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Type 1 Diabetes: Insulin Care With Integrative Support in Mumbai and Online

Medically reviewed by Dr Krushal Pabari, MD, PGCP - Rheumatic & Musculoskeletal Diseases · Last reviewed: 4 November 2026

Key facts

Type 1 diabetes is an autoimmune condition in which the immune system destroys the cells of the pancreas that make insulin, so people with it need insulin every day to live, according to the US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [1]. About 9.5 million people worldwide live with type 1 diabetes, according to 2025 International Diabetes Federation estimates [2], and India has more children and teenagers with it than any other country, about 300,000 [3]. Standard treatment, set out in the 2026 American Diabetes Association (ADA) Standards of Care, the 2026 ADA and European (EASD) adult consensus and the 2022 Indian Council of Medical Research (ICMR) guideline, is lifelong insulin by injections or pump, a glucose sensor, and education in matching insulin to food [4][5][6]. There is no cure yet, and diet and lifestyle do not cause type 1 diabetes [7][8]. At Cure4Pain, an integrative and functional medicine clinic in Malad West, Mumbai, with online consultations worldwide, Dr Krushal Pabari (MD, PGCP Rheumatic & Musculoskeletal Diseases) prescribes and adjusts insulin, working with AT. Chintan Dalal, N.D. (BNYS, R.AP), and adds diet, autoimmune screening, supervised vitamin D therapy (Coimbra Protocol-based methods) and regular reviews alongside insulin, never in place of it. Vitamin D is not a guideline treatment for type 1 diabetes: the ADA does not recommend it without deficiency [9], and no Coimbra Protocol study in type 1 diabetes was found in our October 2026 PubMed search.

Watch our explainer videos
AT. Chintan Dalal, N.D.

Scientific explainer videos in our Resources section

In our Resources section, our clinical team discusses type 1 diabetes and its management in detail: insulin alongside counted carbohydrates and millets, functional nutrition and supervised vitamin D therapy (Coimbra Protocol-based methods).

Watch our scientific explainer videos

What is type 1 diabetes?

Type 1 diabetes is an autoimmune condition: the immune system attacks the beta cells of the pancreas that make insulin, and without insulin, glucose builds up in the blood, according to NIDDK [1]. Overall, 5% to 10% of people with diabetes have type 1 diabetes [1].

  • Who gets it: it often starts in children and teenagers, but more than half of new diagnoses worldwide are in adults aged 20 or over, according to the International Diabetes Federation [10].
  • In India: India has about 300,000 children and teenagers with type 1 diabetes, the most of any country, and close to a million people of all ages, according to the 2025 IDF Diabetes Atlas [3].
  • LADA: latent autoimmune diabetes in adults is type 1 diabetes that starts slowly in adults; it makes up 2% to 12% of diabetes that starts in adulthood, according to a 2020 international expert consensus [11], and over 40% of people diagnosed with type 1 after age 30 are first treated as type 2 [5].
  • Not caused by lifestyle: “Diet and lifestyle habits don’t cause type 1 diabetes,” according to the US Centers for Disease Control and Prevention (CDC) [8].

What are the symptoms of type 1 diabetes?

The main symptoms of type 1 diabetes are peeing more than usual, especially at night, feeling very thirsty, feeling very tired and losing weight without trying, which the NHS sums up as the 4 Ts: toilet, thirsty, tired, thinner [12]. Blurred vision, breath that smells sweet or fruity, slow-healing cuts and frequent infections can also occur, and children may start wetting the bed [12].

  • Children: symptoms are often missed until a child is very unwell; in India’s youth diabetes registry, 28.7% of 2,108 young people were already in diabetic ketoacidosis (DKA) when diagnosed, more often the youngest children [13].
  • DKA warning signs: stomach pain, feeling or being sick, breathing faster and more deeply than usual, breath that smells fruity, and feeling sleepy or confused need urgent medical help [12][14].

What causes type 1 diabetes?

