>> [MUSIC] Hi, I'm Dr. Yogish C Kudva.
I'm an endocrinologist at
Mayo Clinic and I'm here to answer some
of the important questions you may
have about type one diabetes.
The best current treatment for
type one diabetes is
an automated insulin delivery system.
This system includes
a continuous glucose monitor,
insulin pump,
and a computer algorithm
that continually adjust
insulin responding to
the continuous glucose monitoring signal.
The patient still has to enter
information about the amount of
carbohydrate he or she
eats at mealtimes provide
the meal time time-related insulin [MUSIC].
Testing using a glucose meter is not enough
because glucose measurements in
people with type one diabetes,
wary from normal to low and
normal to high very
rapidly in the course of a day,
a continuous glucose monitor is
needed to assess whether
treatment is effective and also
to determine how to improve treatment.
Current guidelines recommend use
of a continuous glucose monitor.
The percentage of time that is
spent daily with glucose
between 70 and 180 milligram per
deciliter is
the main measurement
of appropriate treatment.
This percentage should be
70% or higher daily.
In addition, percentage of time
spent with glucose below 70 should
be less than four percent and greater than
250 should be less than five percent.
Clearly, hemoglobin A1C
testing to evaluate adequacy
of treatment is not enough.
In certain people with
type one diabetes
transplantation can be undertaken.
This could be pancreas transplantation or
transplantation of
insulin making cells called islet.
Islet transplantation is considered
research in the US.
Pancreas transplantation is available
as a clinical treatment.
These patients with hypoglycemia unawareness
may benefit from a pancreas transplant.
People with type one diabetes who develop
recurrent diabetic ketoacidosis may
also benefit from a pancreas transplant.
People with type one diabetes
who have developed kidney failure,
could have their lives transformed by
transplantation of
both the pancreas and the kidney.
There is active research going on
to prevent type one diabetes from
happening in children and
adults who are less than 45 years old.
People who are eligible for
such research studies are people who have
a positive antibody test for
type one diabetes and
are willing to be in such studies.
The treatment being tested is
medication that suppresses the immune system.
Willing participants would be randomized to
receive immune suppressive treatment
or placebo treatment.
Placebo looks like the medication,
but does not do the same thing in the body.
Initial research studies have been
successful in decreasing the risk of
development of type one diabetes
in people that have
received the immune system
suppressing treatment and therefore,
larger studies are now being underpaid.
[MUSIC] Try to be
informed about research going on and
treatments that may be
approved for type one diabetes.
You can get this information
through already available publications.
Make sure that at least annually you see
a physician who is
an expert on your disorder.
Never hesitate to ask
your medical team any questions
or concerns you have.
Being informed makes all the difference.
Thanks for your time and
we wish well
[MUSIC].