Type 1 Diabetes medications & treatments

Medically reviewed by  Jamie Winn, PharmD

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Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in children, with the average age at diagnosis between 4 to 6 years of age and in early puberty (10 to 14 years). T1DM was once known as insulin-dependent or juvenile diabetes. It is less common than type 2 diabetes, representing only 5% to 10% of people with diabetes. There are approximately 1.6 million people in the U.S. with T1DM and that number is expected to increase to 5 million by 2050. It is the seventh leading cause of death in the United States. The highest rate of T1DM in America is seen in non-Hispanic whites, affecting both females and males almost equally.

What is type 1 diabetes?

Type 1 diabetes mellitus (T1DM) is an autoimmune disease that develops when your immune system destroys insulin-producing beta cells (islet cells) in the pancreas. Insulin is an important hormone that regulates your blood glucose (sugar) levels. Without insulin the glucose from your food can’t make its way into your cells, leaving it to circulate in your blood. Chronic high blood sugar levels can lead to life-threatening complications such as diabetic ketoacidosis (DKA).

T1DM typically develops in children, adolescents, and young adults but can occur at any age. Although the exact causes are unknown, experts believe there is a genetic component. People with T1DM will require life-long insulin replacement.

Type 1 diabetes causes

You may be more likely to develop T1DM if you have any of the following risk factors:

• Family history. If you have a family member with T1DM, you are more likely to develop this condition. There are also certain gene mutations that may increase your risk. However, not everyone with these mutations develops T1DM. Researchers believe something else triggers this condition in people with these inherited genes.
• Viral infections. It is thought that certain viral infections may trigger the onset of T1DM. These include enteroviruses, rotavirus, mumps, and cytomegalovirus.
• Race. Race may play a factor in the development of T1DM. Non-Hispanic whites in America are more likely to develop this condition.
• Age. Although T1DM can affect any age group, it most commonly develops between 4 to 6 years of age and 10 to 14 years.

How is type 1 diabetes diagnosed?

A blood test is typically all that is needed for a type 1 diabetes diagnosis. You are usually diagnosed after showing symptoms of this condition. Some tests your healthcare provider may perform include:

• Glycated hemoglobin (A1C) test. This blood test measures the amount of blood sugar attached to the hemoglobin in your red blood cells. It shows your average blood sugar level over the past 2 or 3 months. If your hemoglobin A1C level is greater than 6.5% on 2 separate tests, you have diabetes.
• Random blood glucose test. If the hemoglobin A1C test isn’t available, or if you have certain conditions (pregnancy) that might affect the test, your doctor may take a random blood sample to measure your blood sugar. If your random blood sugar level is above 200mg/dl (11.1 mmol/L), you may have diabetes.
• Fasting blood glucose test. This test requires a blood sample to be taken in the morning after you haven’t eaten overnight. A fasting blood sugar level that is less than 100 mg/dL (5.6 mmol/L) is normal. It is considered prediabetes if it is between 100mg/dL (5.6mmol/L) and 125 mg/dL (6.9 mmol/L). If your level is above 125mg/dL (6.9 mmol/L), you are diagnosed with diabetes.
• Antibody test. Once you have been diagnosed with diabetes, your doctor may perform this test to determine if you have type 1 or type 2 diabetes. The presence of certain autoantibodies can confirm you have type 1 diabetes.
• Urinalysis. A urine test can be used to look for acids that are produced from the breakdown of fat (ketones) that are typically present in people with type 1 diabetes.

Type 1 diabetes symptoms

Some common symptoms of type 1 diabetes include:

• Frequent urination
• Excessive thirst
• Excessive hunger
• Blurred vision
• Unexplained weight loss
• Fatigue
• Irritability or other mood changes
• Bedwetting in children

What are some type 1 diabetes treatment options?

Type 1 diabetes management will require insulin injections or the use of an insulin pump. You will need frequent blood glucose monitoring, lifestyle, and carbohydrate (carbs) counting in your diet to help manage your condition.