Type 1 diabetes is caused by an autoimmune attack on the insulin-making cells in people with a genetic risk, mainly certain HLA gene types; the environmental triggers are still poorly defined, according to the 2026 ADA Standards of Care [15].

  • Genes and family: the risk is about 3%, 5% and 8% when a mother, father or sibling has type 1 diabetes, according to the 2022 ICMR guideline [6], but about 90% of people who develop type 1 diabetes have no affected relative [15].
  • Antibodies come first: children with two or more islet antibodies had a 70% chance of developing diabetes within 10 years in a 2013 study in JAMA [16].
  • Viruses: a 2023 meta-analysis of 60 observational studies linked enteroviruses with type 1 diabetes, but this shows an association, not a proven cause [17].

How is type 1 diabetes diagnosed?

Type 1 diabetes is diagnosed with blood glucose and HbA1c tests, and confirmed with islet antibody tests (GAD, IA-2, ZnT8) and, in some people, C-peptide, which shows how much insulin the body still makes, according to the 2026 ADA Standards of Care [15]. The ADA defines three stages: stage 1 is two or more antibodies with normal glucose, stage 2 is antibodies with abnormal glucose, and stage 3 is diabetes with symptoms [15].

  • Tests at Cure4Pain: HbA1c, glucose sensor or meter data, our standard panel of about 100 measures with ANA by the IFA method (our clinic protocol for every autoimmune patient), including thyroid tests (TSH and TPO antibodies), coeliac screening, vitamin B12, vitamin D, PTH, calcium, kidney function and lipids, with antibody and C-peptide results where available. Outside India, tests are done at a laboratory near you and uploaded to our patient portal.

What is the difference between type 1 and type 2 diabetes?

Type 1 diabetes is an autoimmune loss of insulin-making cells and needs insulin from diagnosis, while type 2 diabetes starts mainly with insulin resistance and is usually treated first with lifestyle changes and tablets, according to NIDDK and the 2026 ADA Standards of Care [1][15][4].

Type 1 diabetesType 2 diabetes
CauseAutoimmune loss of insulin-making cells [1]Insulin resistance with falling insulin output [15]
AntibodiesIslet antibodies in most people [15]Usually absent
Typical startOften children and young adults, but any age [7][10]More common in older people and people who are overweight [7]
TreatmentInsulin from diagnosis, for life [4]Lifestyle and tablets first; insulin for some
  • Both together: some people with type 1 diabetes also develop insulin resistance and weight gain, sometimes called double diabetes, which raises the risk of heart and kidney problems independent of glucose control, according to a 2024 review [18]. Insulin is still needed. See our Type 2 Diabetes page.

What is the conventional treatment for type 1 diabetes? Insulin as per guidelines

Insulin is essential in type 1 diabetes: the 2026 ADA Standards of Care state that “insulin treatment is essential for individuals with type 1 diabetes” and that background (basal) insulin should not be stopped “even if not eating” [4][19]. Most people use multiple daily injections of long-acting and mealtime insulin or an insulin pump, and the ADA now prefers automated insulin delivery, in which a pump adjusts insulin from a glucose sensor [4][20].

