Type 1 diabetes is a chronic condition caused by an autoimmune reaction, in which your body attacks the cells in your pancreas that make the hormone insulin.
Treatment typically involves daily insulin injections or the use of an insulin pump to manage your blood sugar levels. Individuals with type 1 diabetes may require other treatments depending on the severity of the disease and to manage complications of diabetes.
This article discusses the medications and other therapies for managing type 1 diabetes.
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Insulin for Type 1 Diabetes
If you have type 1 diabetes, you will need to either inject insulin or use an insulin pump every day to make up for the insulin that your pancreas is not producing.
It's not possible to take insulin in pill form because stomach acid would break it down before it could reach your bloodstream.
Insulin is needed to manage your blood sugar levels and provide energy for your body. Without it, glucose cannot enter the muscles and use it for energy.
Types
Insulin is categorized by how fast and how long it works in your body. For individuals with type 1 diabetes, a combination of insulin types is commonly used. Insulin replacement plans typically consist of:
- Basal insulin: Provides a background dose to help regulate blood sugar levels between meals
- Mealtime insulin: Taken before meals to prevent a rise in blood glucose caused by carbohydrates in the meal
- Correction insulin: Administered to lower blood glucose levels when they are above the target range
See the table below for the different types of insulins available:
| Insulin Type | How Long They Take to Work | Duration of Action | Administration | Examples |
|---|---|---|---|---|
| Rapid-acting | 15 minutes | Two to four hours | Usually taken right before a meal; often used with longer-acting insulin | Fiasp, NovoLog (insulin aspart); Apidra (insulin glulisine); Admelog, Humalog, Lyumjev (insulin lispro) |
| Rapid-acting, inhaled | 10 to 15 minutes | Three hours | Usually taken right before a meal; often used with injectable long-acting insulin | Afrezza (inhaled insulin) |
| Regular-/short-acting | 30 minutes | Three to six hours | Usually taken 30 to 60 minutes before a meal | Humulin R, Novolin R, Myxredlin (regular insulin) |
| Intermediate-acting | Two to four hours | 12 to 18 hours | -Often used with rapid- or short-acting insulin | Humulin N, Novolin N (insulin NPH) U-500 |
| Long-acting | Two hours | Up to 24 hours | Often used, when needed, with rapid- or short-acting insulin | Levemir (insulin detemir); Basaglar, Lantus, Toujeo, Semglee, Rezvoglar (insulin glargine) |
| Ultra-long-acting | Six hours | 36 hours or longer | Tresiba (degludec) | |
| Premixed (intermediate + short-acting insulin) | Five to 60 minutes | 10 to 16 hours | Usually taken 10 to 30 minutes before breakfast and dinner | Novolog Mix 70/30 (insulin aspart protamine/ insulin aspart 70/30); Humalog Mix 50/50 (insulin lispro protamine/ insulin lispro 50/50); Humalog Mix 75/25 (insulin lispro protamine/ insulin lispro 75/25); Humulin 70/30, Novolin 70/ 30 (insulin NPH/insulin regular 70/30) |
For more information about types of insulin, talk to your healthcare provider or pharmacist.
Delivery Methods
Insulin is available in two dosage forms, as follows:
- Injectable solution in vials or pens
- Inhalation powder in cartridges
Insulin can be administered through several different methods, including:
- Syringe
- Pen
- Pump
- Inhaler
Syringe
Your healthcare provider will tell you how much insulin you need to draw up from the vial for each dose. The insulin is injected through a needle.
Pen
Some pens use cartridges inserted into the pen, while others are prefilled and discarded after use. The insulin dose is dialed on the pen, and the insulin is injected through a needle.
Pump
An insulin pump delivers insulin continuously through a semi-permanent tube in the stomach or back of the upper arm. Your healthcare provider will show you how and where to place the tube.
The pump gives you a basal dose of short- or rapid-acting insulin every hour. You can also calculate the mealtime/correction insulin dose to receive from your pump when you eat or when your blood sugar is high.
Inhaler
Inhaled insulin is taken using an oral inhaler.
Amylinomimetic Injectables
Symlin (pramlintide) is an amylin analog used in conjunction with insulin in the treatment of type 1 and type 2 diabetes in adults. It is typically prescribed when insulin alone does not control blood sugar well enough.
