J Korean Diabetes.  2020 Sep;21(3):156-160. 10.4093/jkd.2020.21.3.156.

Management of Type 1 Diabetes Mellitus in Adults

Affiliations
  • 1Diabetes Education Unit, Jeonbuk National University Hospital, Jeonju, Korea

Abstract

The number of adults living with type 1 diabetes is increasing due to an increase in the number of newly diagnosed adult type 1 patients, and the longevity of individuals with childhood-onset diabetes. In addition, adults with type 1 diabetes currently span a wide range of ages, from 18 to 100 years of age, and diabetes self-management may vary by developmental stage. A reasonable A1C goal for many nonpregnant adults with type 1 diabetes is < 7%. But, as with all management issues for people with type 1 diabetes, providers need to individualize assessment and treatment options by individual patient. A structured education program for type 1 diabetes patients includes procedures for blood glucose self-monitoring, carbohydrate counting, and insulin dose adjustment at mealtimes to achieve optimal glycemic control and quality of life. Diabetes self-management education is the ongoing process of facilitating the knowledge, skill, and abilities necessary for diabetes patients to accomplish self-care, which includes the needs, goals, and life experiences of each individual with diabetes.

Keyword

Adult; Diabetes mellitus; type 1; Disease management

Reference

1. International Diabetes Federation. IDF diabetes atlas. 8th ed. Brussells: International Diabetes Federation;2017.
2. American Diabetes Association. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020; 43(Suppl 1):S14–31.
3. Miller RG, Secrest AM, Sharma RK, Songer TJ, Orchard TJ. Improvements in the life expectancy of type 1 diabetes: the Pittsburgh Epidemiology of Diabetes Complications study cohort. Diabetes. 2012; 61:2987–92.
Article
4. Lee YB, Han K, Kim B, Jin SM, Lee SE, Jun JE, et al. High proportion of adult cases and prevalence of metabolic syndrome in type 1 diabetes mellitus population in Korea: a nationwide study. Diabetes Metab J. 2019; 43:76–89.
Article
5. Jin SM, Kim JH. Management of adults with type 1 diabetes: current status and suggestions. J Korean Diabetes. 2014; 15:1–6.
Article
6. Chiang JL, Kirkman MS, Laffel LM, Peters AL. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes Care Jul. 2014; 37:2034–54.
Article
7. Rawshani A, Rawshani A, Franzén S, Eliasson B, Svensson AM, Miftaraj M, et al. Range of risk factor levels: control, mortality, and cardiovascular outcomes in type 1 diabetes mellitus. Circulation. 2017; 135:1522–31.
8. Balfe M, Doyle F, Smith D, Sreenan S, Brugha R, Hevey D, et al. What's distressing about having type 1 diabetes? A qualitative study of young adults' perspectives. BMC Endocr Disord. 2013; 13:25.
Article
9. Korean Diabetes Association. Treatment guideline for diabetes. 6th ed. Seoul: Seoul Medcus;2019. p. 33–7.
10. Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group, Lachin JM, White NH, Hainsworth DP, Sun W, Cleary PA, et al. Effect of intensive diabetes therapy on the progression of diabetic retinopathy in patients with type 1 diabetes: 18 years of follow-up in the DCCT/EDIC. Diabetes. 2015; 64:631–42.
Article
11. Writing Group for the DCCT/EDIC Research Group, Orchard TJ, Nathan DM, Zinman B, Cleary P, Brillon D, et al. Association between 7 years of intensive treatment of type 1 diabetes and long-term mortality. JAMA. 2015; 313:45–53.
Article
12. American Diabetes Association. 6. Glycemic targets: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020; 43(Suppl 1):S66–76.
13. Battelino T, Danne T, Bergenstal RM, Amiel SA, Beck R, Biester T, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care. 2019; 42:1593–603.
14. Jin SM, Baek JH, Suh S, Jung CH, Lee WJ, Park CY, et al. Factors associated with greater benefit of a national reimbursement policy for blood glucose test strips in adult patients with type 1 diabetes: a prospective cohort study. J Diabetes Investig. 2017; 9:549–57.
Article
15. Beck RW, Riddlesworth TD, Ruedy KJ, Kollman C, Ahmann AJ, Bergenstal RM, DIAMOND Study Group, et al. Effect of initiating use of an insulin pump in adults with type 1 diabetes using multiple daily insulin injections and continuous glucose monitoring (DIAMOND): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2017; 5:700–8.
16. Lind M, Polonsky W, Hirsch IB, Heise T, Bolinder J, Dahlqvist S, et al. Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: the GOLD randomized clinical trial. JAMA. 2017; 317:379–87.
17. Korean Diabetes Association. Treatment guideline for diabetes. 6th ed. Seoul: Seoul Medcus;2019. p. 52.
18. Reddy M, Rilstone S, Cooper P, Oliver NS. Type 1 diabetes in adults: supporting self management. BMJ. 2016; 352:i998.
Article
19. Little SA, Leelarathna L, Walkinshaw E, Tan HK, Chapple O, Lubina-Solomon A, et al. Recovery of hypoglycemia awareness in long-standing type 1 diabetes: a multicenter 2 × 2 factorial randomized controlled trial comparing insulin pump w ith multiple daily injections and continuous with conventional glucose self-monitoring (HypoCOMPaSS). Diabetes Care. 2014; 37:2114–22.
20. Campbell F, Lawton J, Rankin D, Clowes M, Coates E, Heller S, et al. Follow-Up Support for Effective Type 1 Diabetes self-management (the FUSED model): a systematic review and meta-ethnography of the barriers, facilitators and recommendations for sustaining self-management skills after attending a structured education programme. BMC Health Serv Res. 2018; 18:898.
Article
21. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020; 41:111–88.
22. Korean Diabetes Association. Treatment guideline for diabetes. 6th ed. Seoul: Seoul Medcus;2019. . p94.
23. Korean Diabetes Association. Treatment guideline for diabetes. 6th ed. Seoul: Seoul Medcus;2019. p. 88.
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