How Do You Treat Type 1 Diabetes?
Treating type 1 diabetes (T1D) is not as simple as just taking a particular medication or using a therapy, but it's more of a management puzzle that has many different parts.
People with T1D must take insulin because their bodies do not naturally produce it. This is a required and first-line treatment for anyone with this autoimmune condition.
Beyond that, people with T1D may also take other medications and use different methods to help manage their blood sugar levels. This is where your healthcare team plays a key role in helping to create a diabetes management plan and how to best treat your T1D based on many factors.
Managing type 1 diabetes
While the 'treatment' for a chronic condition is often viewed through the lens of medications or other therapies, T1D is one of those that requires constant management and affects how certain medications work.
That is why treating T1D goes beyond just insulin and medication use. Diabetes management involves monitoring blood sugar levels, keeping track of what you consume each day, maintaining enough physical activity, managing your mental health, and more.
Using insulin
People with T1D must take insulin each day.
Their bodies don't naturally make insulin, so it must be administered in another way.
Many different types of insulin exist, ranging from fast short-acting insulin taken each time you eat or consume carbohydrates to longer-acting insulin that lasts in your body for hours at a time.
Whatever type of insulin you take, you administer it through injections with a syringe or prefilled insulin pen. Others may choose to use an insulin pump device to administer their insulin each day.
Insulin pens
Many different types of insulin pens exist for long-acting and mealtime insulin forms. You may find these differ slightly based on the insulin you're using.
Many of the most common insulin pens are disposable. They contain a prefilled cartridge that can be used for a certain number of days, and when the cartridge is empty, the entire pen is thrown away.
Some reusable pens are also available, allowing you to replace the insulin cartridge when it's empty.
The needles on insulin pens are known as pen needles, and they come in different lengths and thicknesses based on your preferences.
Insulin pumps
Insulin pumps are wearable devices that people with diabetes use to deliver insulin. They are connected to a spot on your body and continuously give insulin for 2 to 4 days.
These devices deliver a programmed amount of insulin through a small tube called a cannula, inserted just under the top layer of your skin. Your doctor will work with you to determine how much insulin you need each day.
Insulin pumps can also deliver an insulin bolus, which is an extra dose of insulin in addition to your basal rate.
Some pumps may automatically give you boluses based on your higher blood sugar or carbs, but most allow you to enter a manual bolus for the pump to deliver when needed.
Historically, insulin pumps were completely manual devices that you had to program for any insulin. In more recent years, advanced technology now available allows for algorithms to calculate and automatically deliver if you use the device with a connected CGM.
Off-label medications for type 1 diabetes
Other diabetes medications may also be something to discuss with your doctor. These may include Metformin, GLP-1s, or SGLT-2s meds, which aren't cleared by regulators to use with T1D but may be beneficial beyond that labeling.
While some research does show the benefit of these medications for T1D, it indicates there may not be a significant blood sugar improvement, and there may be a high risk of increased hypoglycemia, hyperglycemia, and DKA.
That is why it's always important to consult a doctor and your diabetes care team to discuss possible pros and cons if you're interested in using an off-label treatment for T1D along with insulin. It's also important to take all medications as prescribed.
Metformin
Metformin is a type of oral medication that's approved for type 2 diabetes. However, it's now also commonly prescribed by doctors, and some people with T1Ds use them successfully along with their insulin.
Since some T1Ds can develop insulin resistance, the insulin they take each day may not work as well as it once did. Metformin may be an option because it helps reduce sugar production in the liver.
Your doctor may advise you to take Metformin in addition to insulin, but that could mean they'd have to write an off-label prescription.
GLP-1s
Glucagon-like peptide-1 receptor (GLP-1) agonists help manage blood sugar levels and reduce hunger and food intake, possibly supporting weight loss along with managing diabetes glucose levels.
These may include:
Ozempic
Wegovy
Trulicity
Victoza
While these are FDA-cleared for those with T2D, some people with type 1 diabetes also choose to use these for the same reasons.
The diabetes clinical community, along with T1Ds, has been advocating for the FDA to consider labeling these medications beyond just T2D use, but as of mid-2025, that hasn't yet materialized.
SGLT-2 inhibitors
Sodium-glucose transport protein 2 (SGLT2) inhibitors are a class of medications that are also known as gliflozins. These prevent glucose from reabsorbing after it's filtered through your kidneys, helping that glucose to leave your body through urine and lowering blood sugar levels.
Invokana
Jardiance
Farxiga
Steglatro
This 2023 research review found moderate benefits for SGLT-2s in people type 1 diabetes, without an increase in risk or side effects.
One specific SGLT-2 called Sotagliflozin (Zynquista) could eventually be used to treat T1D along with insulin. It would work to lower glucose levels by forcing the body to release it in urine and reducing glucose absorption in the gut.
This 2019 research review shows the promise of the medication being used for T1D. However, the Food and Drug Administration (FDA) denied Sotagliflozin in both 2019 and 2024 due to some concerns about the medication.
However, it is approved by the European Medicines Agency (EMA) and may be reconsidered by the FDA in the future.
Consult your diabetes care team
Managing and treating type 1 diabetes is a very individualized process that requires working with your healthcare team. They can best help you understand the condition and learn what treatments may be best for your personal diabetes management and health goals.
Always consult your care team before making any treatment decisions, including the types and dosages of any medications you take.
For people with T1D, this will likely include diabetes specialists, including an endocrinologist, diabetes care and education specialist, and nutritionist or dietitian.
Cure research and related treatments
While there isn't a T1D cure on the horizon, researchers continue studying ways to prevent this autoimmune condition and reverse it for those who've already been diagnosed.
Some of the more promising research avenues currently include:
Gene therapy
For T1D, gene therapy could involve reprogramming alternative cells, making those reprogrammed cells perform the functions of the original insulin-producing beta cells.
But the reprogrammed cells would be different enough from beta cells so that your own immune system wouldn't recognize them as 'new cells' and attack them, which is what happens in the development of T1D.
Islet cell transplants
This involves transplanting donated or newly created insulin-making islet cells into the body or pancreas of someone with T1D. Islet transplants aren't new and have been an experimental treatment for many years.
This requires immunosuppressant drugs, which often have other side effects and are more expensive. Despite the limited promise of this therapy, many challenges exist.
In 2023, the FDA approved a first-of-its-kind treatment for a small number of people with T1D who have severe hypoglycemia and struggle to maintain their blood sugars. Known as Lantrida, this is the first pancreatic islet cellular therapy made from deceased donor pancreatic cells.
Other ongoing research explores using stem cells to generate new islet cells rather than transplanting them.
Functional bionic therapy
Largely based on technology that includes insulin pumps and continuous glucose monitors (CGM), these options to treat and manage T1D may be considered a 'functional cure' —something that basically makes life with this type of diabetes minimally burdensome and almost as 'good as being cured' for some people.
These may be the evolving technologies, including closed-loop systems that automatically manage insulin and glucose monitoring to keep blood sugars in target range. Various early systems exist and are getting better, and some believe that this could eventually become a standard of care in managing T1D — assuming affordability and access allow for it.
The takeaway
Insulin is the main and only required treatment for type 1 diabetes. This is needed because people with T1D don't naturally make insulin in their bodies as those without the condition do.
Other medications and types of therapy, alongside insulin, may also help people manage their blood sugar levels and diabetes overall. Some of these prescription medications may be considered 'off-label' drugs if your doctor is willing to prescribe them for T1D.
Diabetes management means routine blood sugar monitoring, exercise and eating routines, and other aspects, from sleep to mental health.
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