Treatment for type 1 diabetes
Insulin and other medications
Anyone who has type 1 diabetes needs insulin therapy throughout their life. There are many types of insulin, including:
Short-acting insulin. Sometimes called regular insulin, this type starts working around 30 minutes after injection. It reaches a peak effect at 90 to 120 minutes and lasts about 4 to 6 hours.
Rapid-acting insulin. This type of insulin starts working within 15 minutes. It reaches peak effect at 60 minutes and lasts about 4 hours. This type is often used 15 to 20 minutes before meals.
Intermediate-acting insulin. Also called NPH insulin, this type of insulin starts working in about 1 to 3 hours. It reaches a peak effect at 6 to 8 hours and lasts 12 to 24 hours.
Long- and ultra-long-acting insulin. This type of insulin may provide coverage for as long as 14 to 40 hours.
You'll probably need several daily injections that include a combination of long-acting insulin and rapid-acting insulin. A combination of three or more insulin injections a day has been shown to improve blood sugar levels according to a study. Insulin can't be taken by mouth to lower blood sugar because stomach enzymes will break down the insulin, preventing it from working. You'll need to either get shots (injections) or use an insulin pump.
Injections. You can use a fine needle and syringe or an insulin pen to inject insulin under the skin. Insulin pens look like ink pens and are available in disposable or refillable varieties. If you choose shots (injections), you'll probably need a mixture of insulin types to use during the day and night.
An insulin pump. This is a small device worn on the outside of your body that you program to deliver specific amounts of insulin throughout the day and when you eat. A tube connects a reservoir of insulin to a catheter that's inserted under the skin of your abdomen. There's also a tubeless pump option that involves wearing a pod containing the insulin on your body combined with a tiny catheter that's inserted under your skin.
Other medications also may be prescribed for people with type 1 diabetes, such as:
High blood pressure medications. Your provider may prescribe angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) to help keep your kidneys healthy. These medications are recommended for people with diabetes who have blood pressures above 140/90 millimeters of mercury (mm Hg).
Aspirin. Your provider may recommend you take a baby or regular aspirin daily to protect your heart. Your provider may feel that you have an increased risk of a cardiovascular event. Your provider will discuss the risk of bleeding if you take aspirin.
Cholesterol-lowering drugs. Cholesterol guidelines are stricter for people with diabetes because of their higher risk of heart disease.
Blood sugar monitoring
Depending on the type of insulin therapy you select or need, you may have to check and record your blood sugar level at least four times a day. You will have to check blood sugar levels before meals and snacks, before bed, before exercising or driving, and whenever you think you have low blood sugar. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. Even if you take insulin and eat on a strict schedule, blood sugar levels can change. You'll learn how your blood sugar level changes in response to food, activity, illness, medications, stress, hormonal changes, and alcohol.
Healthy eating and monitoring carbohydrates
There's no such thing as a diabetes diet. However, it's important to center your diet on nutritious, low-fat, high-fiber foods such as fruits, vegetables, and whole grains. You should eat fewer animal products and refined carbohydrates, such as white bread and sweets. This healthy-eating plan is however even recommended for people without diabetes. You'll need to learn how to count the number of carbohydrates in the foods you eat. By doing so, you can give yourself enough insulin. This will allow your body to properly use those carbohydrates.
Physical activity
Everyone needs regular aerobic exercise, including people who have type 1 diabetes. Choose activities you enjoy, such as walking or swimming, and do it every day whenever you can. Try not to go for more than two days without any exercise. Remember that physical activity lowers blood sugar. If you begin a new activity, check your blood sugar level more often than usual until you know how that activity affects your blood sugar levels. You might need to adjust your meal plan or insulin doses because of the increased activity.
Potential future treatments
Pancreas transplant. With a successful pancreas transplant, you would no longer need insulin. But pancreas transplants aren't always successful and the procedure poses serious risks. Because these risks can be more dangerous than diabetes itself, pancreas transplants are generally used for those with very difficult-to-manage diabetes. They can also be used for people who need a kidney transplant.
Islet cell transplantation. Researchers are experimenting with islet cell transplantation. This provides new insulin-producing cells from a donor pancreas.
Coping and support
Diabetes can affect emotions both directly and indirectly. Poorly controlled blood sugar can directly affect emotions by causing behavior changes, such as irritability. There may be times when you resent your diabetes. People living with diabetes have an increased risk of depression and diabetes-related distress. Many diabetes specialists regularly include a social worker or psychologist as part of their diabetes care team. You can even try talking to other people with type 1 diabetes. Online and in-person support groups are always available.
Lifestyle tips
Apart from the treatment mentioned above careful management of type 1 diabetes can lower your risk of serious life-threatening complications. Consider these lifestyle tips:
Take your medications as recommended.
Learn all you can about type 1 diabetes. Establish a relationship with a diabetes educator. Ask your healthcare team for help.
Make healthy eating and physical activity part of your daily routine. Eating healthy foods and exercising regularly can help control high blood pressure and cholesterol.
Wear a tag or bracelet that says you are living with diabetes. Keep a glucagon kit nearby in case of a low blood sugar emergency. Make sure your friends and loved ones know how to use the kit.
Schedule a yearly physical exam and regular eye exams. During the physical checkup, your provider will look for any diabetes-related complications. Your eye care specialist will check for signs of eye complications, such as retina damage, cataracts, and glaucoma.
Keep your vaccinations up to date. High blood sugar can weaken the immune system. Get a flu shot every year. Your provider will likely recommend the pneumonia vaccine, too. They may also recommend getting the COVID-19 vaccine.
Pay attention to your feet. Wash your feet daily in lukewarm water. Dry them gently, especially between the toes. Moisturize your feet with lotion. Check your feet every day for blisters, cuts, sores, redness or swelling. Consult your healthcare provider if you have any of the above issues.
Smoking increases your risk of diabetes complications. These include heart attack, stroke, nerve damage, and kidney disease. Talk to your provider about ways to stop smoking or to stop using other types of tobacco.
If you drink alcohol, do so responsibly. Alcohol can cause either high or low blood sugar. It depends on how much you drink and if you eat at the same time. If you choose to drink, do so only in moderation and always with a meal. Check your blood sugar levels before going to sleep.
Take stress seriously. The hormones the body produces when you're under long-term stress may prevent insulin from working properly. This can cause further stress and frustration. Take a step back and set some limits. Prioritize your tasks. Learn ways to relax. Get plenty of sleep.
