Everyone with type 1 diabetes needs to take insulin. You are probably taking more than one type of insulin, either as an injection, or using an insulin pump.

The amount and type of insulin you take will likely change over time, depending on changes that occur with normal aging, changes in your exercise routine, and hormonal changes (such as during rapid growth of adolescence or pregnancy). You may need higher doses of insulin when you are ill or experiencing emotional stress. A woman needs much more insulin than usual during the last part of pregnancy.

You should:

• Know the dose of each type of insulin you take, when you take the doses, how long it takes for each type of insulin to start working (onset), when it will have its greatest effect (peak), and how long it will work (duration).
• Never skip a dose of insulin without the advice of your doctor.

Medication Choices

Insulin

Amylinomimetics, such as pramlintide (Symlin)

What To Think About

You may need other medicines at some point in your life.

• If small amounts of protein are found when your urine is tested (microalbuminuria), you may be in the early stage of diabetic nephropathy. You may be given an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB). An ACE inhibitor may reverse early kidney damage.¹⁴
• If you have had a heart attack, stroke, or other large blood vessel disease, you need to take aspirin, unless there are health reasons why you cannot. If you are age 30 or older and are at risk for heart and blood vessel disease, you also may want to take aspirin to help prevent these complications.⁶ Do not give aspirin to anyone under 20 years old, because it has been linked with Reye's syndrome.
• If you have high blood pressure or high cholesterol, you may need other medicines to treat these conditions. Adequate treatment may help prevent complications from diabetes. You may need one or more medicines to lower blood pressure. You also may need to take statins to lower your cholesterol. Statins are medicines that can reduce LDL levels and the risk of heart disease in people with diabetes.⁸ They also have been shown to reduce the risk of heart attack and stroke by one-third in people with diabetes, even those who do not have high LDL levels or existing heart disease.¹⁵