Part of careWhat the guidelines advise (generic terms)
InsulinBasal-bolus injections (long-acting plus mealtime insulin analogues) or an insulin pump; automated insulin delivery preferred where available [4][20][21]
Glucose monitoringA continuous glucose monitor (sensor) from diagnosis, with a finger-prick meter always available [20]
TargetsPersonal; for many adults HbA1c below 7% and more than 70% of the day in the target glucose range [19][22]
Lows (hypoglycaemia)Fast-acting glucose; glucagon prescribed for everyone on insulin, with family and school staff trained [19][23]
Sick days and ketonesNever stop basal insulin; check ketones when ill or glucose is high; hospital care for high ketones [19][14][22]
EducationStructured education in carbohydrate counting, insulin adjustment and sick-day rules [4][21][5]
  • Why good control matters: in the DCCT and its follow-up, intensive insulin treatment lowered HbA1c by about 2% over 7 years and cut eye damage by about 60%, kidney damage by about 30% and nerve damage by about 20%, according to the 2026 ADA and EASD consensus [5].
  • Other medicines never replace insulin: the 2026 ADA and EASD consensus says metformin “is generally not recommended for people with type 1 diabetes, although it may be considered on an individual basis”, and that SGLT2 inhibitors raise the risk of DKA about 2.6 to 6 times [5]; in the REMOVAL trial, metformin did not durably lower HbA1c [24].
  • Delaying type 1 diabetes: teplizumab, an immune medicine given as a 14-day drip, delayed the stage needing insulin from a median of 24.4 to 48.4 months in 76 relatives of people with type 1 diabetes, 72% of them aged 18 or under, who had stage 2 type 1 diabetes, in a 2019 trial in the New England Journal of Medicine [25]. The ADA advises discussing it for selected people aged 8 or over with stage 2 [26]; it was approved in the US in 2022 and in the UK in 2025, and by the European Medicines Agency in 2026, as reported in a 2026 UK consensus, and is not a treatment for established type 1 diabetes [27][4]. We found no approval in India in October 2026.
  • Transplants and stem cells: islet and pancreas transplants are used for selected people, need lifelong immune-suppressing medicines, and are mainly for repeated severe lows or alongside a kidney transplant [4]. In a small 2025 study of stem-cell-derived islets in the New England Journal of Medicine, 10 of 12 people no longer needed insulin at 1 year, but all took immune-suppressing medicines and 2 participants died, one from a fungal brain infection (cryptococcal meningitis) and one from worsening of dementia present before the study; it is still experimental [28]. In India, the 2017 National Guidelines for Stem Cell Research state that “every use of stem cells in patients outside an approved clinical trial is unethical and shall be considered as malpractice” [29].
  • The honeymoon phase: soon after diagnosis, some people need very little insulin for a while; NICE calls this “a partial remission phase (a ‘honeymoon period’)” [30], which is temporary and not a cure: the ADA says “the absence of symptoms doesn’t mean the diabetes is gone” [31], and no approved treatment prolongs it [4].
  • In India: the 2022 ICMR guideline calls insulin “the only effective treatment” and notes that stopping insulin for economic reasons is a common cause of DKA [6]; the ICMR Standard Treatment Workflow sets HbA1c every 3 months with a personalised target [22].

At Cure4Pain, Dr Krushal Pabari, with his team of experts on the clinic panel, prescribes and adjusts insulin as per guidelines, in coordination with your existing consulting physician and endocrinologist or diabetologist (a paediatric endocrinologist for children); insulin pumps, glucose sensors and teplizumab are arranged with your endocrinologist. For people outside India, we coordinate with your consulting diabetologist or endocrinologist for a formal prescription that can be filled and monitored where you live. Supervised vitamin D therapy (Coimbra Protocol-based methods) and the integrative plan are added alongside insulin, never in place of it; never stop or reduce insulin on your own.

How does Cure4Pain manage type 1 diabetes?

Cure4Pain, an integrative and functional medicine clinic in Malad West, Mumbai, with online consultations worldwide, manages type 1 diabetes as a lifelong condition: Dr Krushal Pabari prescribes and adjusts insulin as per guidelines, and the clinic adds supervised vitamin D therapy and a nutritional layer, never in place of insulin. We see children and teenagers together with a paediatric endocrinologist, adults, people with LADA and people in the honeymoon phase; DKA and severe lows are treated in hospital first. The plan includes:

