The Challenges of Treating Type 1 Diabetes

In theory, type 1 diabetes should be simple to treat, according to David Maahs, M.D., M.A., Ph.D., from Stanford University.

Type 1 diabetes is caused by the body’s inability to make insulin and therefore is a chronic disease that needs everyday treatment.

“It's very simple what we need to do,” Maahs said. “We just need to replace insulin in the way your body should make it but can't make it. The challenge is, it's really hard to do that.”

The key to type 1 diabetes management is always knowing the blood glucose levels, which historically was checked through blood samples taken from the fingers, usually six to 10 times a day.

Earlier this year, Maahs and his colleagues reported findings from a pragmatic, real-world study of a comprehensive approach of managing type1 diabetes in Nature Medicine. They enrolled 133 young (median age 11) people in the Teamwork, Targets, Technology and Tight Control — 4T, for short — study. At 12 months after enrollment, the participants had an average HbA1c of 6.58% and average glucose monitoring indicator of 7.11%. Close to two-thirds (64%) meet the target HbA1c target of 7%. The study participants had an average “time in range” of 68%, which means their blood sugar levels were in the desired range 68% of the time.

Maahs is currently a pediatric endocrinology professor at Stanford University and the Associate Chair for Academic Affairs in Pediatrics at Stanford University and the Lucile Packard Children’s Hospital.