- Part 1 Principles of international endocrine practice
- Part 2 Pituitary and hypothalamic diseases
- Part 3 The thyroid
- Part 4 Parathyroid, calcium, and bone metabolism
- Part 5 The adrenal gland and endocrine hypertension
- Part 6 Neuroendocrine tumours and genetic disorders
- Part 7 Growth and development during childhood
- Part 8 Female endocrinology and pregnancy
- Part 9 Male hypogonadism and infertility
- Part 10 Endocrinology of ageing and systemic disease
- Part 11 Endocrinology of cancer
- Part 12 Obesity, lipids, and metabolic disorders
- Part 13 Diabetes mellitus
- 13.1 Classification and diagnosis of diabetes mellitus
- 13.2 Aetiology and pathogenesis of type 1 diabetes mellitus
- 13.3 Aetiology and pathogenesis of type 2 diabetes mellitus
- 13.4 Management of diabetes mellitus
- 13.4.1 Clinical features, lifestyle management, and glycaemic targets in type 2 diabetes mellitus
- 13.4.2 Pharmacological therapy of hyperglycaemia in type 2 diabetes mellitus
- 13.4.3 Diabetes in diverse ethnic groups
- 13.4.4 Structured education for people with type 2 diabetes mellitus
- 13.4.5 Metabolic surgery in the treatment of type 2 diabetes mellitus
- 13.4.6 Management of type 1 diabetes mellitus
- 13.4.7 Type 1 and type 2 diabetes mellitus in children
- 13.4.8 Hypoglycaemia in the treatment of diabetes mellitus
- 13.4.9 Non-biological technologies in glucose sensing
- 13.4.10 Management of diabetes mellitus in special situations
- 13.5 Microvascular complications
- 13.6 Macrovascular diseases and diabetes mellitus
- 13.7 The diabetic foot
- 13.8 Mental health and diabetes mellitus
- 13.9 Organization of diabetes care
- 13.10 Transplantation in Diabetes
- 13.11 Gene therapy in diabetes mellitus
Management of type 1 diabetes mellitus
- Chapter:
- Management of type 1 diabetes mellitus
- Author(s):
Simon R. Heller
- DOI:
- 10.1093/med/9780199235292.003.1420
Almost 90 years after the discovery of insulin, people with type 1 diabetes still use subcutaneous insulin to manage their condition. Such treatment is life saving, preventing early death from ketoacidosis, relieving symptoms, and reversing most of the pathophysiological features within a few weeks of diagnosis. Yet people with diabetes still die prematurely from long-term complications, and the quality of the lives of others is blighted by impaired vision, amputation, renal replacement therapy, or recurrent hypoglycaemia. Despite the clear demonstration that tight glycaemic control can delay, and perhaps prevent, both micro- and macro-vascular disease, the limitations of current therapy prevent most from achieving these levels of blood glucose control. There is now a realistic, albeit distant, prospect of a revolution in treatment, involving either cell therapy (see Chapters 13.10 and 13.11) or closed-loop technology combining continuous glucose sensing and insulin-infusion pumps (see Chapter 13.4.9.2). However, for the foreseeable future, the responsibility of the diabetes professional is to assist individuals with type 1 diabetes to achieve both an optimum level of blood glucose and quality of life with best use of available methods.
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- Part 1 Principles of international endocrine practice
- Part 2 Pituitary and hypothalamic diseases
- Part 3 The thyroid
- Part 4 Parathyroid, calcium, and bone metabolism
- Part 5 The adrenal gland and endocrine hypertension
- Part 6 Neuroendocrine tumours and genetic disorders
- Part 7 Growth and development during childhood
- Part 8 Female endocrinology and pregnancy
- Part 9 Male hypogonadism and infertility
- Part 10 Endocrinology of ageing and systemic disease
- Part 11 Endocrinology of cancer
- Part 12 Obesity, lipids, and metabolic disorders
- Part 13 Diabetes mellitus
- 13.1 Classification and diagnosis of diabetes mellitus
- 13.2 Aetiology and pathogenesis of type 1 diabetes mellitus
- 13.3 Aetiology and pathogenesis of type 2 diabetes mellitus
- 13.4 Management of diabetes mellitus
- 13.4.1 Clinical features, lifestyle management, and glycaemic targets in type 2 diabetes mellitus
- 13.4.2 Pharmacological therapy of hyperglycaemia in type 2 diabetes mellitus
- 13.4.3 Diabetes in diverse ethnic groups
- 13.4.4 Structured education for people with type 2 diabetes mellitus
- 13.4.5 Metabolic surgery in the treatment of type 2 diabetes mellitus
- 13.4.6 Management of type 1 diabetes mellitus
- 13.4.7 Type 1 and type 2 diabetes mellitus in children
- 13.4.8 Hypoglycaemia in the treatment of diabetes mellitus
- 13.4.9 Non-biological technologies in glucose sensing
- 13.4.10 Management of diabetes mellitus in special situations
- 13.5 Microvascular complications
- 13.6 Macrovascular diseases and diabetes mellitus
- 13.7 The diabetic foot
- 13.8 Mental health and diabetes mellitus
- 13.9 Organization of diabetes care
- 13.10 Transplantation in Diabetes
- 13.11 Gene therapy in diabetes mellitus