Treatment Overview

The focus of your treatment for type 1 diabetes is to keep your blood sugar level within a target range. This is called tight control. It is the best way to reduce your risk of diabetes complications. But some people—such as those whose blood sugar drops too low with tight control—may need to set a different target range with their doctor.

To keep your blood sugar in a target range, your daily treatment includes:

• Testing your blood sugar several times every day. Do additional blood sugar testing whenever you have symptoms of high or low blood sugar, and now and then test during the night. It is possible for your blood sugar level to change while you are sleeping. Testing at night will help you see if this is happening to you. If it is, your doctor may change your treatment plan. For more information, see:

  Diabetes: Checking Your Blood Sugar.

  Diabetes in Children: Checking Blood Sugar in a Child.

• Taking (several) insulin injections or using an insulin pump. Even children can use an insulin pump. For more information, see:

  Diabetes: Giving Yourself an Insulin Shot.

  Diabetes in Children: Giving Insulin Shots to a Child. At some point your child can learn to give an insulin injection. Talk to your doctor and your child to find out when is a good time to start teaching your child to give an insulin injection.

• Spreading carbohydrate throughout the day to prevent high blood sugar levels after meals. For more information, see:

  Diabetes: Counting Carbs if You Use Insulin.

  Diabetes: Using a Plate Format for Eating.

• Doing moderate activity at least 2½ hours a week. (Teens and children—starting at age 6—should do moderate to vigorous activity at least 1 hour every day.) Some tips for exercising safely may be helpful. Drink plenty of water before, during, and after you are active. This is very important when it's hot out and when you do intense exercise. It may also help to keep track of your exercise on an activity log(What is a PDF document?). Children with type 1 diabetes can participate in sports just like children who do not have diabetes. But children who use insulin are at risk of low blood sugar. Some tips on safe exercising for your child with type 1 diabetes can help prevent low blood sugar. For more information, see the topic Fitness.
• Starting a routine. Your sugar levels may be easier to control if you have a routine where you eat and exercise about the same amounts and at about the same times every day.

Chronic illnesses such as diabetes take a toll on your energy and emotions. It's normal to feel down sometimes. But if you feel seriously overwhelmed, tearful, and not yourself, you may be suffering from depression. Talk to your doctor if you feel depressed. Medicine, counseling, and other support can help you.

How often will I see my doctor?

At first, you will keep in close touch with your doctor while you are trying to find the right dose of insulin that best keeps your blood sugar levels within your target range. After your blood sugar levels are staying within this range, you will see your doctor about every 3 to 6 months. During these checkups, your doctor will evaluate and adjust your treatment. You will also start having exams and tests that check your blood sugar control and monitor your condition on a regular basis.

After you have had diabetes for 3 to 5 years, you will start having yearly exams and tests to watch for signs of complications, particularly eye and kidney damage. If your child has diabetes, this testing should begin at puberty.

What if I have diabetic ketoacidosis?

If your blood sugar level was very high at the time you were diagnosed with diabetes, you may have been treated for diabetic ketoacidosis. This life-threatening condition can happen to you again if you do not take enough insulin, have a severe infection or other illness, or become severely dehydrated. Treatment for diabetic ketoacidosis requires hospitalization and includes:

• Fluids given through a vein (intravenous, or IV), to replace body fluids lost from dehydration and to correct the electrolyte imbalance.
• Frequent monitoring of blood pressure, heart rate (pulse), breathing rate (respirations), and level of consciousness.
• Frequent blood tests for glucose and electrolytes.
• Insulin given through the IV fluid. After blood sugar levels are closer to your target range and you are no longer dehydrated, you can have insulin injected under the skin (subcutaneous).

Will I need treatment during the honeymoon period?

If your blood sugar levels return to the normal range soon after diagnosis, you are in what is called the "honeymoon period." This is a time when the remaining insulin-producing cells in your pancreas are working harder to supply enough insulin for your body. Treatment during this time may include:

• Keeping in close touch with your doctor.
• Testing your blood sugar level frequently to see whether it is rising.
• Taking very small amounts of insulin or no insulin. Even though you may not need insulin, some doctors prefer that you take small doses of insulin daily throughout the honeymoon period. This may decrease the stress on the pancreas. It may also help prevent your child with diabetes from thinking that the disease is gone.

What To Think About

When your child has diabetes

Talk with your child's teachers and the staff at his or her school (or child care center) to develop a plan for diabetes care at school. This plan needs to include clear instructions for dealing with low blood sugar, when to test the child's blood sugar, contents of school meals and snacks, and emergency contact information.

Let your child with diabetes take part in his or her daily care to the extent that is appropriate for your child's age and development. For example, your 4-year-old child cannot be responsible for testing his or her blood sugar but can get out the supplies and perform some of the simpler steps. By the time your child is an adolescent, he or she should be able to take responsibility for his or her diabetes care, with appropriate supervision. For more information, see the topic Type 1 Diabetes: Children Living With the Disease.

Coping with the disease

You (or your child) have just been diagnosed with a disease that requires daily attention and will last for the rest of your life. It is hard to accept and adjust to all the lifestyle changes that you need to make, such as eating the right amount of carbohydrate at each meal and snack, giving injections every day, and coping with blood sugar variations.

Anger, resentment, or denial are normal feelings in these circumstances and can be expected because you are experiencing the loss of what your life was like before you got type 1 diabetes. Give yourself time to deal with your feelings and grieve your loss. For more information, see the topic Grief and Grieving.