The best treatment for Type 1 diabetes involves a comprehensive approach focused primarily on insulin therapy. Here are the key recommendations based on the "American Diabetes Association Standards of Care in Diabetes—2025":
1. Insulin Therapy:
- Most patients should be treated with continuous subcutaneous insulin infusion (insulin pumps) or multiple daily injections of prandial (mealtime) insulin in conjunction with basal insulin[1][2].
- Insulin analogs (including rapid-acting and long-acting analogs) are preferred to minimize the risk of hypoglycemia compared to older human insulins[1].
2.
Continuous Glucose Monitoring (CGM):
- The use of CGM is highly recommended as it helps improve glycemic control and quality of life while reducing hypoglycemia incidents[1][2].
3.
Automated Insulin Delivery Systems:
- Consider offering automated insulin delivery systems (hybrid closed-loop systems) to enhance glycemic outcomes and reduce the frequency of hypoglycemia[1][2].
4.
Education and Adjustment:
- Patients should be educated on how to adjust prandial insulin doses based on carbohydrate intake, as well as on managing sick days and changes in physical activity[1][2].
5.
Regular Reevaluation:
- Regular follow-ups (every 3-6 months) should be scheduled to assess the insulin regimen and make adjustments as needed to achieve individualized glycemic goals[1][2].
6.
Adjunctive Therapies:
- While the mainstay of treatment is insulin, there may be potential use of adjunct therapies like GLP-1 receptor agonists (such as liraglutide) to aid in weight management and further improve glycemic control[3].
This treatment paradigm requires coordination among healthcare providers to perform a detailed evaluation of each patient's needs, preferences, and lifestyle factors.
References
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