Insulin treatment for type 1 diabetes
What is insulin treatment?
People with type 1 diabetes need daily injections of insulin to 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 a balance of the right amount of insulin to maintain balanced blood sugar levels, which is important to stay healthy and avoid damage to health later in life.
Types of insulin treatment
There are several types of insulin treatment 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 treatment aims to match the constant, steady release of insulin in someone without diabetes. It keeps a low, consistent level of insulin in your blood over an extended time to keep your blood sugar levels steady throughout the entire day, including between meals and when you sleep.
It is important that basal insulin gets close to a natural insulin response as too much or too little insulin can cause hypoglycaemia (low blood sugar) or hyperglycaemia (high blood sugar), respectively2,4.
Your blood sugar rises rapidly after eating and sometimes, basal insulin treatment isn't enough to control these 'spikes'. Mealtime, 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 insulins available for managing mealtime spikes, and the latest generation of ultra-fast acting mealtime insulins aim 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 sugar1,3 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.
Another type of insulin treatment is premixed insulins. Premixed insulins combine two insulins in a single injection5 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. Insulin cannot be given as a tablet, like GLP-1s can, because the digestive system would break down the insulin in the stomach before it could start working.
Many people take insulin by injection with insulin pens. There is a wide range of pens and needles available for insulin injections depending on your requirements. These have been designed to be ultra-discreet and easy to use.
They can be pre-filled and disposable or refillable and durable. Some have a memory function and/or require only a very small pressure to operate them, making them suitable for many users, including children as young as 6 years old as well as the elderly population.
Some people with type 1 diabetes take their insulin using a small, computerized device called an insulin pump. 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 course of the day, just like your body would naturally. This means a pump substitutes for continuous, or basal insulin. When it’s time for a meal, the pump also delivers variable amounts of insulin when a meal is eaten (bolus insulin).
An insulin pump is essentially made up of two parts (which are connected by a small, flexible tube):
- A reservoir which holds the insulin
- A needle which sits under the skin
The insulin pump is fitted onto a person’s lower abdomen and held in place with an adhesive patch, or worn in a belt around the waist, armband, bra or other accessory. The average pump is about the size of a pack of cards. It 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 of the 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.
- Home PD. Diabetes Obes Metab 2015; 17(11): 1011–20.
- Tibaldi J. Am J Med 2014; 127: S25-38.
- Cengiz E et al. Expert Rev Med Devices 2016; 13(1): 57-69.
- Bolli GB et al. Diabetes Technol Ther 2011; 13(Suppl. 1): S43-52.
- Downie M et al. Diabetes Ther 2016; 7(4): 641-657.