The best treatment for type 1 diabetes, as per the "American Diabetes Association Releases Standards of Care in Diabetes—2025", is multi-faceted, focusing mainly on insulin therapy. Here are the key approaches:
1. Insulin Therapy:
- Most adults with type 1 diabetes should be treated with either continuous subcutaneous insulin infusion (insulin pumps) or multiple daily doses of prandial (injected or inhaled) and basal insulin[1].
- Insulin analogs (or inhaled insulin) are preferred over injectable human insulins to minimize the risk of hypoglycemia[2].
2.
Continuous Glucose Monitoring (CGM):
- Early use of continuous glucose monitoring is recommended to improve glycemic outcomes and quality of life, as well as to minimize the risk of hypoglycemia[3].
3.
Automated Insulin Delivery:
- Automated insulin delivery systems are advised for all adults with type 1 diabetes to enhance glycemic control and reduce hypoglycemia[4].
4.
Education on Insulin Dosing:
- Patients should receive education on how to match mealtime insulin doses to carbohydrate intake and adjust doses based on ongoing glycemia, sick-day management, and physical activity[5].
5.
Regular Reevaluation:
- The insulin treatment plan and insulin-taking behaviors should be reevaluated periodically (every 3-6 months) to adjust treatment according to the patient's specific needs and goals[6].
6.
Adjunctive Non-Insulin Treatments:
- Some studies are exploring adjunctive therapies like glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter 2 (SGLT2) inhibitors, although these require careful management to mitigate associated risks such as diabetic ketoacidosis (DKA)[7][8].
In summary, the management of type 1 diabetes focuses predominantly on personalized insulin therapy, supported by technology advancements like continuous glucose monitoring and automated delivery systems, as well as patient education to tailor the approach to individual needs.
References
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