  1. Assessment first: your HbA1c, glucose sensor or meter data, insulin plan, antibody and C-peptide results where available, and our full blood panel with ANA.
  2. Insulin as per guidelines: prescribed and adjusted by Dr Krushal Pabari from your glucose data; pumps, sensors and teplizumab arranged with your endocrinologist.
  3. Supervised vitamin D therapy (Coimbra Protocol-based methods): no fixed dose for every person; the dose is set for each person and adjusted to blood tests, never on your own (see below). For children, vitamin D is agreed with the paediatric endocrinologist.
  4. Cofactors and nutrients in supervised doses: magnesium, vitamin B12, vitamin K2 and zinc based on your tests, and omega-3 as general nutrition (clinic practice; see below).
  5. Diet: for adults, home-cooked meals with jowar and millets preferred, a moderate amount of carbohydrate counted and matched to insulin, and fruit counted rather than banned; for children, the guideline diet for healthy growth (see below).
  6. Autoimmune screening: thyroid, coeliac disease and vitamin B12, as the guidelines advise, with our full panel.
  7. Gut health: gut protocols managed by Dr Krushal Pabari where tests show a need (clinic practice).
  8. Mind: screening for diabetes distress, low mood and eating problems, including skipping insulin, with our in-house psychiatrist.
  9. Exercise: daily activity and strength training with the guideline safety steps (see below).
  10. Monitoring: HbA1c and a full review every 3 months, with monthly reporting of glucose data for some people; the full panel with ANA every 6 to 8 weeks during vitamin D therapy (clinic protocol); yearly eye, kidney, nerve and foot checks with specialists.

We do not offer acupuncture or needling for type 1 diabetes, and we never needle diabetic feet.

Does vitamin D help type 1 diabetes? What the research shows

Vitamin D has not been shown to prevent or treat type 1 diabetes: the 2026 ADA Standards of Care state that “universal vitamin D supplementation for people with type 1 or type 2 diabetes without deficiency is not recommended at this time” [9], and small trials in newly diagnosed people are mixed, with low to very low certainty in a 2025 meta-analysis [32].

StudyWhoWhat it found
Finnish birth cohort, Lancet 2001 [33]10,366 children born in northern Finland in 1966Regular vitamin D in infancy linked with lower risk; observational
Mendelian randomisation, PLoS Medicine 2021 [34]9,358 people with type 1 diabetes, European ancestryGenetically lower vitamin D was not linked with type 1 diabetes
Meta-analysis, Frontiers in Immunology 2025 [35]15 studiesVitamin D supplementation did not significantly lower the risk of type 1 diabetes
Trial with cholecalciferol, Arch Pediatr Adolesc Med 2012 [36]38 newly diagnosed people, alongside insulinSlower loss of the body’s own insulin output (C-peptide); HbA1c and insulin dose unchanged
Trial with calcitriol, Diabetes Care 2010 [37]34 newly diagnosed peopleNo effect on C-peptide, HbA1c or insulin dose
Meta-analysis, 2025 [32]12 trials, 485 people, with a focus on childrenNo effect on HbA1c; lower fasting glucose and insulin need; low to very low certainty
  • What this means: vitamin D is not a replacement for insulin, and every trial gave it alongside insulin. No study of the Coimbra Protocol or of very high daily doses in type 1 diabetes was found in our PubMed search in October 2026. At Cure4Pain, vitamin D is used alongside guideline treatment, under supervision, as one therapy among several; individual results vary and further studies are needed.

What is the Coimbra Protocol, and how does Cure4Pain use it in type 1 diabetes?

The Coimbra Protocol is a method of high-dose vitamin D therapy for autoimmune conditions, developed by Dr Cicero Galli Coimbra in Brazil, in which doses are adjusted to blood tests alongside a strict low-calcium diet and at least 2.5 litres of fluid a day [38]. Our methods are derived from the work of Dr Coimbra, and we give the Coimbra Protocol full credit. For type 1 diabetes, Cure4Pain uses supervised vitamin D therapy (Coimbra Protocol-based methods): there is no fixed dose for every person or condition, and the dose is set for each person by clinical judgement and adjusted to blood tests. No trial of the Coimbra Protocol in type 1 diabetes was found in our PubMed search in October 2026, and it is not part of type 1 diabetes guidelines. Dr Krushal Pabari and AT. Chintan Dalal, N.D. apply these methods within an integrative rheumatology practice that manages medicines and drug interactions, with detailed blood monitoring. See our Coimbra Protocol page.

