Treatments for Type 1 diabetes


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Treatment of Type 1 diabetes: medical news summaries: The following medical news items are relevant to treatment of Type 1 diabetes:

Treatments of Type 1 diabetes discussion: Before the discovery of insulin in 1921, everyone with type 1 diabetes died within a few years after diagnosis. Although insulin is not considered a cure, its discovery was the first major breakthrough in diabetes treatment.

Today, healthy eating, physical activity, and insulin via injection or an insulin pump are the basic therapies for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose checking. 1

Today, most people who take insulin to manage diabetes inject the insulin with a needle and syringe that delivers insulin just under the skin. Several other devices for taking insulin are available, and new approaches are under development.

Insulin pens can be helpful if you want the convenience of carrying insulin with you in a discreet way. An insulin pen is a device that looks like a pen with a cartridge. Some pens use replacable cartridges of insulin; other pen models are totally disposable. A fine, short needle, similar to the needle on an insulin syringe, is on the tip of the pen. Users turn a dial to select the desired dose of insulin and press a plunger on the end to deliver the insulin just under the skin.

Insulin jet injectors send a fine spray of insulin through the skin by a high-pressure air mechanism instead of needles.

External insulin pumps connect to narrow, flexible plastic tubing that ends with a needle inserted just under the skin near the abdomen. The insulin pump is about the size of a deck of cards, weighs about 3 ounces, and can be worn on a belt or in a pocket. Users set the pump to give a steady trickle or "basal" amount of insulin continuously throughout the day. Most pumps today have the option for setting several basal rates. Pumps release "bolus" doses of insulin (several units at a time) at meals and at times when blood sugar is too high based on the users' programming. Frequent blood glucose monitoring is essential to determine insulin dosages and to ensure that insulin is delivered.2

Treatment of type 1 diabetes: Lack of insulin production by the pancreas makes type 1 diabetes particularly difficult to control. Treatment requires a strict regimen that typically includes a carefully calculated diet, planned physical activity, home blood glucose testing several times a day, and multiple daily insulin injections. 3

All people with type 1 diabetes need to take insulin (IN-suh-lin) because their bodies do not make enough of it. Insulin helps turn food into energy for the body to work.4

If your pancreas no longer makes enough insulin, then you need to take insulin as a shot. You inject the insulin just under the skin with a small, short needle.

Can insulin be taken as a pill?

Insulin is a protein. If you took insulin as a pill, your body would break it down and digest it before it got into your blood to lower your blood glucose.

How does insulin work?

Insulin lowers blood glucose by moving glucose from the blood into the cells of your body. Once inside the cells, glucose provides energy. Insulin lowers your blood glucose whether you eat or not. You should eat on time if you take insulin.

How often should I take insulin?

Most people with diabetes need at least two insulin shots a day for good blood glucose control. Some people take three or four shots a day to have a more flexible diabetes plan.

When should I take insulin?

You should take insulin 30 minutes before a meal if you take regular insulin alone or with a longer-acting insulin. If you take a rapid-acting insulin, you should take your shot just before you eat.

Are there several types of insulin?

Yes. There are five main types of insulin. They each work at different speeds. Many people take two types of insulin.

Does insulin work the same all the time?

After a short time, you will get to know when your insulin starts to work, when it works its hardest to lower blood glucose, and when it finishes working.

You will learn to match your mealtimes and exercise times to the time when each insulin dose you take works in your body.

How quickly or slowly insulin works in your body depends on

  • your own response

  • the place on your body where you inject insulin.

  • the type and amount of exercise you do and the length of time between your shot and exercise.

Where on my body should I inject insulin?

You can inject insulin into several places on your body. Insulin injected near the stomach works fastest. Insulin injected into the thigh works slowest. Insulin injected into the arm works at medium speed. Ask your doctor or diabetes teacher to show you the right way to take insulin and in which parts of the body to inject it.4

In March 2001, the U.S. Food and Drug Administration (FDA) approved a noninvasive blood glucose monitoring device for adults with diabetes. Noninvasive monitoring means checking blood glucose levels without puncturing the skin for a blood sample. The GlucoWatch Biographer, manufactured by Cygnus Inc., was approved to detect glucose level trends and patterns in adults age 18 and older with diabetes. It must be used along with conventional blood glucose monitoring of blood samples. The device, which looks like a wristwatch, pulls body fluid from the skin using small electric currents. It checks blood glucose levels every 20 minutes.5

Diabetes cannot be cured, but it can be controlled. Good control requires a careful blend of diet, exercise, blood sugar monitoring, and medication. People with type 1 diabetes control their blood sugar with insulin injections and frequent self-monitoring of blood glucose. People with type 2 diabetes generally control their blood sugar with oral medications. In some cases, insulin injections are needed to keep type 2 diabetes under control.

Diet is very important to lowering blood glucose levels. In planning a diet, the doctor considers the patient's weight and daily physical activity. For overweight patients, a weight loss plan is a must for proper blood glucose control. Food exchange lists to help with meal planning are available from your doctor and the American Diabetes Association.

Exercise is very important because it helps the body burn off some of the excess glucose as energy. Taking part in a regular fitness program has been shown to improve blood glucose levels in older people with high levels. A doctor can help plan an exercise program that balances the diet and medication needs and your general health.

Drugs may not be needed for type 2 diabetes if good control can be achieved through diet and exercise. But when these measures fail, oral drugs, insulin, or a combination of the two may be prescribed. A person who normally does well without drugs will need to take medication during acute illnesses.

Foot care is very important for people with diabetes. The disease can lower blood supply to the limbs and reduce feeling in the feet. People with diabetes should check their feet every day and watch for any redness or patches of heat. Sores, blisters, breaks in the skin, infections or buildup of calluses should be reported right away to a podiatrist or family doctor.

Skin care is very important. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean, using skin softeners to treat dryness, and taking care of minor cuts and bruises.

Teeth and gums need special attention to avoid serious infections. People with diabetes should tell their dentist about their condition and schedule regular checkups.6

Footnotes:
1. excerpt from Diabetes Overview: NIDDK
2. excerpt from Devices for Taking Insulin: NIDDK
3. excerpt from Diabetes Statistics in the United States: NIDDK
4. excerpt from Medicines for People With Diabetes: NIDDK
5. excerpt from Noninvasive Blood Glucose Monitors: NIDDK
6. excerpt from Dealing With Diabetes - Age Page - Health Information: NIA

Last revision: April 10, 2003

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