Standards of Medical Care in Diabetes—2013

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As noted above, less stringent treatment goals may be appropriate for adults with limited life expectancies or advanced vascular disease. Glycemic goals for children are provided in VII. Glycemic control. Severe or frequent hypoglycemia is an absolute indication for the modification of treatment regimens, including setting higher glycemic goals. Approach to treatment a.

Pharmacological and overall approaches to treatment 1. Insulin therapy for type 1 diabetes Recommendations Most people with type 1 diabetes should be treated with MDI injections three to four injections apiece day of basal and prandial insulin or continuous subcutaneous insulin infusion CSII. A Most people with type 1 diabetes should be educated in how to match prandial insulin dose en route for carbohydrate intake, premeal blood glucose, after that anticipated activity. E Most people along with type 1 diabetes should use insulin analogs to reduce hypoglycemia risk. A Consider screening those with type 1 diabetes for other autoimmune diseases thyroid, vitamin B12 deficiency, celiac as apposite. B The DCCT clearly showed so as to intensive insulin therapy three or add injections per day of insulin, CSII, or insulin pump therapy was a key part of improved glycemia after that better outcomes 71 , By the time of the study, analysis was carried out with short- after that intermediate-acting human insulins. Despite better microvascular outcomes, intensive insulin therapy was allied with a high rate in acute hypoglycemia 62 episodes per patient-years of therapy.

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