Diabetes mellitus, also known as diabetes mellitus, is a chronic metabolic disease. With diabetes, there is too much sugar in the blood, and the body can no longer maintain the blood sugar level itself. There are several types of diabetes: gestational diabetes, diabetes caused by medication use, surgery or transplantation, but the most common are type 1 diabetes and type 1 diabetes. type 2. In both cases, the blood sugar is too high, but the types develop in different ways.
Type 1 diabetes is an autoimmune disease and about 10% of people with diabetes have this form of diabetes. In people with type 1 diabetes, the body no longer produces insulin. It generally develops at a younger age, as a child or young adult, but can also occur in rare cases at an older age (> 50 years). It occurs quite suddenly and has nothing to do with eating habits, being overweight or not exercising much. Genetic predisposition and heredity may play a role. Other possible causes include viruses, diet, and environmental factors. People who get type 1 diabetes must always inject insulin.
The symptoms of type 1 diabetes are:
• Very thirsty
• Frequent urination
• Dry mouth
• Lose weight for no reason
• Feeling tired and weak
• Eye problems, blurred or poor vision
Type 1 diabetes has an impact on a person's daily life.
Usually the diagnosis is established by the general practitioner. The doctor can determine whether your blood glucose is elevated with a blood drop and/or laboratory test. If it is suspected that you have type 1 diabetes, you will be referred to an internist.
You treat type 1 diabetes by injecting insulin three to four times a day with an insulin pen or insulin pump. With us you will learn how to inject insulin and how to measure your blood glucose. When you choose an insulin pump, we help you get started and we teach you how to use the pump. Depending on your insulin schedule, you measure the values with a blood glucose meter or a sensor. If desired, you will learn to count carbohydrates in the diet and adjust the insulin accordingly.
Usually the diagnosis is established by the general practitioner. The doctor can determine whether your blood glucose is elevated with a blood drop and/or laboratory test. However, elevated blood sugar can also be discovered accidentally. If it turns out that you have type 2 diabetes, the doctor will start the treatment himself.
If you have type 2 diabetes, you will usually first receive lifestyle advice: eat healthy, exercise more and lose weight, for example. Knowledge of healthy nutrition is essential, a dietician can support you. If this is not enough, you start with tablets to lower the blood glucose value. Blood glucose levels may still remain too high. In that case, the GP advises you to start taking insulin or another medication. You may then be referred to an internist and diabetes nurse.
At the first visit you will be seen by the internist or diabetes nurse and a physical examination may be performed. You will also be asked extensively about your history and complaints, and blood tests will be performed. The results are assessed, this can happen within a few weeks. If there is no indication for continued treatment at the Jan van Goyen Medical Center, we can refer you back to your GP.
If it is decided to treat with insulin, the follow-up consultations will take place once every 3 months in consultation. One time you see the internist, the other time the diabetes nurse. Your blood will be drawn prior to these appointments. The result is discussed. Furthermore, blood pressure is measured and, if necessary, the results of the glucose meter/sensor are viewed. If everything goes well, you will be given another appointment in 3 months. If things are not going well, for example because you have hypos or blood sugars are too high, we may want to see you again sooner. We then look together at how we can improve glucose regulation. Sometimes this can be done with small dietary changes, sometimes the medication/insulin has to be adjusted.
Once a year, in the month in which it is your birthday, the check is more extensive. Your feet will be checked for abnormalities, your blood and urine will be checked further and, if indicated, we will make an appointment with the ophthalmologist. You can contact the ophthalmologist of the Jan van Goyen Medical Center for this. We also ask you to complete a questionnaire.
The diabetes team
The treatment revolves around you. With diabetes, good contact between our diabetes team and you is of great importance. We strive for guidance by the same doctor/nursing specialist, but situations may arise in which you are guided by one of the other colleagues.
Who will you be dealing with?
The internist treats the medical side of the diabetes and does, among other things, an extensive physical examination. Based on the research results, the internist proposes a treatment. The internist refers to the diabetes nurse and possibly other experts.
The nurse specialist
The nurse specialist is an independent practitioner with an independent authority. It offers integrated treatment to patients and ensures continuity and quality of treatment. Treatment includes both medical and nursing interventions. The nurse practitioner works from a holistic perspective. This means that she focuses on the disease and on being ill, where you as a patient are central.
The diabetes nurse
The diabetes nurse guides you in all matters related to your diabetes. For example, you suddenly have to think about all kinds of things that used to be automatic. What and when will I eat? What is the effect of this walk on my blood sugar? The diabetes nurse will teach you to check your blood glucose and to inject your insulin. She specializes in insulin pump therapy and has experience with sensors. Ultimately, together with you, she will look at how you can control your diabetes yourself as much as possible. It is also possible to evaluate blood glucose remotely over a period of time in order to quickly arrive at a better setting.
The diabetes nurse also has a lot of knowledge in the field of adolescents and young adults with type 1 diabetes. So if you have just turned 18 and are ready to switch from the pediatrician to the internist, just come and meet us to see if it clicks.
The main reason for keeping blood glucose as good as possible is to prevent complications. If you have had diabetes for a long time and the sugars are not properly adjusted, various organs may not work as well:
Heart and vessels
In the long run, you run a greater risk of a heart attack or stroke. The vessels in the legs can also cause problems, such as shop windows or poorly healing wounds on the feet.
The small blood vessels in the retina can be damaged. If not treated by the ophthalmologist, it can lead to blindness in extreme cases.
The kidneys may not work as well. You will not notice this in the beginning. The risk of kidney damage is greater if you have had diabetes for years and are not well adjusted. That's why controls are so important.
Erectile dysfunction/libido loss
You are more likely to experience erectile dysfunction or loss of libido (earlier). This can have a physical and/or psychological cause.
You can develop joint problems, such as limited movement limitations LJM (limited joint mobility syndrome) or trigger finger.
- Diabetes+ is for, about and by people with type 1 diabetes
- DiabetesExperts.nl: answers to all questions about insulin pumps and glucose sensors
- Nutrition Centre: reliable information about nutrition
- The tools Positive Health gives you insight into your health
- The Diabetes Fund: all information about diabetes
- The Bas van de Goor Foundation (BvdGF): moves people with diabetes towards a better quality of life