Insulin Is Not a Cure
Subcutaneous (i.e., under the skin) injections of insulin are the frontline treatment for type 1 diabetes. However, it's important to realize that insulin is not a cure for diabetes, nor can insulin treatment erase the potential for complications and increased risk for other autoimmune disorders that accompany the disease. The only current “cure” for the disease is the transplantation of a healthy, functioning pancreas or of insulin-producing beta cells, and even those procedures are not without their own set of risks and potential problems.
The finely tuned internal biological mechanisms that dispense just the right amount of insulin in response to blood glucose levels are absent in type 1 diabetes patients. While injected exogenous insulin (insulin manufactured outside of the body) can bring blood glucose levels down to a safe level, it is a far from perfect system.
The type and amount of insulin and the timing and location of injections are just a few of the many factors that influence how well the treatment works. The dose of insulin must adequately cover the amount of carbohydrates that will be eaten and the corresponding rise in blood sugar levels. Too much insulin, and hypoglycemia (or low blood glucose) results. Too little, and blood sugars rise too high. Precision is important, yet it is far from an exact science.
Vigilant attention to diet, a good understanding of how changes in carb intake and exercise affect insulin dose, and basic math skills are essential to proper treatment; yet, even with these, insulin treatment can often be an imprecise science. Circumstances such as emotional stress, use of other medications, and even something as seemingly simple as the common cold can result in rising blood glucose levels and a potential diabetic emergency.
People diagnosed with type 1 diabetes sometimes experience a period of remission known as the honeymoon period, which usually occurs after diagnosis as blood glucose levels are normalized. During a honeymoon, some remaining islets are functioning and the need for insulin injections is temporarily reduced or eliminated completely.
In 2005, the FDA approved a new injectable hormone, Symlin, for use in both type 1 and type 2 diabetes. When used along with insulin, Symlin helps to control postprandial (after-meal) blood glucose levels.
Symlin is a synthetic version of the hormone amylin, and it controls blood glucose levels in three ways. First, Symlin slows digestion, which results in a longer and less pronounced rise in glucose after meals. Second, it helps to inhibit postmeal glucose release by the liver. And third, Symlin enhances the feelings of fullness (or satiety) at mealtime to prevent overeating.