Specific treatment for diabetes will be discussed with you by your healthcare provider based on:
Type of diabetes
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medicines, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
People with type 1 diabetes no longer produce insulin, and they must have insulin injections to use the glucose, or sugar, they obtain from eating.
People with type 1 diabetes must give themselves insulin several times per day. Insulin can either be injected, which involves the use of a needle and syringe, or it can be given by an insulin pump, insulin pen, or jet injector, or inhaler. Extra amounts of insulin may be taken before meals, depending on the blood glucose level and food to be eaten.
Insulin currently can't be taken as a pill. Because it's a protein, it would be broken down during digestion just like the protein in food. It must be injected into the fat under the skin for insulin to get into the blood.
New pharmaceutical materials and techniques have been developed, however, that can protect insulin from being broken down in the digestive tract. The first human trials of oral insulin were reported in 2006. Phase I clinical trials have shown insulin given in a gel capsule to be safe and effective. Clinical trials will continue over the next several years as the medicine moves through the federal approval process.
The amount of insulin needed depends on height, weight, age, food intake, and activity level. Insulin doses must be balanced with mealtimes and activities, and dosage levels can be affected by illness, stress, or unexpected events.
Although people with type 2 diabetes may continue to produce some insulin for some time, their bodies can't efficiently use it. This is known as insulin resistance, and may indicate the need for oral medicines or injections that can help stimulate the pancreas to release insulin or optimize the body's ability to use the insulin secreted. People with type 2 diabetes need insulin during illness and later when they are not able to control diabetes with noninsulin therapies.
Diet and exercise can often bring blood glucose levels down to normal. When these measures are no longer enough, the next step is the addition of medicines that lower blood glucose levels.
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