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What is insulin treatment?

Insulin is the most common treatment for type 1 diabetes. Without it, people with type 1 diabetes wouldn’t survive. Insulin treatment aims to get as close as possible to the natural insulin response of someone without diabetes. This can help people with type 1 diabetes keep insulin levels balanced and maintain healthy blood sugar levels, which is important to avoid damage to health later in life.

Types of insulin treatment

There are several types of insulin treatments available for type 1 diabetes. Speak to your doctor to discuss available treatment options to tailor your diabetes treatment to your specific needs and preferences.

Basal
insulin


Provides a constant, steady release of insulin throughout the day (intermediate or long acting).

Mealtime
insulin


Brings down spikes in blood sugar after eating

Premixed
insulins


Combines two insulins in a single injection

Basal insulin

Basal insulin treatment aims to match the constant, steady release of insulin in someone without diabetes. It keeps a low, consistent insulin level in your blood over an extended time to keep your blood sugar levels steady throughout the day, including between meals and when you sleep. 

Basal insulin must get close to a natural insulin response. Too much or too little insulin can cause hypoglycaemia (low blood sugar) or hyperglycaemia (high blood sugar) respectively.

Mealtime insulin

Your blood sugar rises rapidly after eating, and sometimes, basal insulin treatment isn't enough to control these 'spikes'. Mealtime insulin (also called  bolus insulin) treatment aims to bring down such spikes in blood sugar that can occur after eating. The closer that mealtime insulin treatment can get to the insulin response in someone without diabetes, the quicker it may be able to bring down these spikes. 

There are different types of insulin available for managing mealtime spikes. The latest generation of mealtime insulins aims to close the gap between the speed of insulin treatment and the natural insulin response. As a result, they may improve control of mealtime blood sugar and offer greater flexibility and convenience with insulin dosing, mealtimes, and food choices. These benefits may reduce some of the guesswork in pre-meal dosing and provide greater blood sugar control for people with type 1 diabetes.

Premixed insulins

Another type of insulin treatment is premixed insulins. Premixed insulins combine two insulins in a single injection and aim to replicate the insulin production in the body of someone without diabetes when fasting (between meals and overnight) and after a meal.

Ways to take insulin treatment

Insulin needs to be taken by injection beneath the skin or by infusion with an insulin pump. 

Injections

Many people take insulin by injection. A wide range of pens and needles are available for insulin injections depending on your requirements. 

They can be pre-filled and disposable or refillable and durable. Some have a memory function and/or require only minimal pressure to operate them, making them suitable for many users, including the elderly population. 

Insulin pumps

Some people with type 1 diabetes take their insulin using a small, computerised insulin pump device. Insulin pumps provide the body with insulin throughout the day. The idea is that instead of delivering separate injections during the day, an insulin pump releases insulin gradually over the day, just like your body would naturally.

An insulin pump is essentially made up of two parts (which are connected by a small, flexible tube):

  • A reservoir that holds the insulin
  • A needle that sits under the skin

The insulin pump is fitted onto a person’s lower abdomen, held in place with an adhesive patch, or worn in a belt around the waist, armband, bra, or other accessories. The average pump is about the size of a pack of cards and has a digital display screen and buttons for programming.

There are lots of different types of insulin pumps available with different features. For example, some more modern pumps have touchscreens or can connect wirelessly to a glucometer. Your doctor will be able to help you select a model that’s best suited to your needs and lifestyle.

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References
  1. International Diabetes Federation. IDF Atlas 10th Edition, 2021. Available from: https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf. Last accessed: January 2024.
  2. Diabetes Australia. Medicines for your diabetes. Available from: https://www.diabetesaustralia.com.au/managing-diabetes/medicines/ Last accessed: January 2024.
  3. Holt RIG, DeVries JH, Hess-Fischl A, et al. The Management of Type 1 Diabetes in Adults. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2021;44:2589-2625.
  4. Diabetes Australia. Hypoglycaemia (hypo) and Hyperglycaemia. Available from: https://www.diabetesaustralia.com.au/managing-diabetes/hypo-hyperglycaemia/ Last accessed: January 2024.
  5. Wright BM, Bellone JM and McCoy EK. A review of insulin pen devices and use in the elderly diabetic population. Clin Med Insights Endocrinol Diabetes. 2010;3:53-63.
  6. Diabetes Australia. Diabetes technology. Available from: https://www.diabetesaustralia.com.au/diabetes-technology/ Last accessed: January 2024.