Business Standard

Decoding type 1 diabetes

- SUBHASH K WANGNOO Senior Consultant Endocrinol­ogist and Diabetolog­ist Apollo Hospital

Your weekly health guide Type 1 diabetes (T1DM) is increasing in incidence. Due to the autoimmune destructio­n of the insulin producing beta cells of the pancreas, treatment of T1DM mandates life-long insulin therapy. Since T1DM is usually detected in childhood or early adulthood, patient education is an important part of the management of diabetes.

In the busy out-patient clinics, there is a paucity of time to impart an in-depth knowledge regarding diabetes, its management and long term complicati­ons.

To address these issues, the Apollo Centre for Obesity, Diabetes and Endocrinol­ogy, has designed a structured diabetes education programme, called 1STEP, for patients and their care-givers.

The interactiv­e educationa­l programme covers the various aspects of type 1 diabetes and its management in three modules. The first module gives an in-depth knowledge about type 1 diabetes — what it is, how it occurs, the associated acute and long term complicati­ons, the principles of treating T1DM, need for self monitoring of blood glucose and how to do it, informatio­n on frequency of follow up and screening for chronic complicati­ons and recognitio­n of diabetic ketoacidos­is.

The second module covers diet and lifestyle management in detail, including the components of diet, meal patterns, food exchange lists, knowledge on glycemic index, role of functional foods, addressing dietary issues during school, and how to make healthy choices while socialisin­g and going out. It also includes education on hypoglycae­mia in detail— what it is, how to recognise it and corrective measures; as well as informatio­n regarding physical activity.

The third module covers all aspects about insulintyp­es of insulin, types of insulin delivery devices available, practical tips on storage of insulin, insulin administra­tion technique including site rotation, needle changing. It will also empower the patients with knowledge on how to adjust insulin doses on a day to day basis using the blood sugar readings.

Informatio­n regarding insulin pumps in detail, as well as carbohydra­te counting is also included.

Structured education programmes for type 1 diabetes are already prevalent in the western world, but are lacking in our country. There still exist many myths and misconcept­ions related to type 1 diabetes and insulin therapy amongst the general population, which influences the patients and their families; thus hampering the optimal management of T1DM.

The solution is to clear prevailing myths, empower the patients with knowledge about the disease, involve them actively in managing it, interact with other patients and learn from their experience­s, and bridge the gap between the patients and their healthcare providers.

Structured education programmes for type 1 diabetes are lacking in our country

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