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Diabetes Management

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Diabetes Management

Management

Management of Type 1 Diabetes

Type 1 diabetes is an autoimmune disorder in which your body’s immune system attacks the insulin producing beta cells in the pancreas. Due to this, your pancreas are not able to produce sufficient amount of insulin that is required to breakdown glucose. This leads to increase in glucose levels in your blood, which is known as hyperglycemia.

Symptoms of type 1 diabetes

  • Blurred vision
  • Excessive thirst
  • Frequent urination
  • Poor wound healing
  • Weight loss

The above symptoms may indicate that autoimmune antibodies have destroyed more than 80% of beta cells. This leads to insufficient production of insulin.

Scientists believe that both genetic and environmental factors are responsible for causing type 1 diabetes. Type 1 diabetes happens most often in children and young adults, therefore it used to be referred as juvenile diabetes, but can appear at any age.

Type 1 diabetes can be treated by supplying your body with external insulin. Multiple doses of insulin may be required through the day to meet the body’s demands. Insulin can be administered either through injections, pens, or continuous infusion pumps. Type 1 diabetes also requires that you closely monitor your blood glucose levels.

What is Insulin?

Insulin is a hormone produced by pancreas, which is required by your body to control your blood glucose levels. Without insulin, glucose cannot enter into body cells; thereby cells are deprived of energy.

Therefore, exogenous (external) insulin is supplied to the body. There are many types of insulins available today, generally classified on the basis of how fast they work and how long they continue to work in the body.

Mealtime or “Bolus” Insulin is used before meals to control the rise of blood glucose levels after eating.

  • Rapid-acting: Lispro, aspart, glulisine (Apidra, Humalog Novolog)
  • Short-acting: Regular human insulin (Humulin R, Novolin R)

Basal insulin controls blood glucose levels between meals and throughout the night. This is usually used once or twice daily. It can be used alone or in combination with oral medicines or rapid acting insulin.

  • Intermediate-acting: Human NPH (Humulin N, Novolin N)
  • Long-acting: Glargine and detemir (Lantus, Levemir)

Pre-mixed insulin is a combination of bolus and basal insulin that controls blood glucose levels after and between meals. These are usually used twice daily before breakfast and dinner. They can be used alone or in combination with oral medicines.

  • Pre-mixed: (Humulin 70/30, Novolin 70/30, Humalog Mix 75/25, Humalog Mix 50/50, Novolog Mix 70/30)

The type of insulin your doctor prescribes will depend on the type of diabetes you have, your lifestyle (when and what you eat, how much you exercise), your age, your body’s response to insulin, and your preference. People with type 1 diabetes often need more than one type of insulin. Most people with type 2 diabetes who use insulin just use basal (long-acting) insulin.

What are Human Insulin Analogues?

Insulin analogues are available in the market and are prepared by modifying human insulin. Insulin analogues can be fine tuned to closely mimic the natural basal insulin secretion.

Side Effects: May cause weight gain and risk of low blood glucose; therefore you need to monitor your blood glucose levels regularly.

What are the Options Available for Taking Insulin?

  • Needles/syringes: Insulin injections are the oldest and most commonly used method to take insulin. However, insulin pens and insulin pumps are also becoming more popular due to enhanced convenience and ability to inject insulin as discreetly as possible
  • Insulin Pens: Insulin pens allow for taking insulin conveniently and discreetly. In addition, it is convenient to carry. An insulin pen is filled with the tip of the pen acts as a needle, which is covered by a cap
  • Insulin pumps: Insulin pump is a wearable device and its function is to supply insulin as and when required. In an insulin pump there is a plastic tube, which acts as a carrier, through which insulin travels from the pump (serves as a reservoir) on one end and a small tip called cannula (goes under your skin), on the other end. Insulin pumps are generally preferred by people with type 1 diabetes who prefer tighter glucose control and little more flexibility with their eating habits

Before considering any of the above option you must contact your health care provider.

Last Reviewed on: July 26, 2014

Reviewed By: Dr. Kanchan Anand, MD (Nephrology and Internal Medicine)

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