The best treatment for type 1 diabetes emphasizes intensive insulin management and the use of advanced technologies. Here are the key recommendations based on the "American Diabetes Association Releases Standards of Care in Diabetes—2025":
1. Insulin Therapy: Individuals with type 1 diabetes require insulin therapy to manage blood glucose levels due to the absence of endogenous insulin production. The best practice is to use a combination of:
- Basal Insulin: This can include long-acting insulin analogs or continuous subcutaneous insulin infusion (CSII).
- Prandial Insulin: Short-acting or rapid-acting insulins are used at mealtimes to manage postprandial glucose spikes[1][2].
2.
Insulin Analog Preference: Insulin analogs (including ultra-rapid-acting insulin) are preferred over regular human insulin because they are associated with a lower risk of hypoglycemia and more stable glycemic control
[3][2].
3.
Continuous Glucose Monitoring (CGM): Early use of CGM technology is recommended to enhance glycemic control and minimize hypoglycemia. It should be integrated into the management plan as soon as possible
[1][2].
4.
Automated Insulin Delivery (AID) Systems: AID systems are recommended for most patients as they have been shown to improve glycemic outcomes while reducing the risk of hypoglycemia. Such systems can adjust insulin delivery based on real-time glucose readings
[1][2].
5.
Education on Insulin Dosing: Patients should receive education on calculating mealtime insulin doses based on carbohydrate intake, and adjustments to insulin dosing should be made according to blood glucose trends, physical activity, and illness management
[1][2].
6.
Regular Follow-Up: The insulin treatment plan and management behaviors should be reevaluated regularly (every 3–6 months) to ensure individualized goals are being met
[1].
7.
Non-Insulin Adjuncts: Although insulin is the cornerstone of management, adjunct therapies such as glucagon-like peptide-1 receptor agonists (e.g., liraglutide) are being studied, though their role is still evolving
[4].
These approaches aim for tight glycemic control, reduce complications, and improve the quality of life for individuals with type 1 diabetes. For specific medications available in Saudi Arabia, prescribed options should align with the guidelines provided by the Saudi FDA.
References
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