The first goal of treatment for type 1 diabetes is control of glucose (blood sugar). This goal can be achieved with insulin, a healthy diet and physical activity.

Because the pancreas does not produce insulin to control glucose, all people with type 1 diabetes must take insulin. It cannot be taken orally as the stomach will digest the insulin before it has a chance to reach the body. Insulin can be taken by methods including syringe injection, pen, pump and jet injector. A new option for some patients is inhaled insulin, although people with type 1 diabetes will still need to inject some insulin. A physician can discuss the best method of delivery for an individual.

Specific treatment will be determined by a physician based on:

• Age, overall health and medical history
• Extent of the disease
• Tolerance for specific medications, procedure or therapies
• Expectations for the course of the disease
• Personal opinion or preference

A pancreas transplant or islet cell transplant may be an option for some patients with type 1 diabetes.

The U.S. Food and Drug Administration (FDA) in 2005 approved pramlintide (Symlin), the only medication other than insulin for treating type 1 diabetes. It is synthetic amylin, an injectable version of amylin, a hormone made by the beta cells. It may be prescribed for certain individuals who have difficulty controlling their glucose with insulin alone.  It is taken at mealtimes and must be injected separately from insulin in a different syringe.

Patients should not use pramlintide if they have gastroparesis or hypoglycemia unawareness, according to the FDA. Women are advised to notify their physician if they are breastfeeding, pregnant or planning to become pregnant. Possible side effects include hypoglycemia, nausea, decreased appetite, vomiting, stomach pain, fatigue, dizziness or indigestion.

In addition, scientists are developing medications to treat complications of type 1 diabetes, including diabetic nephropathy, retinopathy and neuropathy.

People with type 1 diabetes must closely monitor their blood glucose to keep it as near normal as possible. Glucose monitoring is the primary means for checking glucose levels in the blood.

Keeping track of glucose numbers over several days allows the patient with type 1 diabetes to see patterns. The log may show periods of high glucose (hyperglycemia) at certain times of the day or after eating specific foods. Glucose monitoring is important for determining the correct type of insulin and dosage to maintain normal glucose levels.

Physicians use an additional test in the treatment of type 1 diabetes. The glycohemoglobin test gives a picture of glucose control over the past two to three months. This blood test does not replace daily glucose testing. Instead, it provides additional information to confirm test results, judge whether a treatment plan is working and make adjustments as needed. In some cases, a fructosamine test may be used to monitor glycemic control over the previous few weeks.

Periodically, individuals with type 1 diabetes need to have a ketone test performed. Ketones are chemicals that are produced when the body uses stored fat instead of glucose for energy. A high level of ketones (ketosis), combined with severe hyperglycemia, causes diabetic ketoacidosis, which can cause a potentially fatal diabetic coma. A sick-day plan devised by the physician can help prevent such complications.

Diabetes organizations recommend that diabetic patients have a pneumonia vaccination and annual flu shots. Patients should see an ophthalmologist for regular dilated pupil exams to screen for eye diseases such as diabetic retinopathy, glaucoma and cataracts. They are advised to ask their physician how often they should have a physical examination, a complete foot exam, a neurological exam and tests of kidney function, such as microalbuminuria testing or glomerular filtration rate. Patients may also be advised to undergo cardiovascular assessments or other testing.

Insulin is the primary tool for keeping blood glucose within the normal range. There are other factors, though, that should be included in the diabetic treatment plan. A nutritious and appropriate diet and exercise help manage glucose, promote general health and reduce the risk of developing insulin resistance and double diabetes.

A diabetes treatment plan will help an individual maintain a healthy life with normal or near–normal glucose levels. By controlling glucose, diabetic patients will have as few medical complications as possible.