Treating type 1 diabetes
Type 1 is treated with insulin and by eating a healthy diet. Insulin can't be taken by mouth because the digestive juices in the stomach destroy it. This means that for most people it has to be given by injections. Most people find giving the injections simple and relatively painless, since the needle is so fine.
How often someone needs to inject depends on what their diabetes specialist has recommended, and which type of insulin they're using. Insulin is given at regular intervals throughout the day, usually two to four times.
Each injection may contain one, or a combination of different types of insulin, which act for a short, intermediate or longer period of time.
An automatic insulin pump is available, which means that fewer injections are needed. The needle is sited under the skin, and connected to a small electrical pump that attaches to a belt or waistband and is about the size of a pager. Inside is a reservoir of fast-acting insulin which is delivered continuously at an adjustable rate.
Inhaled insulin has recently become available for treating people with a proven needle phobia or people who have severe trouble injecting.
What is insulin?
Insulin was first used to treat diabetes in 1921. Under normal circumstances, it's made by beta cells that are part of a cluster of hormone-producing cells in the pancreas.
The hormone regulates the level of glucose in the blood, preventing the level from going too high. Insulin enables cells to take up the amount of glucose they need to provide themselves with enough energy to function properly. It also allows any glucose left over to be stored in the liver.
Most insulin used today is 'human insulin', although some people still use insulin from cows and pigs. 'Human insulin' is a product of genetic engineering, where bacteria bred in a laboratory are given a gene that allows them to produce insulin.
Treating type 2 diabetes
Type 2 may have been considered the 'milder' form of diabetes in the past, but this is no longer the case. For many people, type 2 diabetes can be controlled by diet alone. Medication in tablet form is used when diet doesn't provide adequate control.
The different types of tablets work by one of these methods:
- helping the pancreas to make more insulin
- increasing the use of glucose and decreasing glucose production slowing down the absorption of glucose from the intestine
- stimulating insulin release from the pancreas
- enabling the body to use its natural insulin more effectively
Over time, a careful diet combined with oral medication may not be sufficient to keep the diabetes under control. If this is the case then insulin injections may be recommended.
BBC Health. This article was last medically reviewed by Dr Rob Hicks in September 2006. First published in April 2001.