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Type 1 diabetes completely damages the pancreas, an organ responsible for making insulin. For that reason, persons with type 1 diabetes cannot produce any insulin on their own. Every patient with type 1 diabetes depends on injections of insulin so that glucose can be used as energy in the body.

Two major types of insulin are used to treat patients with type 1 diabetes: rapid-acting or short- acting and long-acting insulin.

 
  How They Work When They’re Taken Examples
Long-Acting (“Basal”) Insulin
 Basal Insulin
  • Basal insulin keeps blood glucose in a normal range throughout the day, even when the patient is not eating.
  • Once or twice a day, depending on which type is prescribed (see examples).
Short-Acting and Rapid-Acting (“Bolus”) Insulin
Nutritional Insulin
  • Nutritional insulin helps the body digest carbohydrates from meals.
  • Up to fifteen minutes before each meal (rapid-acting) or 30 minutes before each meal (short-acting). Short-acting insulin is most effective a few hours after it’s injected.
Correctional Insulin
  • Correctional insulin corrects high blood glucose before meals.
  • Similar to nutritional insulin.
  • Similar to nutritional insulin.

 

Most patients with type 1 diabetes are treated with “intensive” or “basal-bolus” insulin therapy, which requires four injections a day. This method allows a great deal of flexibility with regards to the types of food patients eat, when they eat it, and how much they eat.

The usual treatment schedule is:

  • The long acting insulin is typically taken at bedtime and/or morning
  • Nutritional insulin is taken before each meal, based on how many carbohydrates are in the meal, in addition to correctional insulin which is based on the blood glucose reading before the meal. Meeting with a dietitian can help patients learn carbohydrate counting, with specific dosing recommendations from the health care provider.

However, every individual treatment regimen is individualized; talk to your health care provider about the best regimen for you.

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