The best treatment for type 1 diabetes, as outlined in the "American Diabetes Association Releases Standards of Care in Diabetes—2025," includes several key components. Here are the primary recommendations:
1. Insulin Therapy:
- Continuous subcutaneous insulin infusion (CSII) or multiple daily injections of prandial and basal insulin are recommended for most adults with type 1 diabetes[1].
- Insulin analogs (or inhaled insulin) are preferred over human insulins to minimize the risk of hypoglycemia[2].
2.
Continuous Glucose Monitoring (CGM):
- Early use of CGM is recommended to improve glycemic outcomes and quality of life, and to minimize episodes of hypoglycemia[1].
3.
Automated Insulin Delivery Systems:
- Automated insulin delivery systems should be offered to improve glycemic outcomes among individuals with type 1 diabetes[1].
4.
Education on Insulin Management:
- Education on matching insulin doses to carbohydrate intake, and how to adjust doses based on concurrent glycemia and trends, is essential[1].
5.
Regular Reevaluation:
- The insulin treatment plan should be regularly reevaluated (every 3-6 months) to ensure appropriate adjustments are made according to individual goals[1][2].
6.
Individualized Care:
- Total daily insulin requirements typically range from 0.4 to 1.0 unit/kg/day, and adjustments may be necessary based on various factors, including activity level and dietary intake[3].
7.
Non-Insulin Medications:
- Some adjunctive therapies, such as pramlintide (approved for type 1 diabetes) and glucagon-like peptide-1 (GLP-1) receptor agonists, have shown benefits in reducing A1C and supporting weight management in patients with type 1 diabetes[4][5].
In summary, effective management of type 1 diabetes requires comprehensive insulin therapy, integration of technology for monitoring and delivery, continuous education for self-management, and personalized treatment goals to optimize glycemic control and minimize complications.
References
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