How is vitamin D therapy monitored for safety?

High doses of vitamin D can raise blood calcium and harm the kidneys, according to the US National Institutes of Health [39]. In a 2022 study of 319 people with autoimmune diseases treated with high-dose vitamin D under the Coimbra Protocol, with a strict low-calcium diet and at least 2.5 litres of fluid a day, average calcium and kidney results stayed within normal ranges for up to 3.5 years; the study was retrospective, came from one centre in Germany, had no comparison group and did not include type 1 diabetes [38].

  • Official limit: the upper limit for vitamin D without medical supervision is 1,000 to 4,000 IU a day depending on age, according to the US National Institutes of Health [39].
  • Kidneys in diabetes: diabetes can affect the kidneys, so kidney function and urine albumin are checked closely during vitamin D therapy [40].
  • At Cure4Pain: the full panel, including vitamin D, calcium, PTH and kidney function, is mandatory every 6 to 8 weeks, and doses are adjusted to the results. Please never copy doses from the internet, from forums or from videos.

What should you eat with type 1 diabetes?

There is no single diet for type 1 diabetes: the 2026 ADA and EASD consensus says “carbohydrate counting is the most common meal planning approach in type 1 diabetes”, matching mealtime insulin to the carbohydrate eaten [5], and the 2026 ADA Standards of Care advise high-fibre, minimally processed carbohydrate and water instead of sugary drinks and juices [9].

  • Lower-carbohydrate eating: in a 2025 meta-analysis of 35 trials, diets with less carbohydrate improved time in range but not HbA1c, and higher-fibre diets lowered HbA1c and lows [41]; the 2026 ADA and EASD consensus says low-carbohydrate patterns “may be used safely with appropriate education and monitoring” [5], while the ADA does not recommend very-low-carbohydrate eating for children, pregnancy, kidney disease or people at risk of eating disorders [9].
  • Fasting: basal insulin is never stopped, even when not eating, and doctors give detailed instructions for adjusting insulin during illness or fasting [19]; intermittent fasting showed no effect on glucose in the few trials [41]. Religious fasts are planned in advance with your doctor.
  • Indian food: the 2022 ICMR guideline encourages millets, legumes, fruit and vegetables within carbohydrate counting, limits sugar, and gives carbohydrate exchanges for Indian foods such as roti, rice and dosa [6].
  • Gluten: a gluten-free diet is needed for people with coeliac disease [42]; in a 2025 randomised trial in people with islet antibodies, a gluten-free diet did not change insulin output or glucose tolerance [43].
  • At Cure4Pain (adults): home-cooked meals, with jowar and millets preferred over wheat as clinic practice; a moderate amount of carbohydrate, counted and matched to insulin; fruit counted rather than banned; no fasting unless Dr Krushal Pabari adjusts your insulin. Research has not shown that wheat harms people with type 1 diabetes who do not have coeliac disease; our preference for millets is clinic practice.
  • At Cure4Pain (children and teenagers): the guideline diet for healthy growth, with carbohydrate counting and no strict low-carbohydrate diet, agreed with the paediatric endocrinologist and dietitian.
  • During vitamin D therapy: calcium intake is managed within a limit set for you.

Which vitamins and minerals matter in type 1 diabetes?

No supplement treats type 1 diabetes: the 2026 ADA Standards of Care say micronutrient or herbal supplements are “not recommended for glycemic benefits” [9]. Correcting a deficiency found on testing is different.

