Managing Type 1 Diabetes - Managing Your Diabetes An Overview: Diabetes

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Managing type 1 diabetes

Insulin is the foundation of therapy for people with type 1 diabetes. Insulin, at least in its present form, cannot be taken orally because digestive enzymes in the gastrointestinal tract destroy it. In the recent past, the only means of taking insulin was by injection. However, an inhaled insulin approved by the Food and Drug Administration (FDA) in 2006 may eliminate the need for some of the shots for some people with type 1 diabetes. Because inhaled insulin cannot replace insulin shots completely in people with this type of diabetes, insulin must still be injected. It is also not clear yet whether inhaled insulin can control blood sugar as tightly as injected insulin can (see "Insulin therapy for type 1 diabetes,"). Oral insulin and skin-patch delivery systems are being studied, but are not currently approved for general use. Diet and exercise are also integral to treatment because both affect blood sugar levels and insulin requirements.

The goal of insulin replacement is to mimic the levels normally supplied by the pancreas. This means maintaining a small, stable quantity in your bloodstream between meals and taking a larger, measured dose with meals to limit the increase in blood sugar that would otherwise occur.

Your doctor initially determines the insulin regimen, including the pattern and number of doses, by looking at your blood glucose, diet, and activity levels. Higher blood sugar, bigger meals, and low amounts of activity require more insulin, while lower blood sugar, smaller meals, and increased activity require less.

Because food, activity, and medications all influence your blood sugar and because they affect each individual differently, it's important to perform frequent checks. By providing a snapshot of blood sugar at a given time, self-monitoring (see "Monitoring your blood sugar levels,") gives you the information you need to tailor your treatment plan. For example, as your blood sugar fluctuates, you can adjust the doses and timing of insulin throughout the day and better maintain your target blood sugar levels.

Last updated:	January 23, 2007