Type 1 Diabetes Mellitus – treatment

All patients with type 1 diabetes should be treated chronic (lifetime) with insulin to maintain glucose levels as close to the optimal value. Insulin therapy requires:

-Daily insulin injections or use an insulin pump

-Ambulatory monitoring of blood sugar testing

-Maintaining a healthy diet in which carbohydrates are distributed throughout the day to avoid sudden increases in blood sugar after meals

-Regular program of exercise, because physical activity increases insulin effectiveness

-Periodic medical examination. Regular screening tests and examination are mandatory

-Smoking cessation

-Limiting the intake of alcohol

Treatment in children

Treatment of type 1 diabetes in children, as in adults, include the same measures in order to keep blood sugar normal.

In addition, measures are needed to allow normal growth and development parameters.

Prophylaxy

Currently, there is a prophylactic treatment of type 1 diabetes, however, researches are attempting to find ways of prevention in patients with genetic predisposition to the disease.

Prevention of diabetes complications

People with type 1 diabetes can prevent or delay the chronic complications of it:

– Diabetic nephropathy, retinopathy, neuropathy or cardiovascular disease by keeping blood sugar normal. They will undergo regular medical checks to detect early signs and symptoms of these complications. If they are detected and treated early, organ damage can be stopped, their evolution can be slowed or even reversible

– Chronic diseases like hypertension or hypercholesterolemia should be treated with medication. Stopping smoking reduces the risk of these complications

– Superimposed health problems can increase the risk of developing chronic complications.

People with insulin-dependent diabetes will be subject to annual influenza and pneumococcal vaccination every five years. Pneumococcal vaccination prevents disease caused by pneumococcus, common in diabetics with heart disease and renal complications increasing the risk of installation, hospitalizations and mortality of influenza and pneumococcal infections.

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

Especially in children, these three important ways of regulating blood glucose will be adequate depending on their activity.

Daily treatment of diabetes include:

-Repeated injections of insulin, or use of insulin pumps

-Distribution-balanced diet with carbohydrates during the day

-Physical-activity

-Glucose to be checked several times a day and night if necessary.

Diabetic patient must:

-Wear a medical identification bracelet that emergency physicians to quickly find a diagnosis of diabetes

– know how to intervene quickly in case of both hyper and hypoglycaemia to prevent onset of acute life-threatening complications

-Know how to adjust insulin doses if they become ill or if pregnancy occurs

-submit to regular medical examination for disease monitoring and treatment.

In type 1 diabetes, insulin-dependent due to absolute insulin deficiency, drug therapy means the administration of insulin daily. It will be administered by subcutaneous injections of insulin pumps.

Usually associated with long-acting insulin administered once or two times a day with rapid-acting insulin before each meal. Administered insulin doses are individualized. Also, the type of insulin dose is adjusted over time according to age, hormonal constellation (as in periods of rapid growth or pregnancy) or the type of physical activity performed. During periods of high emotional stress or during a disease superimposed insulin dosage should be increased.

If there are complications of diabetes (eg diabetic nephropathy), you need to add medications to address that complication.

Treatment of hypertension or cholesterol lowering medicines help prevent diabetes complications installation. After 30 years of age, we recommend low dose aspirin which is useful for preventing myocardial infarction, cerebrovascular accident or large blood vessel diseases.

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