Treatment of Type 1 Diabetes

All patients with type 1 diabetes must be treated chronically (for life) with insulin to maintain glucose levels as close to the target value. Insulin treatment involves:

-daily insulin injections or use an insulin pump
-monitoring of blood glucose level by testing ambulatory
-maintaining a healthy diet in which carbohydrates to be distributed throughout the day so to be avoided glucose spikes occurred immediately after meals
-scheduled exercise because physical activity increases insulin effectiveness
-periodic medical examination which monitor and adjust treatment. Screening tests are mandatory and periodical examination and are made in order to prevent the installation of chronic complications of diabetes: retinopathy, nephropathy, neuropathy, cardiovascular disease
-stop smoking
-limiting alcohol intake, alcohol consumption increases the risk of hypoglycaemic coma.

Many patients discover that they have diabetes after emergency hospitalization for diabetic ketoacidosis (CAD). If symptoms are severe, be transferred to an intensive care ward. CAD treatment requires administration of fluid infusion to control dehydration and electrolyte balance, and insulin intravenously to relieve marked hyperglycaemia and stop excess production of ketone bodies. Type 1 diabetes in children requires the same treatment as adults, in order to keep blood sugar within normal limits. In addition, measures are needed to allow growth and development in properly.

The insulin-dependent diabetes specialist doctor will set up a balanced diet, prescribe an individualized treatment with insulin and regular exercise to keep blood sugar at a safe level.

Diabetic patients must:

-wear a medical identification bracelet, so doctors can quickly identify them as having diabetes, in case of emergency
-know how to intervene quickly in case of both hyperglycaemia and hypoglycaemia to prevent installation of acute, life-threatening complications
-know how to adjust insulin dose if case of sickness or pregnancy
-introduce themselves to regular medical checks for disease monitoring and treatment.

Drug therapy is the daily administration of insulin. It will be administered by subcutaneous injection or insulin pump.

It is typically associated long-acting insulin administered once or 2 times a day with rapid-acting insulin before each meal. Doses of insulin are administered individually. Also, the type of insulin doses depends on age, hormonal constellation (as in periods of rapid growth or pregnancy) or the type of physical activity that took place. In periods of high emotional stress or during an illness, insulin doses should be increased.

Treatment of high blood pressure or cholesterol-lowering medicines helps prevent diabetes complications installation. After the age of 30, a low dose of aspirin is useful in preventing cardiovascular problems.