what is the treatment plan for type i diabetes

What is the main treatment for type 1 diabetes?

What is a treatment plan for diabetes?

What are the three treatment targets for diabetes?

What is the goal of type 2 diabetes treatment?

How to manage type 1 diabetes?

By taking insulin, working with your doctor to get the right medications, eating a healthy diet, and getting regular exercise, you can keep your blood sugar levels under control, prevent complications, and stay healthy for the activities you enjoy.

How to help someone with diabetes?

Your physician might have a counselor or social worker on their diabetes care team, or you can find a therapist to speak with on your own. There are also many diabetes support groups where you can talk with people who understand the challenges you are facing and can share their experiences and suggestions. Finally, talking to a supportive friend or family member can help reduce your stress.

How does diabetes affect mood?

Managing type 1 diabetes can be stressful, and fluctuating glucose levels can affect your mood throughout the day. Diabetes can also increase your risk of depression. It’s important to manage your stress by getting enough sleep and finding support.

What is islet cell transplant?

Islet cell transplantation is a procedure that takes healthy insulin-producing cells from a donor pancreas, and transplants them into a person with type 1 diabetes. Clinical trials have shown that islet transplantation therapy can restore a person’s natural ability to produce insulin on their own, reducing or even eliminating the need for insulin injections.

What is an insulin pump?

Insulin pump. An insulin pump is a device you wear on your body at all times. Instead of injecting yourself throughout the day, the pump delivers a steady dose of insulin, as well as supplemental doses at meal times. You’ll need to maintain and refill the pump, and move it to a different site on your body every few days.

How to control blood sugar levels in type 1 diabetes?

Monitoring carbohydrates can help you avoid a blood sugar spike and plan ahead for the amount of insulin you need to take. Eating a healthy diet with plenty of fruits, vegetables, and whole grains, and limiting animal proteins, sugars, and refined carbohydrates like white bread can also help you stabilize your blood sugar and keep your heart and cardiovascular system healthy.

How long does it take for insulin to work?

Rapid-acting insulin, which starts working in 15 minutes after injection and lasts three to four hours.

How to treat type 1 diabetes?

Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting. Treatment of type 2 diabetes primarily involves lifestyle changes, monitoring of your blood sugar, along with diabetes medications, insulin or both.

Where to go if you have diabetes?

You're likely to start by seeing your primary care doctor if you're having diabetes symptoms. If your child is having diabetes symptoms, you might see your child's pediatrician. If blood sugar levels are extremely high, you'll likely be sent to the emergency room.

Why do people with diabetes have to be screened?

Symptoms of type 1 diabetes often appear suddenly and are often the reason for checking blood sugar levels. Because symptoms of other types of diabetes and prediabetes come on more gradually or may not be evident , the American Diabetes Association (ADA) has recommended screening guidelines. The ADA recommends that the following people be screened for diabetes:

How to do a glucose challenge?

You'll begin the glucose challenge test by drinking a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level below 140 mg/dL (7.8 mmol/L) is usually considered normal on a glucose challenge test, although this may vary at specific clinics or labs.

What blood test is used to determine blood sugar levels?

Tests for type 1 and type 2 diabetes and prediabetes. Glycated hemoglobin (A1C) test. This blood test, which doesn't require fasting, indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells.

Is there a diet for diabetics?

Healthy eating. Contrary to popular perception, there's no specific diabetes diet. You'll need to center your diet on more fruits, vegetables, lean proteins and whole grains — foods that are high in nutrition and fiber and low in fat and calories — and cut down on saturated fats, refined carbohydrates and sweets. In fact, it's the best eating plan for the entire family. Sugary foods are OK once in a while, as long as they're counted as part of your meal plan.

Can you test for diabetes at your first prenatal visit?

If you're at high risk of gestational diabetes — for example, if you were obese at the start of your pregnancy; you had gestational diabetes during a previous pregnancy; or you have a mother, father, sibling or child with diabetes — your doctor may test for diabetes at your first prenatal visit.

How to prevent diabetes complications?

Keeping your blood sugar levels as close to target as possible will help you prevent or delay diabetes-related complications. Stress is a part of life, but it can make managing diabetes harder, including managing your blood sugar levels and dealing with daily diabetes care.

Who manages diabetes?

Unlike many health conditions, diabetes is managed mostly by you, with support from your health care team (including your primary care doctor, foot doctor, dentist, eye doctor, registered dietitian nutritionist, diabetes educator, and pharmacist), family, teachers, and other important people in your life.

What is a DKA?

Diabetic ketoacidosis (DKA) is a serious complication of diabetes that can be life-threatening. DKA develops when your body doesn’t have enough insulin to allow blood sugar into your cells for use as energy. Very high blood sugar and low insulin levels lead to DKA. The two most common causes are illness and missing insulin shots.

