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2014糖尿病指南: 一型糖尿病Type 1 Diabetes
Insulin Therapy
Most patients with type 1 diabetes:
• Treat with multiple-dose insulin injections (3-4 injections/day of basal and prandial insulin) or continuous subcutaneous insulin infusion
• Educate on how to match prandial insulin dose to carbohydrate intake, premeal blood glucose, and
anticipated activity
• Use insulin analogs to reduce risk of hypoglycemia
• Consider using sensor-augmented low glucose suspend threshold pump in patients with frequent nocturnal hypoglycemia and/or hypoglycemia unawareness
Most patients with type 1 diabetes: Consider screening for autoimmune diseases as appropriate
• Thyroid dysfunction, vitamin B12 deficiency, celiac disease
Screening
Inform individuals with type 1 diabetes of the opportunity to have relatives screened for risk of type 1
diabetes in the clinical research setting
• Early diagnosis may limit complications, extend long-term endogenous insulin production
Widespread testing of asymptomatic low-risk persons: not recommended
Screen high-risk persons only in clinical research setting