Treating type 1 diabetes: procedures and medications

You can live a full and healthy life with type 1 diabetes. Innovative treatments and expert medical care will help you control your symptoms, and manage your diabetes successfully.

• Refinements in the care of this serious, lifelong disease have improved—from the development of new forms of medication to insulin pumps that continuously measure your blood sugar. Managing this complex condition is easier now than ever before.

• To deal with this chronic, potentially damaging disease, you'll need to be under the long-term care of a specialized medical team. They'll help you learn day-to-day management techniques to keep your blood sugar levels in normal ranges, including how to give yourself daily insulin injections.
• To determine how much insulin you need, you'll have to test your blood sugar levels several times a day. If levels are too high, you inject insulin. If they're too low (a condition called hypoglycemia), you eat a sugar-containing food, such as orange juice or candy. Ultimately, a balanced diet and regular exercise will go a long way toward regulating your blood sugar levels.
• There’s no cure for diabetes, but by monitoring your blood sugar levels and by maintaining meticulous control, you can dramatically reduce your risk for complications. An oral diabetes drug such as metformin (Glucophage) may also be added to increase your sensitivity to the insulin you inject. The good news is that once you start treating diabetes, you'll feel better almost instantly.

• The goal of successful diabetes management is to get just enough insulin to keep glucose levels steady.
• This can be a delicate balance to maintain, and you'll need to do regular glucose testing. You'll need to test your glucose from one to four times a day, depending on how closely you're tracking it.
• Aim for pre-meal levels of 4.0 to 7.0 millimoles per litre, and bedtime levels of 5.5 to 7.7 millimoles per litre.

• To test glucose levels, most people use a device that makes a tiny jab into their fingertip.
• They then place a drop of blood on a specially treated test strip, and insert the strip into a glucose meter for a reading.
• Recent innovations produce very little discomfort: microneedle devices are so tiny you can barely feel the pinprick.

• Ask your doctor about the possibility of an insulin pump, which you wear on your body.
• This amazing device measures your glucose all the time, injecting exactly the amount of insulin your body needs.

• Rarely, for people with very severe diabetes, a pancreas transplant—or a double pancreas/kidney transplant—may be needed.

To keep your blood sugar levels within normal limits, you'll need insulin therapy, which is determined by your weight, diet, activity level, overall health and other shifting factors. Insulin is destroyed by digestive juice so it must be injected through the skin.  Various forms of insulin are used for different situations.

• Fast-acting insulin (Humalog) can be valuable before eating and for tight glucose control because it can have an effect in 15 minutes.
• Intermediate- and longer-acting insulins are active from two to 20 hours. Your doctor will help design a program using one or more types of insulin to optimize your blood sugar control. A common regimen is a short-acting insulin before you eat, and a longer-­acting one for coverage between meals or at night.

• After a couple of meetings with an instructor (often a nurse), you'll feel comfortable drawing insulin up into a syringe, cleaning your skin with alcohol and administering a virtually pain-free shot.
• For convenience, insulin "pens" can be prefilled and are re­usable. Jet injectors use a high-pressure stream of air to send a fine flow of insulin through the skin. They're bulky, expensive and not pain-free, but good if you're afraid of needles.
• Battery-operated pumps may appeal to those aiming for tighter glucose control.