
April 20, 2002
Daily Care
Question from Billings, Montana, USA:
I am a 16 year old who has type 1 diabetes. What are the possible treatments for type 1 diabetes currently? How effective are they?
Answer:
If you have type 1A (autoimmune) diabetes (which is much the most probable form), then you must already have realised that the only treatment is by a lifetime commitment to some form of insulin replacement. For the most part this is by subcutaneous injection including the more flexible insulin pump. There are new approaches to the kinds of insulin used, especially Lantus (insulin glargine) for basal needs with short-acting insulins like Humalog or Novolog given at meal times in proportion to the ‘carbs’ consumed. All these means can be very effective in maintaining near normal blood sugars and greatly diminishing long term complications.
However, insulin can also be successfully given through the mucosal membrane of the mouth or by inhaling it. See Oralin and Inhaled insulin. However, these products are not yet FDA approved.
Also, before too long, it should be possible to get around the restrictions of not enough donors and the need for lifetime immunosuppression for transplantation with some form of surrogate islet cells together a much abbreviated means of permanent graft tolerance.
DOB