How does Type 1 diabetes happen?

Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake) that destroys the cells in the pancreas that make insulin, called beta cells. This process can go on for months or years before any symptoms appear. Some people have certain genes (traits passed on from parent to child) ...

Why do you need insulin every day?

If you have type 1 diabetes, you’ll need to take insulin shots (or wear an insulin pump) every day to manage your blood sugar levels and get the energy your body needs. Insulin can’t be taken as a pill because the acid in your stomach would destroy it before it could get into your bloodstream.

How to check blood sugar?

Recognize the signs of high or low blood sugar and what to do about it. Give yourself insulin by syringe, pen, or pump. Monitor your feet, skin, and eyes to catch problems early. Buy diabetes supplies and store them properly.

What is the test for type 1 diabetes?

If your doctor thinks you have type 1 diabetes, your blood may also be tested for autoantibodies (substances that indicate your body is attacking itself) that are often present with type 1 diabetes but not with type 2. You may have your urine tested for ketones (produced when your body burns fat for energy), which also indicate type 1 diabetes instead of type 2.

What are the goals of diabetes treatment?

Goals Of Diabetes Treatment. To keep the blood sugar as normal as possible without serious high or low blood sugars. To prevent tissue damage caused by too much sugar in the blood stream.

What is the ultimate goal for Type 1 diabetes?

What are the blood sugar (glucose) targets for diabetes? The ultimate treatment goal for Type 1 diabetes is to re-create normal (non-diabetic) or NEARLY normal blood sugar levels – without causing low blood sugars. Good blood sugar control requires that you know and understand a few general numbers.

What is the blood sugar level for insulin?

To minimize this risk, many providers will recommend that individuals treated with insulin target a pre-meal blood sugar (plasma glucose) of 90-130 mg/dl and post meal blood sugar (plasma glucose) of less than 180 mg/dl.

What is the goal of insulin replacement therapy?

The goal is to replace the insulin in the right amount and at the right time. Sometimes, more insulin than needed is taken and this will cause hypoglycemia.

Is diabetes type 1 or type 2?

Of course, these are general standards for everyone with diabetes – both type 1 as well as type 2. Ask your diabetes team for personalized goals and blood sugar (blood glucose) monitoring schedules. For example: When you have type 1 diabetes you are treated with insulin replacement therapy. The goal is to replace the insulin in ...

What are adjunctive therapies for type 1 diabetes?

Adjunctive therapies for patients with type 1 diabetes are under investigation but are not currently recommended. 22 Sodium glucose cotransporter-2 inhibitors, which promote the renal excretion of glucose, are approved for use in patients with type 2 diabetes but have not been approved for use in patients with type 1 diabetes. Pramlintide (Symlin)—a synthetic analogue of human amylin that reduces postprandial glucose via slowed gastric emptying, inhibition of glucagon secretion, and satiety promotion—is approved by the U.S. Food and Drug Administration for use in type 1 diabetes and may have an association with improved glycemic control; however, long-term benefits remain unclear. 23 Despite studies suggesting that the addition of metformin might reduce insulin doses in patients with type 1 diabetes, 24 this has not been substantiated. Additionally, a recent well-designed double-blind randomized controlled trial of adults with type 1 diabetes taking metformin did not show significant improvement in glycemic control. 25 The potential cardiovascular disease benefit from adjunctive therapies remains under investigation.

Which insulin regimen is recommended for most people with type 1 diabetes?

C. 8. Basal-bolus insulin regimens are recommended for most persons with type 1 diabetes. C. 14. The decision to administer insulin via multiple daily injections or insulin pump can be individualized in persons with type 1 diabetes; neither method appears to be universally more effective.

How does diabetes education help?

All patients with type 1 diabetes should participate in continuous diabetes self-management education, which works to empower patients to understand how diet, physical activity, and insulin affect their glucose levels and how glycemic levels relate to acute and chronic complications ( Table 3) . 6, 26 – 29 Diabetes self-management education has been shown to improve A1C levels and quality of life, and reduce health care costs. 30, 31 National standards for diabetes self-management education have been published by the American Diabetes Association in conjunction with the American Association of Diabetes Educators. 32 Online diabetes education resources are available at http://professional.diabetes.org/content/diabetes-educator-resources. To find a diabetes educator or a preexisting diabetes education program, visit http://www.diabeteseducator.org/living-with-diabetes.

What is the A1C goal for type 1 diabetes?

