Diabetes mellitus, Type 1

Question 1

Preferred insulin regimens:

Answer 1

1). 4 injections per day (basal-bolus):

• short-acting or neutral (regular) insulin before each meal (breakfast, lunch and dinner) i.e. bolus,
• with an intermediate or long-acting insulin at bedtime (basal)

2). 2 pre-mixed injections (biphasic) per day:

• ‘split and mix’ of short-acting and long-acting insulin (e.g. Mixtard or Humulin 30/70),
• twice daily before breakfast and before the evening meal (the most common)

3). 3 injections per day:

• short-acting insulin before breakfast and lunch
• and long-acting before evening meal

Question 2

Control guidelines for diabetic management

Answer 2

Question 3

Illustration of time course of insulin injections regimens

Answer 3

Question 4

Glycaemic targets for adults with type 1 diabetes

Answer 4

HbAIc 53 mmol/L (<7.0%)

Blood glucose —fasting preprandial 4–7 mmol/L

—postprandial 5–10 mmol/L