Medications

Many available types of insulin can be used to treat T1DM. These include:

Ultra long-acting insulin (lasts 36 to 42 hours)

• Toujeo Solostar (insulin glargine)
• Tresiba (insulin degludec)

Long-acting insulin (lasts 24 hours)

• Lantus (insulin glargine)
• Levemir (insulin detemir)

Intermediate-acting insulin (lasts 12 hours)

• Humulin N (insulin NPH)
• Novolin N (insulin NPH)

Short-acting insulin

• Humulin R (insulin regular)
• Novolin R (insulin regular)

Rapid-acting insulin (lasts 2 to 4 hours)

• Novolog (insulin aspart)
• Humalog (insulin lispro)
• Apidra (insulin glulisine)

Rapid-acting inhalation powder (lasts 3 hours)

• Afrezza (insulin human)

Artificial pancreas

The FDA approved an artificial pancreas system in 2016 called a closed-loop system. It checks your blood glucose levels every 5 minutes through a continuous glucose monitor (CGM) and automatically administers or withholds a dose of long-acting (basal) insulin through a separate insulin pump. You will need to manually request insulin doses to counter carbohydrate (meal) consumption from meals or snacks.

What is the best medication for type 1 diabetes?

The best medication for the treatment of type 1 diabetes will depend on the individual’s specific medical condition, medical history, medications that the individual is already taking that may potentially interact with type 1 diabetes medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best treatment plan for you. The table below includes a list of the most prescribed or over-the-counter type 1 diabetes medications approved by the Food and Drug Administration (FDA).

Best medications for type 1 diabetes

Your healthcare provider will determine the right dosage based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist; this is not a complete list.

What are the most common side effects of type 1 diabetes medications?

The major side effect of diabetes treatment is low blood sugar (hypoglycemia). Hypoglycemia occurs if your blood sugar level drops below 70mg/dL (3.9 mmol/L). Symptoms from hypoglycemia come on quickly and need to be treated immediately. They can include:

• Sweating
• Shakiness
• Looking pale in color
• Flu-like symptoms
• Dizziness
• Hunger
• Nausea
• Fast heart rate
• Headache
• Confusion
• Fatigue
• Irritability
• Weight gain
• Injection site reactions

The American Diabetes Association recommends treating hypoglycemia using the “15-15 rule”. You should have 15 grams of carbohydrates and check it after 15 minutes. If it’s still below 70mg/dL (3.9 mmol/L), have another 15 grams of carbohydrates. You should repeat these steps until your blood sugar is over 70mg/dL (3.9 mmol/L).

Young children typically need less than 15 grams of carbohydrates to treat hypoglycemia. Please discuss with your pediatrician or diabetes care team the correct amount needed.

What are some home remedies for type 1 diabetes?

While you will require insulin therapy to treat this type 1 diabetes, there are self-care measures that can help you manage your condition, including:

• Check your blood sugar regularly with a glucose meter or a continuous glucose monitor (CGM).
• Take your medications as prescribed by your healthcare provider.
• Eat healthy, well-balanced meals and snacks.
• Aim for 150 minutes per week of physical activity. Work with your doctor or healthcare team to find an exercise plan that is right for you.
• Manage your stress because it can raise your blood sugar. Try relaxation exercises or hobbies you enjoy. You can also look for support from a friend, family member, or mental health professional.
• Visit your doctor for regular cholesterol, blood pressure, and kidney function tests.
• Learn about your condition. The more you know, the better you will be able to prevent complications.
• Check your feet daily for cuts, blisters, and red spots. Call your doctor immediately if you notice any changes or have sores that won’t go away.

Frequently asked questions about type 1 diabetes

Will I have to take insulin for the rest of my life with T1DM?

Yes, if you have type 1 diabetes, your body does not make enough insulin. You will have to give yourself multiple injections daily or use an insulin pump to give your body the correct amount of insulin.

Do I need to monitor my blood sugar if I feel fine?

Just because you feel good doesn’t mean your blood sugar levels are in your target range. Regular monitoring can help prevent serious complications from high blood sugar.

What are some complications of type 1 diabetes?

The most common complications of T1DM are:

• Hypoglycemia
• Hyperglycemia
• Diabetic ketoacidosis (shortness of breath, fruity breath, nausea)
• Heart disease and high blood pressure
• Increased risk of heart attack
• Nerve damage (diabetic neuropathy)
• Retinopathy, glaucoma, and other eye problems
• Kidney disease
• Foot ulcers and infections
• Amputations

Related resources for type 1 diabetes

• The pathophysiology of type 1 diabetes mellitus. StatPearls, National Library of Medicine
• What is type 1 diabetes? Centers for Disease Control and Prevention
• Diabetes basics. JDRF
• Type 1 diabetes symptoms and causes. Mayo Clinic
• What is type 1 diabetes? National Institute of Diabetes and Digestive and Kidney Diseases