Tight glycemic control remains the standard of care for most patients with type 1 diabetes. The American Diabetes Association recommends an A1C goal of less than 7% for non-pregnant adults ( Table 1). 6 Despite the benefits of lower A1C levels, goals should be personalized to account for individual preference, history of severe hypoglycemia, older age, and frailty. Higher glycemic targets for older adults or those with functional impairments, multiple comorbidities, or limited life expectancy are advisable. 7

What is the role of diabetes in self management?

All patients with type 1 diabetes should participate in diabetes self-management education and develop individualized premeal insulin bolus plans under the guidance of a dietitian, if possible. Blood pressure and lipid control are important to prevent cardiovascular disease events.

Why is it important to monitor blood glucose levels for type 1 diabetes?

In persons with type 1 diabetes mellitus, self-monitoring blood glucose levels more frequently is recommended because it leads to improved A1C levels.

How does continuous glucose monitoring work?

9 With this method, a sensor inserted into the subcutaneous tissue measures interstitial glucose levels in real time and transmits them to a receiving device and monitor ( Figure 1) . The effectiveness of continuous glucose monitoring devices depends on adherence and does not completely eliminate the need for capillary testing, which is still required for device calibration and to confirm abnormal levels.

What type of insulin is used for diabetes?

Two major types of insulin are used to treat patients with type 1 diabetes: rapid-acting or short- acting and long-acting insulin.

When is insulin taken?

The usual treatment schedule is: The long acting insulin is typically taken at bedtime and/or morning. Nutritional insulin is taken before each meal, based on how many carbohydrates are in the meal, ...

What is correctional insulin?

Correctional insulin corrects high blood glucose before meals. Similar to nutritional insulin. Similar to nutritional insulin. Most patients with type 1 diabetes are treated with “intensive” or “basal-bolus” insulin therapy, which requires four injections a day. This method allows a great deal of flexibility with regards to the types ...

Can type 1 diabetes produce insulin?

For that reason, persons with type 1 diabetes cannot produce any insulin on their own.

Is every treatment regimen individualized?

However, every individual treatment regimen is individualized; talk to your health care provider about the best regimen for you.

Is insulin taken before or after a meal?

Nutritional insulin is taken before each meal, based on how many carbohydrates are in the meal, in addition to correctional insulin which is based on the blood glucose reading before the meal. Meeting with a dietitian can help patients learn carbohydrate counting, with specific dosing recommendations from the health care provider.

What are the clinical recommendations for diabetes mellitus?

Clinical recommendation Evidence rating References In persons with type 1 diabetes mellitus, self-monitoring blood glucose levels more frequently is recommended because it leads to improved A1C levels. C 8 Basal-bolus insulin regimens are recommended for most persons with type 1 diabetes. C 14 The decision to administer insulin via multiple daily injections or insulin pump can be individualized in per- sons with type 1 diabetes; neither method appears to be universally more effective. C 16 In persons with type 1 diabetes, adjunctive treatment with metformin for improved glycemic control is not advised. C 25 Regular education regarding sick day management and hypoglycemia should be provided to all persons with type 1 diabetes. C 35, 37

How much physical activity should I do a week with type 1 diabetes?

The American Diabetes Association suggests that adults with type 1 dia- betes should engage in 150 minutes of moderate- to vigorous-intensity physi- cal activity per week with no more than two consecutive days without activity.26

What is diabetes self management education?

All patients with type 1 diabetes should participate in continuous diabetes self-management education, which works to empower patients to understand how diet, phys-ical activity, and insulin affect their glucose levels and how glycemic levels relate to acute and chronic complications (Table 3).6,26-29 Diabetes self-management education has been shown to improve A1C levels and quality of life, and reduce health care costs.30,31 National standards for diabe-tes self-management education have been published by the American Diabetes Association in conjunction with the American Association of Diabetes Educators.32

How to monitor glucose levels for diabetes?

There is a strong association between more fre- quent self-monitoring of blood glucose and lower A1C levels.8The conventional approach, practiced by approximately 83% of patients with type 1 diabetes, is to monitor glucose levels via capillary blood testing.9Testing is advised before meals, before exercise, before bedtime, occasion- ally postprandially, and anytime hypoglycemia is perceived.6Although the optimal number of daily tests should be individualized, using these indications corresponds to six to 10 tests per day. The newer practice of continuous glucose monitoring, used by approxi- mately 17% of persons with type 1 dia- betes, can also achieve tight glycemic control.9With this method, a sensor inserted into the subcutaneous tissue measures interstitial glucose levels in real time and transmits them to a receiving device and monitor (Figure 1). The effectiveness of continuous glucose monitoring devices depends on adher- ence and does not completely eliminate the need for capillary testing, which is still required for device calibration and to confirm abnormal levels. Compared with conventional self-monitoring, continuous glucose monitoring has been associated with improved glycemic control.10One randomized controlled trial demon- strated a reduction in A1C levels from approximately 7.6% to 7.1% over six months in persons 25 years or older with type 1 diabetes who used continuous glucose monitoring, compared with traditional self-monitoring of blood glu- cose at least four times daily.11Data do not show a defin- itive reduction in overall severe hypoglycemic events, but continuous glucose monitoring alarm features and trend alerts can notify patients and caregivers to expeditiously administer treatment.12The significant increase in cost associated with continuous glucose monitoring needs to be considered when an individual is choosing between glu - cose monitoring approaches.13

What are the benefits of tight glucose control?

