Stephen J. Schueler, M.D.

Juvenile-Onset Diabetes Treatment

The successful treatment of type 1 diabetes requires a lifetime commitment to daily insulin use, strict adherence to a diet, and a variety of important lifestyle choices. The key components to the treatment of type 1 diabetes include a diabetic diet, blood sugar monitoring, insulin therapy, weight control, and regular exercise.

Basic goals for treating type 1 diabetes include:

  • Maintaining a healthy weight.
  • Maintaining a healthy level of physical activity
  • Maintaining the blood glucose levels within an acceptable range:
    • Maintaining blood sugar levels during the day between 80 and 120 mg/dl.
    • Maintaining a blood sugar level at bedtime between 100 and 140 mg/dl.
    • Fasting blood sugars should be less than 100 mg/dl.
    • Glycosylated hemoglobin levels should remain less than 7%. In some cases, your doctor may suggest a level less than 6.5%.

Treatments for type 1 diabetes include:

Juvenile-Onset Diabetes Diet

A healthy diet is essential, in order to treat type 1 diabetes successfully.

Dietary goals for type 1 diabetes include:

  • Provide adequate calories for normal growth and development in children.
  • Provide adequate calories for maintaining a normal adult weight.
  • Provide adequate calories for pregnancy and breastfeeding.
  • Maintain normal blood glucose levels:
    • Balance food intake with your physical activity level.
    • Diet and insulin doses must be adjusted as activity levels change.
  • Maintain normal:

Juvenile-Onset Diabetes Drugs Hormone Analog

Amylin is a hormone that slows the movement of food form the stomach to the intestines, and may reduce the appetite. This hormone may help reduce blood glucose levels in those who are unable to control glucose levels with appropriate insulin therapy.

Synthetic amylin medications include:

Juvenile-Onset Diabetes Drugs Insulin

Insulin therapy is the primary treatment for type 1 diabetes. Insulin reduces sugar levels in the bloodstream by stimulating the body to utilize glucose for energy. Insulin is given by injection, or through an automatic insulin pump. Both methods require regular blood sugar measurements, in order to monitor therapy.

Insulin pumps are small devices that that deliver insulin through a tiny needle placed in the skin. This provides a constant dose of short-acting insulin at all times. The pump can be adjusted to release extra insulin before a meal.

Insulin injection therapy involves injections of short, intermediate, or long-acting insulin, at different times of the day. Some may mix short and longer acting insulins into a single injection. Insulin injections may be given 2 to 4 times per day. Insulin doses vary, depending on a person's size, blood sugar level, caloric intake and activity.

Juvenile-Onset Diabetes Sliding Scale

A sliding scale is an individualized program that allows short-acting insulin to be given when blood sugar levels become too high. Such a program can be individualized for each person.

Example of Sliding Scale Insulin Dosing

Glucose ReadingRegular Insulin Dosing
140 - 1602 units, re-check glucose in 2 hrs
200 - 2404 units, re-check glucose in 2 hrs
240 - 3006 units, re-check glucose in 2 hrs
300 - 4008 units, re-check glucose in 2 hrs
400 - 50010 units, re-check glucose in 2 hrs
> 500See doctor now!

Check with your doctor for specific adjustments in sliding scale doses. Your sliding scale dose will vary with your weight, diet, level of activity, and sensitivity to insulin.

Juvenile-Onset Diabetes Types of Insulin

Different types of insulin may be used for the treatment of type 1 diabetes. The types are determined by how long the medication works after a dose is taken.

Short-acting insulin:

Intermediate-acting insulin:

Long-acting insulin:

Combinations of short-acting and long-acting insulin:

Juvenile-Onset Diabetes Exercise

Exercise, along with good nutrition and medication, helps keep type 1 diabetes under control. Exercise usually lowers blood sugar and helps insulin work more effectively. If you are overweight, exercise can also help you lose weight.

Regular exercise also provides cardiovascular benefits. This is particularly important for the diabetic, who has 2 to 4 times the incidence of heart disease. Benefits of exercise include improved endurance, lower LDL cholesterol and triglycerides, and increased levels of protective HDL cholesterol.

Develop an exercise program with your doctor. Remember to monitor blood glucose levels before and after exercise. Try to perform exercise the same time of day when possible. Always wear a bracelet, identifying you as diabetic.

Juvenile-Onset Diabetes Questions For Doctor

The following are some important questions to ask before and after the treatment of type 1 diabetes.

Questions to ask before treatment:

  • What are my treatment options?
  • Do I need to take additional medication?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • When should I take insulin?
  • How do I change my diet?
  • Do I need to lose weight?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • How often do I need to measure my blood sugar?
  • What else can I do to reduce my risk for complications?
  • How often will I need to see my doctor for checkups?
  • How often will I need tests to evaluate my diabetes?
  • What local support and other resources are available?

Juvenile-Onset Diabetes Regular Monitoring

Type 1 diabetes monitoring should include:

  • Regular visits to the doctor
  • Regular measurement of height, weight, and sexual maturation
  • Annual measurement of blood cholesterol and triglycerides
  • Annual eye exams
  • Annual foot exams by a podiatrist
  • Hemoglobin A1C measurements every few months
  • Fasting blood glucose measurement target of less than 110 mg/dl
  • Blood pressure target of less than 125/75

Juvenile-Onset Diabetes Specialist

Physicians from the following specialties evaluate and treat type 1 diabetes:

Continue to Juvenile-Onset Diabetes Home Care

Last Updated: Jun 8, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Juvenile-Onset Diabetes References
  1. Davis RE, Morrissey M, Peters JR, Wittrup-Jensen K, Kennedy-Martin T, Currie CJ. Impact of hypoglycaemia on quality of life and productivity in type 1 and type 2 diabetes. Curr Med Res Opin. 2005 Sep;21(9):1477-83. [16197667]
  2. Larsson K, Elding-Larsson H, Cederwall E, Kockum K, Neiderud J, Sjoblad S, Lindberg B, Lernmark B, Cilio C, Ivarsson SA, Lernmark A. Genetic and perinatal factors as risk for childhood type 1 diabetes. Diabetes Metab Res Rev. 2004 Nov-Dec;20(6):429-37. [15386804]
  3. Mannucci E, Rotella F, Ricca V, Moretti S, Placidi GF, Rotella CM. Eating disorders in patients with type 1 diabetes: a meta-analysis. J Endocrinol Invest. 2005 May;28(5):417-9. [16075924]
  4. Schlosser M, Strebelow M, Rjasanowski I, Kerner W, Wassmuth R, Ziegler M. Prevalence of diabetes-associated autoantibodies in schoolchildren: the Karlsburg Type 1 Diabetes Risk Study. Ann N Y Acad Sci. 2004 Dec;1037:114-7. [15699502]
  5. Steck AK, Bugawan TL, Valdes AM, Emery LM, Blair A, Norris JM, Redondo MJ, Babu SR, Erlich HA, Eisenbarth GS, Rewers MJ. Association of non-HLA genes with type 1 diabetes autoimmunity. Diabetes. 2005 Aug;54(8):2482-6. [16046318]
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