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Ten to 15 years after the onset of overt nephropathy , 50 % of patients with type 1 diabetes have ESRD . A study published in <i> Diabetes Care </i> in January 2003 showed that teens with type 1 who were having difficulty with control could benefit from the addition of metformin , an oral agent typically used in type 2 diabetes . We sincerely hope that all families with type 1 diabetes will send a quilt square in honor of their family member . This page summarizes my view of the best care practices as they apply to kids with type 1 diabetes . Ten Rufus bears and four Ruby bears are now on a two-year-long excursion that will span four continents and visit well over 300 families with Type 1 diabetes . Although people with type 1 diabetes and type 2 diabetes can use inhaled insulin , it wo n't replace the longer acting ( basal ) insulin that may be required as part of a diabetes treatment program . As this minimally invasive procedure is improved , it may prove to be another viable option for people with type 1 diabetes . About a third of the 1.5 million patients with type 1 diabetes eventually need a kidney transplant , or must spend hours every other day hooked up to a dialysis machine . People who have a parent , brother , or sister with type 1 diabetes are more likely than other people to develop the disease ; however , most people with type 1 diabetes do not have a family history of it . People with type 1 diabetes must take daily insulin injections to survive . During puberty , for example , teens with type 1 can become resistant to the effects of insulin . Usually people with type 1 diabetes take a combination of types of insulin , such as a long-acting insulin once or twice a day and a rapid-acting insulin before each meal .