Type 1 diabetes is treated with daily injections of insulin. Oral diabetes medications are not effective. Many patients with type 1 diabetes, after beginning insulin injections, experience a period of reduced insulin need called the honeymoon period. During the honeymoon period, the remaining beta cells continue to produce insulin. It is very important to continue insulin therapy during the honeymoon period, because even low doses of insulin appear to help prolong the duration of the honeymoon.
Treatment for type 1 diabetes includes:
1. Taking insulin
2. Carbohydrate, fat and protein counting
3. Frequent blood sugar monitoring
4. Eating healthy foods
5. Exercising regularly and maintaining a healthy weight
There are currently several tools available to help track and maintain blood sugar levels including insulin pumps, CGMs (Continuous Glucose Monitoring Systems), blood meters and some very exciting technologies on the horizon. To learn more, view the Management Tools section.
What Is Insulin?
Insulin is a hormone produced by beta cells in the pancreas. It has three important functions:
1. Insulin allow glucose to pass into cells, where it is used for energy.
2. Insulin suppresses excess production of sugar in the liver and muscles.
3. Insulin suppresses the breakdown of fat for energy.
In the absence of insulin, blood sugar levels rise because muscle and fat cells aren’t able to utilize glucose for energy. They signal the body that they’re “hungry.” The liver then releases glycogen, a form of stored glucose. This further increases the blood sugar level. When the blood sugar level reaches about 180 mg/dl, glucose begins to spill into the urine. Large amounts of water are needed to dissolve the excess sugar, resulting in excessive thirst and urination.
Without glucose for energy, the body begins to metabolize protein and fat. Fat metabolism results in the production of ketones in the liver. Ketones are excreted in the urine along with sodium bicarbonate, which results in a decrease in the pH of the blood. This condition is called acidosis. To correct the acidosis, the body begins a deep, labored respiration, called Kussmaul’s respiration. Left unchecked, a person in this situation will fall into a coma and die.
Why Does It Have to Be Injected?
Insulin must be injected because it is a protein. If it were taken orally, the body’s digestive system would break it down, rendering it useless.
Where Should I Store It?
Unopened insulin vials should be kept cool. Storing them in the refrigerator will help them last as long as possible. Never freeze insulin, however, as freezing can destroy it. Open insulin, whether vials or pens, can be kept at room temperature for about a month.
Where Does Insulin Come From?
Insulin used by people with diabetes can come from three sources: human (created via recombinant DNA methods), pork, or beef. Beef insulin has been discontinued in the US, and essentially all people who are newly diagnosed are placed on human insulin.