What is the recommended management plan for diabetes type 1?

From the Guidelines

The recommended management plan for type 1 diabetes should prioritize continuous subcutaneous insulin infusion or multiple daily doses of prandial and basal insulin, with a focus on minimizing hypoglycemia risk and improving glycemic outcomes and quality of life, as outlined in the most recent guidelines 1. The management of type 1 diabetes involves several key components, including:

• Insulin therapy: Continuous subcutaneous insulin infusion or multiple daily doses of prandial (injected or inhaled) and basal insulin are recommended for most adults with type 1 diabetes 1.
• Insulin analogs: Insulin analogs (or inhaled insulin) are preferred over injectable human insulins to minimize hypoglycemia risk 1.
• Continuous glucose monitoring: Early use of continuous glucose monitoring is recommended for adults with type 1 diabetes to improve glycemic outcomes and quality of life and minimize hypoglycemia 1.
• Automated insulin delivery systems: Automated insulin delivery systems should be offered to all adults with type 1 diabetes 1.
• Education: Patients should receive education on how to match mealtime insulin doses to carbohydrate intake and fat and protein intake, as well as how to modify the insulin dose based on concurrent glycemia, glycemic trends, sick-day management, and anticipated physical activity 1. Regular medical follow-up every 3-6 months is necessary to adjust treatment and screen for complications, with a focus on individualized glycemic goals and minimizing hypoglycemia risk 1. Key lifestyle components include regular physical activity, healthy eating, and maintaining a healthy weight, as well as education on hypoglycemia recognition and treatment, hyperglycemia management, and ketone testing during illness 1.

From the FDA Drug Label

Individualize the dosage of MERILOG based on the patient's metabolic needs, blood glucose monitoring results and glycemic control goal. Dosage adjustments may be needed with changes in physical activity, changes in meal patterns (i.e., macronutrient content or timing of food intake), changes in renal or hepatic function or during acute illness Generally use MERILOG (administered by subcutaneous injection) in regimens with an intermediate- or long-acting insulin.

The recommended management plan for diabetes type 1 involves:

• Individualized dosage: of insulin based on the patient's metabolic needs, blood glucose monitoring results, and glycemic control goal.
• Regimens with intermediate- or long-acting insulin: using MERILOG in combination with these types of insulin.
• Dosage adjustments: as needed with changes in physical activity, meal patterns, renal or hepatic function, or during acute illness.
• Close medical supervision: with increased frequency of blood glucose monitoring when making changes to the insulin regimen 2.

From the Research

Management Plan for Diabetes Type 1

The management plan for diabetes type 1 involves several key components, including:

• Insulin therapy: Insulin is the primary treatment for type 1 diabetes mellitus (T1DM) 3, 4, 5
• Glycemic targets: The target glycated hemoglobin A1c (HbA1c) for children with T1DM is < 7.5% (< 58 mmol/mol), while for nonpregnant adults, a target of < 7% (53 mmol/mol) is recommended 3, 4
• Insulin regimens: Multiple daily injections of basal/bolus insulin or continuous subcutaneous insulin infusion (CSII) are commonly used 3, 4, 5, 6
• Blood glucose monitoring: Regular monitoring of blood glucose levels is essential for effective insulin therapy 3, 4, 6

Insulin Therapy

Insulin therapy for T1DM typically involves:

• Multiple daily injections of short-acting or rapid-acting insulin analogues before meals, along with one or more daily injections of intermediate or long-acting insulin 3, 4, 5
• Continuous subcutaneous insulin infusion (CSII) as an alternative to multiple daily injections 4, 5, 6
• The use of insulin analogues, such as glargine, detemir, and lispro, which have been shown to improve glycemic control and reduce hypoglycemia 5, 6, 7

Glycemic Control

Glycemic control is critical in managing T1DM, and involves:

• Monitoring blood glucose levels regularly to adjust insulin doses and prevent hyperglycemia and hypoglycemia 3, 4, 6
• Using continuous glucose monitoring systems to detect glycemic fluctuations and improve glycemic control 6, 7
• Adjusting insulin regimens to minimize glycemic variability and reduce the risk of long-term complications 3, 4, 5, 7