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Compensating insulin deficiency

Insulin deficiency is compensated for by administering insulin products using multiple daily injections (MDI) or pump therapy. Basal insulin is required throughout the 24-hour period and mealtime insulin is taken with eating.

To compensate for impaired or missing insulin secretion due to the dysfunction of the beta cells of the pancreas, insulin products are injected into the subcutaneous fat tissue with a needle or pump. The goal is for blood sugar to be as close to normal as possible without disruptive or severe hypoglycaemia or major blood sugar fluctuations.

As a person with type 1 diabetes you will learn to adjust the dosage on the basis of glucose sensor and, if necessary, blood sugar self-monitoring. With self-management guidance as well as professional and peer support, you learn to adjust your insulin doses on the basis of changes in meals, exercise, different situations and daily routines.

Insulin replacement therapy requires basal insulin, which acts throughout the day and regulates the release of sugar into circulation from the liver at night and between meals. In MDI therapy, long-acting insulin derivatives are used as basal insulin. Long-acting insulin derivatives include insulin degludec, insulin detemir and insulin glargine.

In pump therapy, the need for basal insulin is covered by the continuous administration of rapid-acting insulin.

Mealtime insulin is taken in connection with meals based on the meal’s carbohydrate content and potential exercise. Rapid-acting insulin derivatives include insulin aspart, insulin glulisine and insulin lispro.

In pump therapy, only rapid-acting insulin is used. The insulin dosed for meals in pump therapy is also referred to as a bolus.

Small doses of rapid-acting insulin i.e. correction insulin are used to correct temporarily high blood sugar before a meal or during illness.

Updated 17.10.2023