The benefit of tight glucose controlin patients with type 1 diabetes mellitus is well established.1-4Microvascular complications (e.g., neuropathy, nephropathy, retinopathy) and macrovascular complications (e.g. , myocardial infarc- tion , cerebrovascular accident, cardiovascular disease– related deaths) are dramatically decreased when glucose levels are maintained as close to the nondiabetic range as possible.4The numbers needed to treat with intensive ther- apy (A1C of approximately 7% vs. 9%) for a 10-year period to prevent progression of retinopathy and clinical neurop- athy are 3 and 1.5, respectively.2Additionally, intensive glycemic control reduces the risk of cardiovascular disease by 42% and severe cardiovascular events (nonfatal myo- cardial infarction, stroke, or death from cardiovascular disease) by 57% over 11 years among patients with type 1 diabetes.3Long-term follow-up of the Diabetes Control and

What is the A1C goal for type 1 diabetes?

The American Diabetes Asso- ciation recommends an A1C goal of less than 7% for non- pregnant adults (Table 1).6Despite the benefits of lower A1C levels, goals should be personalized to account for individual preference, history of severe hypo- glycemia, older age, and frailty. Higher glycemic targets for older adults or those with functional impairments, multiple comorbidities, or limited life expectancy are advisable.7

What insulin do you use for insulin pump?

Most patients who use the pump use rapid-acting insu- lin (e.g., aspart [Novolog], glulisine [Apidra], lispro [Hum- alog]), whereas a small minority still use regular insulin. Rapid-acting insulin boluses can be administered immedi- ately before meals to allow more flexibility.17Small amounts of rapid-acting insulin are continuously infused to provide basal insulin. Depending on pump type, basal rates can be titrated as low as 0.01 units per hour.18Patients who do not use the pump tend to use long-acting insulin (e.g., detemir [Levemir], glargine [Lantus]) to meet basal demands. Intensive glucose control requires knowing the various factors affecting a patient’s insulin sensitivity and dos- ing requirements (Table 2).19,20Insulin sensitivity varies throughout the day and throughout a person’s lifetime. Puberty, pregnancy, and illness are physiologic states that often require extra insulin titration. Before dosing of pre- meal insulin, consideration needs to be made regarding planned carbohydrate intake, planned exercise or activity levels, and current blood glucose levels (eTable A). Choice of insulin type needs to account for duration of action, cost, and route of administration15,21(eTable B).

What is type 2 diabetes care plan?

A type 2 diabetes care plan is an essential tool for understanding and managing the condition. An individual and a healthcare team work together to create a plan that is tailored to the person’s needs. The plan enables them to better manage their diabetes and therefore take care of their health.

What is a care plan for diabetes?

The care plan will outline treatment according to someone’s blood glucose levels. This includes cases of low or high blood sugar.

Why do people with type 2 diabetes need to manage their blood sugar levels?

People with type 2 diabetes need to manage their blood sugar levels in order to stay as healthy as possible. A care plan can outline the steps a person needs to take to reach their health goals.

Why are treatment goals at the center of a diabetes type 2 care plan?

Treatment goals are at the center of a diabetes type 2 care plan, because they dictate what the care plan must include.

What to do if someone already has a care plan?

If someone already has a care plan and feels it no longer suits their needs, they can bring the plan to the appointment and discuss potential modifications. For instance, if their lifestyle has changed or if they have trouble meeting blood sugar targets, a doctor will want to know.

What information do you need to bring to a diabetic?

The person may need to bring with them some information, such as the type of medication they have used or dietary changes they have made so far to manage diabetes.

How many people have type 2 diabetes?

Globally, around 462 million people live with type 2 diabetes. Optimal condition management is key to improving a person’s quality of life.

Diagnosis

Treatment

• Depending on what type of diabetes you have, blood sugar monitoring, insulin and oral medications may play a role in your treatment. Eating a healthy diet, maintaining a healthy weight and participating in regular activity also are important factors in managing diabetes.

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Clinical Trials

Lifestyle and Home Remedies

Alternative Medicine

Coping and Support

Preparing For Your Appointment