Trials and tribulations of managing type 1 diabetes

Effective type 1 diabetes mellitus (T1DM) management tools are education, empowerment, insulin, and diet control. Exercise should be of moderate intensity so as to avoid hypoglycaemia. It is prudent to ensure that the required insulin levels are achieved in all children in order to manage the disorder well. The total daily dose of insulin may be 0.6–1.0 u/kg body weight, and it may be 2/3, 1/3 for split mixed insulin, and 50/50 for multiple subcutaneous injections. The dosages for the pump also vary from child to child. Basal bolus regimen is important and necessary in all T1DM children. It is not necessary to use all types of insulin analogs in all T1DM children, and the decision should depend on cost and delivery limiting factors. The advantages of using analogues are that some of these exhibit low hypoglycemic events (especially nocturnal events with basal insulin) and a few offer flexibility of administration to patients (most prandial analogs and some basal analogs).