Symlin works just like the naturally occurring amylin to lower blood sugar in three ways:
- Lowers glucagon release
- Slows the rate at which food moves from the stomach
- Triggers the feeling of fullness to decrease food intake
Symlin is available as an injection pen administered under the skin, alongside insulin injection, but as a separate injection. It is usually given just before a meal.
Other Medications Prescribed in Type 1 Diabetes
There are other types of medications that you may need if you have type 1 diabetes to manage complications of the disease, like hypoglycemia (low blood sugar) and diabetic ketoacidosis (DKA).
Hypoglycemia is blood sugar below 70 milligrams (mg) per deciliter (dL) and needs to be treated quickly.
Low blood sugar (55–69 mg/dL) can be treated with over-the-counter glucose tablets or gel. It can also be treated with food items that have about 15 grams of carbohydrates, such as:
- 4 ounces (one-half cup) of juice or regular soda
- 1 tablespoon of sugar, honey, or syrup
- Hard candies, jellybeans, or gumdrops (refer to the food label for appropriate quantity)
Severely low blood sugar (less than 55 mg/dL) must be treated with prescription glucagon.
If you experience low blood sugar several times a week. it's important to talk to your healthcare provider, as your treatment plan may need adjustments.
In the case of DKA, treatment will typically take place in the emergency room or hospital, and may involve continuous intravenous insulin, fluid replacement, and treatment of any underlying cause of DKA, such as sepsis, heart attack, or stroke.
Can Ozempic Help Treat Type 1 Diabetes?
Ozempic (semaglutide) is not approved for the treatment of type 1 diabetes. Ozempic is a once-weekly injection that helps lower blood sugar in adults with type 2 diabetes. However, some research suggests that semaglutide can still provide benefits for those with type 1 diabetes.
A small clinical study found an association between starting Ozempic soon after the diagnosis of type 1 diabetes and reduced insulin needs and better glycemic control. Other research has shown that it can encourage weight loss and improve glucose levels in people with type 1 diabetes who are overweight or have obesity.
If your healthcare provider prescribes Ozempic for type 1 diabetes, they will be doing so off-label, which means using the medication for a purpose other than what the Food and Drug Administration (FDA) approved it for.
Are There Other Treatment Options for Type 1 Diabetes?
Insulin is the mainstay of treatment for type 1 diabetes. However, in some cases, two other medical procedures are used: islet cell transplantation and whole pancreas transplantation. These procedures help replace the destroyed islets in type 1 diabetes.
Lantidra (donislecel) is an infusion cell therapy made from donor pancreatic islet cells.
It was approved for adults with type 1 diabetes who are unable to meet their A1c (average blood sugar over two or three months' time) goal because of repeated episodes of severe hypoglycemia despite intensive diabetes management and education.
Lantidra is thought to work by restoring the body's insulin-producing islet beta cells. In some patients, these infused cells can produce enough insulin so they no longer need insulin to control their blood sugar levels.
Pancreas transplantation can be performed for the following three types of people with type 1 diabetes:
- Those with chronic kidney failure who can receive both a pancreas and a kidney transplantation at once
- Those who have had a successful kidney transplant
- Those with poor glucose control despite optimal insulin therapy or those who experience problematic hypoglycemia and/or suffer from worsening complications of diabetes
Lifestyle Modifications
In addition to medications and medical procedures, healthy lifestyle habits that may help manage type 1 diabetes include:
- Healthy food choices, such as a diet that includes vegetables, fruit, whole grains, lean protein, low-fat dairy, and heart-healthy foods
- Regular physical activity
- Adequate sleep
- Blood pressure and cholesterol control
- Stress management
Summary
Type 1 diabetes is primarily managed with insulin. Depending on how well-controlled your diabetes is, your healthcare provider may also prescribe Symlin for additional help or glucagon for severely low blood sugar.
Islet cell transplantation or whole pancreas transplantation are medical procedures that are also available for eligible adults.
Maintaining a healthy lifestyle is also a beneficial complementary method for keeping your diabetes under control. Be sure to visit your healthcare provider regularly to monitor your condition.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Temitope Oyeleke, PharmD
Oyeleke is a Maryland-based clinical pharmacist. She received her Doctor of Pharmacy degree from Hampton University School of Pharmacy.
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