Understanding Diabetes -- Diagnosis and Treatment
If you have type 1 diabetes, your pancreas no longer makes the insulin your body needs to use blood sugar for energy. You will need insulin in the form of injections or through use of a continuous pump. Learning to give injections to yourself or to your infant or child may at first seem the most daunting part of managing diabetes, but it is much easier that you think.
Some people with diabetes use a computerized pump -- called an insulin pump -- that gives insulin on a set basis. You and your doctor program the pump to deliver a certain amount of insulin throughout the day (the basal dose). Plus, you program the pump to deliver a certain amount of insulin based on your blood sugar level before you eat (bolus dose).
Insulin comes in four types:
- Rapid-acting (taking effect within a few minutes and lasting 2-4 hours)
- Regular or short-acting (taking effect within 30 minutes and lasting 3-6 hours)
- Intermediate-acting (taking effect in 2-4 hours and lasting up to 18 hours)
- Long-acting (taking effect in 6-10 hours and lasting beyond 24 hours)
- Ultra-long-acting (taking effect in 30-90 minutes and lasting 42 hours)
A rapid-acting inhaled insulin (Afrezza) is also FDA-approved for use before meals. It must be used in combination with long-acting insulin in patients with type 1 diabetes and should not be used by those who smoke or have chronic lung disease. It comes as a single dose cartridge. Premixed insulin is also available for people who need to use more than one type of insulin.
Degludec (Tresiba) is an especially long-acting insulin, providing a basal dose of insulin lasting beyond 42 hours. It is also available in combination with rapid-acting insulin (Ryzodeg 70/30).
Each treatment plan is tailored for the person and can be adjusted based on what you eat and how much you exercise, as well as for times of stress and illness.
By checking your own blood sugar levels, you can track your body's changing needs for insulin and work with your doctor to figure out the best insulin dosage. People with diabetes check their blood sugar up to several times a day with an instrument called a glucometer. The glucometer measures glucose levels in a sample of your blood dabbed on a strip of treated paper. Also, there are now devices, called continuous glucose monitoring systems (CGMS), that can be attached to your body to measure your blood sugars every few minutes for up to a week at a time. But these machines check glucose levels from skin rather than blood, and they are less accurate than a traditional glucometer.