Treatment & Management
Advancements in medication types and delivery methods give people the freedom to choose which treatment options work best for them individually.
Type 1 Diabetes Treatments
People with type 1 diabetes (T1D) can live long, happy lives with proper care and disease management.
Advancements in medication types and delivery methods give people the freedom to choose which treatment options work best for them individually. Life with T1D can be greatly improved with a combination of treatments and lifestyle choices.
What is insulin?
Insulin is a hormone produced by the pancreas, which helps your body use the sugar (also referred to as glucose) from food you eat as energy.
After you eat, your body breaks down the food you eat into glucose and releases it into your bloodstream. Insulin then helps the glucose enter the cells of your body to be used as energy (for daily tasks like talking, walking, etc.).
Insulin is often described as a “key,” which unlocks the cells in your body to allow sugar to enter and be used for energy. Without insulin or enough insulin, glucose levels in your blood continue to rise. Those with T1D stop producing insulin and without this naturally occurring hormone, people with T1D must rely on regular insulin therapy to help manage their blood-glucose levels.
Insulin to Manage T1D
T1D is managed through use of a variety of insulins. People with T1D must work closely with their diabetes medical team to find the right insulin treatment for their condition.
Insulin can be delivered via syringes, pumps or new artificial pancreas systems. Though the administration method, frequency and type of insulin dosage vary on a case-by-case basis, injections may be needed multiple times per day.
Different Types of Insulin and How They Work
There are five main types of insulin. The difference is how long they take to start working to lower blood sugar and the duration – how long they work in your bloodstream to affect blood sugar. The “insulin peak” is the point at which the dose is working at its maximum. Most people with T1D need to use more than one kind of insulin to mimic the role of the pancreas as closely as possible.
- Rapid-acting: Rapid-acting insulin starts working about 15 minutes after injection, peaks (or is at maximum effectiveness) at about 1 hour and continues to work for 2 to 4 hours after injection.
- Regular or Short-acting: Regular or short-acting insulin starts working 30 minutes after injection, peaks anywhere from 2 to 3 hours after injection, and continues to work for about 3 to 6 hours.
- Intermediate-acting: Intermediate-acting insulin starts working 2 to 4 hours after injection, peaks about 4 to 12 hours later, and lasts approximately 12 to 18 hours.
- Long-acting: Long-acting insulin is most often combined with rapid or short-acting insulin. It starts working several hours after injection and tends to lower glucose levels up to 24 hours or almost a full day.
- Ultra long-acting: Ultra long-acting insulin starts working in 6 hours, but it does not peak and lasts about 36 hours, and in some cases longer than that.
There are also different ways to administer insulin.
Combined with insulin, diet and exercise, type 2 diabetes (T2D) drug metformin is sometimes prescribed to people with T1D to help treat their diabetes. Metformin helps control the body’s blood-sugar levels and how the liver processes sugar.
Blood pressure drugs, cholesterol medications and aspirin
Medications for high blood pressure and high cholesterol as well as aspirin can be prescribed with insulin to help with overall health and treatment of diabetes.
Since people with diabetes have an increased chance of cardiovascular disease, these drugs are sometimes used in combination with other diabetes medications.
Side effects of medications
The benefits of T1D medications far outweigh their associated side effects.
The most common side effects of insulin are injection site reactions, which includes redness, soreness or irritation around the area.
People can also experience lowered potassium levels and a risk of hypoglycemia.
While these side effects can sound daunting, know that many people using these medications don’t experience serious side effects at all.
Treatment for T1D includes monitoring and lifestyle choices in addition to medications. Each plays a role in the management and mitigation of T1D’s effects.
Knowing your blood-sugar levels and acting accordingly are among the most important ways to treat T1D.
Accurate monitoring lets a person know when insulin may be needed to correct high blood sugar or when carbohydrates may be needed to correct low blood sugar. Monitoring blood sugar can be done using traditional blood-sugar meters or flash glucose monitors (Flash GMs) and continuous glucose monitors (CGMs).
People with T1D work with an endocrinologist to determine proper insulin-to-carb ratio. This ratio is the amount of insulin needed to balance the intake of carbohydrates (typically measured in grams). Measuring the amount of carbohydrates and factoring the insulin to carb (I:C) ratio helps maintain stable blood-sugar levels after eating.
For example, if your I:C is 1:12 and you have an apple that contains 24g carbs, you would take two units of insulin. Taking those two units of insulin prior to having the apple helps to avoid a high or low blood-sugar fluctuation post-snack.
Exercise and diet
A balanced diet helps to balance blood sugars. People with T1D benefit from a healthy mix of all four food groups, but a lower intake of high sugar carbs. Eating well and exercising regularly are important. Ensuring proper nutritional intake and keeping a healthy weight help to keep blood sugars balanced and mitigate some of the potential complications of diabetes.
Regular medical check-ups
People with T1D regularly meet with a team of medical professionals (endocrinologist, ophthalmologist and dietitian) to help manage their diabetes and to mitigate the effects it has on the body.
Diabetes can cause complications to the kidneys, eyes, heart and circulatory system. Some of these secondary health issues may present themselves in consistently elevated blood sugars, dark urine, nausea/vomiting, spotty vision and more. Medical teams should be well informed about your individual health and be prepared to put together a customized treatment plan.
What it’s like to have T1D
It can be difficult and upsetting. It can be life threatening, and it never goes away. T1D is affected by every bite you eat and every jog you go on. Despite this, people with T1D serve as an inspiration by facing the disease’s challenges with courage and perseverance, and they don’t let it stand in the way of achieving their goals.
Day-to-day with T1D
Learning how to manage T1D means balancing insulin, food, exercise and stress to keep blood sugar levels in a target range (as determined by your healthcare professional) as much as possible. Living with T1D isn’t easy, but with advances in technology it can managed more easily than before.
Daily management of T1D is an ongoing process and takes time for you to learn what works best for you.
We Are Here to Help
At JDRF, our commitment is to provide you with a compassionate community and valuable resources as you navigate the challenges that life with T1D presents.