Type 1 diabetes treatment

Insulin and other medications

All patients with type 1 diabetes require lifelong insulin therapy. There are multiple types of insulin, including:

• Short-acting (regular) insulin
• Rapid-acting insulin
• Intermediate-acting (NPH) insulin
• Long-acting insulin

Insulin cannot be taken orally, because the enzymes in the stomach will break it down and prevent it from acting on the body. There are multiple ways of administering insulin:

• Injections: Administering injections often requires you to use a mixture of insulin types throughout the day and night. Multiple daily injections that include a combination of long-acting and rapid-acting insulin more closely mimic the body’s normal use of insulin than do older insulin regimens.

If you choose to take insulin injections, you will likely have to inject yourself multiple times a day. You can use a fine needle and syringe or an insulin pen to inject the hormone under your skin.

• An insulin pump: Insulin pumps^[15], which are about the size of a cell phone, are worn on the outside of the body. A tube connects a reservoir of insulin to a catheter that’s inserted under the skin of the abdomen. Some pumps offered are wireless—you wear a pod that houses the insulin reservoir on your body that has a tiny catheter inserted under your skin. The pod can be worn on the abdomen, lower back, or on a leg or arm.

Insulin pumps are programmed to replace long-acting insulin by automatically dispensing specific amounts of rapid-acting insulin. This steady dose of insulin provided is known as your basal rate. When you eat, you program the pump with the number of carbohydrates you’re eating and your current blood sugar. The pump then gives a dose of insulin to cover your meal and correct your blood sugar, if it’s elevated.

Lifestyle choices

One of the foremost ways of treating all forms of diabetes is with healthy lifestyle choices. This includes:

• Eating a healthy diet: Choose foods low in fat and calories and high in fiber. It’s important to eat plenty of fruits, vegetables, and whole grains.
• Getting physical activity: Being physically active makes your body’s insulin work better. Aim to get 30–60 minutes of moderate physical activity on most days of the week.
• Carbohydrate monitoring and counseling: You will need to learn how to count the carbohydrates in the foods you eat in order to give yourself enough the right amount of insulin to properly metabolize them. A registered dietitian can help you create a meal plan that fits your needs and wants.

Blood sugar monitoring

Depending on the type of insulin therapy you receive, you may need to check and record your blood sugar level at least 4 times a day. Even if you take insulin and eat meals on a strict schedule, blood sugar levels can change unpredictably. You’ll learn how your blood sugar levels change in response to food, activity, illness, medications, stress, hormonal changes, and alcohol. Careful monitoring is the only way to make sure that your blood sugar levels are within your target range. Continuous glucose monitoring (CGM) is the newest way of monitoring blood sugar levels. Continuous glucose monitors attach to the body with a fine needle just under the skin that checks your blood glucose level every few minutes. These devices may be especially helpful for preventing low blood sugar (hypoglycemia) and, when used by people older than 25, have been shown to lower A1C. They aren’t yet considered as accurate as standard blood sugar monitoring, however, so it’s still important that you check your blood sugar levels manually.

Diabetes treatment

The treatment of type 2 diabetes^[16] primarily involves lifestyle changes and monitoring of your blood sugar. However, sometimes the condition also requires the administering of diabetes medications and/or insulin. Although it’s not specifically considered a treatment for type 2 diabetes, bariatric surgery may benefit people with type 2 diabetes who are obese and have a body mass index (BMI) higher than 35. While people who have undergone gastric bypass have seen significant improvements in blood sugar levels, this procedure’s long-term risks and benefits for patients with type 2 diabetes aren’t yet known.

Type 1 diabetes medication

Your healthcare provider will work with you to find the best treatment plan.

Diabetic diet

Many people with diabetes wonder what they should eat to manage their condition. While there are many resources on nutrition^[17] for people with diabetes, The American Diabetes Association reports “What can I eat?”^[18] is the #1 question asked by people after being diagnosed with diabetes. The ADA emphasizes that even if you have diabetes, what certain foods you should or should not eat and your overall diet should be determined based on your individual health requirements and preferences. All bodies respond differently to various types of foods and diets. Because of this, no one particular diet is prescribed for people with diabetes. There are, however, some guidelines that can help you manage your blood sugar. The ADA’s 2019 Nutrition Consensus Report^[19] provides some tips for determining the right diet for you. It also recommends meeting with a registered dietician nutritionist (RDN) to help you determine what eating plan makes the most sense for you and your treatment goals. One great way for people with diabetes to reduce their risk of developing health complications—such as cardiovascular disease and kidney disease—is to swap unhealthy foods for more nutritious, less fattening options. For example, you may want to replace foods that are high in saturated fat (such as butter and fatty beef) with foods rich in unsaturated fats (such as olive oil and fish). While many different diets can help you manage your diabetes, it is important to minimize added sugars and refined grains and eat lots of non-starchy vegetables and whole, minimally processed foods.