Management of type 1 diabetes

Although less prevalent than type 2 diabetes, autoimmune type 1 diabetes presents numerous challenges, including many that must be addressed daily. Patients must have appropriate tools to confront and manage their physiologic insulin deficiency syndrome. The vast majority of patients who have type 1 diabetes require a basal insulin to suppress hepatic glucose production in the fasting state, as well as prandial (mealtime) insulin to cover glycemic excursions that occur as carbohydrate absorption occurs in response to meals. Patients need algorithms to self-adjust both their prandial and basal insulin doses. The ultimate goal of all patients who have diabetes is to attain and maintain an A1C as close to normal as possible, while maintaining safety, avoiding hypoglycemia, and minimizing glycemic variability, as close to normal as possible, while maintaining safety and avoiding severe hypoglycemia.