Therapy of Type 1 Diabetes Mellitus

  • Andrew J. Drexler
  • Carolyn Robertson


The treatment of type 1 diabetes mellitus is both completely clear and extremely complex. Individuals with type 1 diabetes must receive insulin therapy. There are no alternatives and no exceptions. How that insulin should best be administered as well as what blood sugar level should be targeted was unknown prior to 1993. At that time, the Diabetes Control and Complications Trial (DCCT) ended a many decades long debate over the relationship between improved glucose control and the microvascular complications of diabetes.1 During the DCCT, patients were randomly divided into an intensive control group, which was treated with either insulin injections taken at least three times a day or with an insulin pump, or a conventional group which was treated with only two injections a day. Both groups were given diet instruction, but the former group met with members of a diabetes team on a regular basis. They were taught how to adjust their insulin, manipulate a meal plan and alter their lifestyles to achieve blood glucose levels as close as possible to those seen in non-diabetics. With a difference in hemoglobin A1C of only 1.5% between the two groups, there was an approximately 50% reduction in the microvascular complications (retinopathy, nephropathy and neuropathy). As a result of the strongly affirmative answer from the DCCT, programs of intensive management with blood glucose targets of near normoglycemia became the standard of care for individuals with type 1 diabetes.2, 3


Human Insulin Insulin Glargine Basal Insulin Insulin Analog Lispro Insulin 
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© Springer Science+Business Media New York 2004

Authors and Affiliations

  • Andrew J. Drexler
  • Carolyn Robertson

There are no affiliations available

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