influence how much insulin people need to get to the desired "perfect balance" of glucose and insulin. These factors include foods with different absorp­tion rates as well as the effects of stress, illness, and exercise.
Despite rigorous attention to maintaining a meal plan and exercise regimen, and always injecting the proper amount of insulin, many other factors can adversely affect efforts to tightly control blood sugar levels including: stress, hormonal changes, periods of growth, physical activity, medications, illness/infection, and fatigue.

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High Blood Sugar
High blood sugar, or hyperglycemia, occurs when the body has too much food or glucose, or too little insulin. The following are all potential reasons that a person with type 1 diabetes might have high blood sugar:
  • Not enough insulin taken
  • Eating more than usual
  • Eating earlier than usual
  • Eating food with higher glucose content without injecting extra insulin
  • Injecting insulin at a site on the body where the absorption rate is slower
  • Missing or skipping an insulin dose
  • A clog in insulin pump tubing
  • Less exercise than normal
  • Stress
  • Illness or injury
  • Other hormones
  • Medications
High blood sugar generally does not immediately put the person with type 1 diabetes in danger. However, high blood sugar levels over long periods of time can lead to serious complications such as heart disease, blindness, kidney failure, and amputation.
Very high blood sugar levels can lead to diabetic ketoacidosis (DKA), or a "diabetic coma." DKA occurs when the cells can't get the energy they need from glucose, and the body begins to burn fat and body tissue for energy. This causes the release of byproducts called ketones, which are dangerous when released at high levels. Ketones become like poison to the body and are passed in the urine as they build up in the blood.
A person with type 1 diabetes and high blood sugar may exhibit one or more of the following diabetes symptoms:
  • Thirst (dehydration)
  • Frequent urination
  • Blurry vision
  • Stomach pain
  • Increased hunger
  • Nausea
  • Drowsiness, lethargy, exhaustion
  • Confusion
  • Sweating
  • Fruity, sweet, or wine-like odor on breath
  • Vomiting
  • Inability to concentrate
  • Weight loss (a longer term symptom) that eventually leads to coma
Low Blood Sugar
Low blood sugar (hypoglycemia) is the most common and most dangerous condition for many people with type 1 diabetes. Very low blood sugar may lead to insulin shock, which can be life threatening if not promptly treated. Low blood sugar occurs when the body has too little food/glucose or too much insulin. The following are all potential reasons that a person with diabetes might have low blood sugar:
  • Too much insulin taken
  • Eating less than usual
  • Eating later than usual
  • Insulin was injected at a site on the body where the absorption rate is faster than usual
  • Injecting extra insulin after forgetting about a previous dose
  • More exercise than normal
  • Illness or injury
  • Other hormones
  • Medication interaction
The following is a list of general symptoms that indicate low blood sugar (the person with type 1 diabetes may exhibit one or more of these):
  • Dizziness
  • Nervousness
  • Personality change/irrational behavior
  • Blurry vision
  • Shakiness
  • Nausea
  • Crying
  • Sluggishness
  • Sweating
  • Poor coordination
  • Hunger
  • Lightheadedness
  • Irritability
  • Drowsiness
  • Erratic response to questions
  • Inability to concentrate

Effects of Exercise, Illness, Stress, and Growth on Blood Sugar Levels
Exercise, illness, stress, and growth all affect blood sugar levels in a child with type 1 diabetes.
Exercise makes insulin work more effectively because it takes less insulin to balance the carbohydrates consumed. Therefore, children who begin to exercise more may find that taking their typical doses of insulin before eating a typical amount of food may result in lower blood sugar levels.
Illness and stress, on the other hand, often cause blood sugar levels to rise. A child who doesn't feel well may have trouble performing in class. She may have difficulty concentrating, for example. In such cases, the teacher can help reduce some of the stress by providing extra time for students with type 1 diabetes to complete tests or other work. Teachers may also need to be more patient as the student works to grasp new ideas and concepts.
Sometimes a child will achieve (at least for a short time) the "perfect balance" of insulin and food intake. Life can be rewarding and even close to normal for several months or longer. Then something as simple as a growth spurt could suddenly throw everything off. Early adolescence is an especially difficult time: the body grows, and hormones turn boys and girls into men and women. Children may have more issues with blood sugar at this time and require more help emotionally and physically, both at home and at school.

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