Type 1 Diabetes Treatment

Type 1 diabetes develops when the immune system attacks the insulin-producing beta cells in the pancreas.

When these cells don't work properly, the body can no longer produce insulin. People with type 1 diabetes therefore require lifelong insulin therapy.

Other medications and lifestyle changes may also help people manage the disease.

Insulin Delivery

Insulin cannot be taken orally because the stomach's digestive juices will destroy the hormone. It must instead be taken by injection, using an insulin pen or a syringe, or through an insulin pump.

Computerized insulin pumps have digital displays and are about the size of a cell phone.

They also consist of an insulin reservoir and a catheter that is usually inserted into abdominal fat with a needle (it can also be inserted into the hips, thighs, buttocks, or arms).

The pump continuously injects a pre-programmed small amount of insulin into the body (known as basal insulin), and the user programs a higher dose whenever food is eaten (known as a bolus dose of insulin).

There's also a rapid-acting form of insulin, Afrezza, that can be inhaled through the mouth using an inhaler.

Types of Insulin

There are several different types of insulin, which vary based on how quickly they start working, when they peak in action, and how long they last.

Rapid-acting insulin, such as Afrezza, Humalog (insulin lispro), Apidra (insulin glulisine), and Novo Rapid and NovoLog (insulin aspart), starts working about 15 minutes after administration, peaks after about one hour, and continues to work for two to four hours, according to the American Diabetes Association.

Regular (short-acting) insulin, such as Humulin R and Novolin R, starts working after about 30 minutes, peaks after two to three hours, and continues to work for three to six hours.

Intermediate-acting insulin, such as NPH insulin (Humulin N and Novolin N), starts working after about two to four hours, peaks after 4 to 12 hours, and continues to work for 12 to 18 hours.

Long-acting insulin, such as Levemir (insulin detemir) and Lantus or Toujeo (insulin glargine), starts working several hours after delivery and has a fairly steady effect over a 24-hour period.

Lantus is available in a 10 milliliter (ml) vial containing 100 units of insulin per ml (U100), and a 3 ml SoloStar disposable insulin device (100 Units/1 ml).

Toujeo is available in a stronger formula containing 300 units of insulin per ml (U300) in a 1.5 ml prefilled injectable SoloStar pen.

Other Type 1 Diabetes Medications

In addition to insulin, some people with type 1 diabetes may also take Symlin (pramlintide), an injectable drug that can help treat sudden increases in blood glucose levels after meals (postprandial hyperglycemia).

Pramlintide works by slowing the rate at which food moves through the stomach, as well as by reducing the liver's glucose production.

Other possible medications for type 1 diabetes include:

• GlucaGen (glucagon) to treat low blood glucose caused by insulin therapy
• Drugs for high blood pressure
• Drugs for cholesterol control
• Aspirin for prevention of heart disease

Lifestyle Modifications for Type 1 Diabetes

Certain lifestyle modifications may help people with type 1 diabetes stay healthy and better manage their disease. These include:

• Monitoring blood glucose levels by checking your glucose multiple times every day with glucose meters
• Eating a well-balanced diet and monitoring carbohydrate intake (carbs greatly affect blood glucose levels)
• Regular exercise, which can lower blood glucose and increase the body's sensitivity to insulin

People with diabetes have a higher risk of developing foot problems, since the disease can damage nerves and blood vessels in the feet. This risk can be reduced by by:

• Not smoking
• Checking your feet every day, and getting regular foot exams throughout the year
• Treating athlete's foot and other foot infections immediately
• Moisturizing the feet with lotion
• Wearing shoes designed to minimize diabetic foot problems