Type 1 diabetes mellitus: insulin therapy
To provide the body with insulin, there are in type 1 diabetes different treatment concepts
The amount of insulin, which pours out of the body of a healthy person, fluctuates throughout the day. A certain basic need for insulin it is continuously from the blood. He also showered with meals addition of insulin in much larger quantities.
Modern forms of insulin therapy to try these natural fluctuations in
insulin secretion differently acting by demand injections insulin
preparations imitate. They are called "intensified insulin therapy". They are now standard in the treatment of people with type 1 diabetes.
In contrast, the required insulin is distributed to two daily
injections in a high dose in the formerly used "conventional therapy". This form of insulin therapy are fairly uncommon today. Another way the insulin supply provides the insulin pump. With it, even the smallest amounts of insulin can be dosed.
For details on the various forms of insulin therapy and how insulin is injected correctly, read our guide insulin .
1. Intensified insulin therapy
In this form of treatment usually cover one or two injections of long-acting insulin from the independent of meals basic needs. During meals fast and short-acting insulin is injected ( bolus ). This allows to freely choose the timing of meals or will do without the food. The dose considered the portion size (especially carbohydrates), any physical activity and the current blood glucose level. The intensified insulin therapy allows Type 1 diabetes much flexibility.
Measuring the blood sugar regularly, therefore is an important part of treatment, take the patient himself. This is useful, for example, before each injection of a bolus and one to two hours after a meal. This allows testing whether the injected dose was correct. In sports, in cases of suspected hypoglycaemia , with infection and before going to bed - to protect against hypoglycemia - can be important also measurements.
At very restless blood sugar history and tendency to high fasting
levels of blood glucose from time to time checked at night should be.
Intensified insulin therapy offers freedom, but is costly
to cope with an intensified insulin therapy independently is expensive,
requires a lot of knowledge, practical skills and a willingness to
several times a day to make decisions for metabolic control and thus to
take responsibility for their own health. Patients should acquire the necessary knowledge necessarily in a training. Some patients need special support. So take in children depending on their age, parents glycemic control and insulin injections.
Health Care and Caregiver, for an appropriate training is offered to
partially or completely the implementation of diabetes care for people
who can not or alone no longer care.
But the effort is worthwhile. performed correctly, the intensified insulin therapy allows not only, meal times and quantities to choose freely. Affected parties can also align on his life, the insulin therapy.
This is especially important for people with an irregular lifestyle,
for example, shift workers, frequent travelers, but also athletes. Also for children facilitates more Corset intensive insulin therapy treatment.
2. Conventional insulin therapy
The concept is a much more rigid scheme than the intensified insulin therapy.
The patient injected twice daily (rarely even once) either a ready
mixture of fast and long-acting insulin preparation or he mixes his
insulin prior to injection into a syringe.
Depending on the action of insulin timing and size of meals are fixed,
so the patient does his daily routine after treatment depend. The fixed dose your doctor is maintained every day. Responding to high blood sugar levels, is limited. For frequent blood glucose measurements are dispensable, few tests are sufficient.
Who needs a flexible daily routine and sometimes more, sometimes less
physically active, will soon reach the limits of conventional therapy,
because the cumbersome balanced system soon gets out of balance.
In type 1 diabetes the rigid conventional therapy is therefore only
used as a rule, if someone is not able to implement a more extensive
therapy. But there are also transitional forms from conventional to intensive therapy.
3. insulin Pump
It is a small device that constantly carry patients to the body.
The pump is via a cannula continuously small amounts of insulin into
the subcutaneous fatty tissue from which mimics the natural secretion of
insulin by. In addition, the wearer can easily Add a button additional insulin to correct such excessive values after meals.
Thus, the syringes with the Pen does not apply to the treatment with
the insulin pump, which many sufferers feel as great relief.
However, by far not received all people with type 1 diabetes, the cost
of an insulin pump refundable but especially children, pregnant women or
patients with inadequate metabolic control. In addition, intensive training requirement to learn the correct use of the device. More about the advantages and disadvantages can be found in our guide to insulin .