  • Magnesium: a 2020 meta-analysis of 9 studies linked low magnesium with poorer glucose control in type 1 diabetes, but these were cross-sectional studies [44]. Magnesium is needed by the enzymes that activate vitamin D, and in a 2018 randomised trial in adults without diabetes, magnesium supplements changed vitamin D levels [45]. The upper limit from supplements is 350 mg a day for adults, and magnesium can loosen stools [46].
  • Vitamin B12: the ADA advises checking B12 in people with type 1 diabetes and nerve symptoms or unexplained anaemia, because autoimmune stomach disease and pernicious anaemia are more common [47].
  • Omega-3: a small 2020 randomised trial in 27 adults found no change in HbA1c or blood vessel markers after 6 months [48]; Cure4Pain uses it only as general nutrition.
  • Probiotics: a 2024 meta-analysis in children found worse, not better, glucose control with probiotics [49], so they are used only where gut tests show a need (clinic practice).
  • Vitamin K2: used with vitamin D as clinic practice; we found no trial in type 1 diabetes. Vitamin K can interfere with blood thinners such as warfarin [50].
  • Zinc: used as clinic practice when tests show a need; we found no trial of zinc in type 1 diabetes. The upper limit for adults is 40 mg a day, according to the US National Institutes of Health [51].

Which other autoimmune conditions go with type 1 diabetes?

About 1 in 4 people with type 1 diabetes develop another autoimmune condition: in a US registry of 25,759 people, 27% had at least one, most often thyroid disease [52]. A 2019 meta-analysis of 293,889 people found an underactive thyroid in 9.8%, coeliac disease in 4.5%, autoimmune stomach disease in 4.3% and vitiligo in 2.4% [53].

  • Screening: the ADA advises checking the thyroid soon after diagnosis and then as needed, and screening children for coeliac disease soon after diagnosis, within 2 years and after 5 years [47][42].
  • At Cure4Pain: thyroid tests, coeliac screening and vitamin B12 are part of our panel. See our Hashimoto’s Thyroiditis page.

Can exercise help type 1 diabetes?

Yes, with safety steps: the 2026 ADA Standards of Care advise most adults with type 1 diabetes to do 150 minutes of moderate to vigorous activity a week plus strength training 2 to 3 times a week, and children 60 minutes a day [9].

  • Safety steps: check glucose before, during and after exercise, carry fast-acting glucose, and do not exercise with blood ketones of 1.5 mmol/L or more or after a severe low in the past 24 hours, according to the 2022 ISPAD exercise guideline [54]; lows can come several hours after exercise [9].
  • At Cure4Pain: daily activity and strength training, planned with these safety steps and adjusted with your insulin.

How does type 1 diabetes affect mood and eating?

About 39% of people with type 1 diabetes have significant diabetes distress, according to a 2026 meta-analysis of 72 studies [55], and depression affects about 22%, compared with 13% without diabetes [56]. Eating disorders are about 2.5 times more common [57], and in an 11-year US study of 234 women, those who skipped insulin to control weight had three times the risk of death [58]. The ADA advises screening for distress, depression, anxiety and disordered eating at least yearly [9].

  • At Cure4Pain: we screen for distress, low mood and eating problems, including skipping insulin, with support from our in-house psychiatrist.

What checks prevent complications?

Complication checks start about 5 years after diagnosis in adults: a dilated eye examination, urine albumin and kidney function, a nerve test and a foot examination, then at least yearly, according to the 2026 ADA Standards of Care [59][40]. In children, the ADA starts eye, kidney and foot checks from about age 11 or puberty, after 3 to 5 years of diabetes [42], and the ICMR Standard Treatment Workflow also starts screening 5 years after diagnosis, then yearly [22].

  • At Cure4Pain: these checks are arranged with eye, kidney and foot specialists, and blood pressure and cholesterol are reviewed at each visit. See our Neuropathy page for nerve care.

Can I get pregnant with type 1 diabetes?

Yes, with planning: the 2026 ADA Standards of Care advise aiming for an HbA1c ideally below 6.5% before conception, using insulin in pregnancy and wearing a glucose sensor [60]. In the 2017 CONCEPTT trial of 215 pregnant women, a continuous glucose monitor improved time in range and halved the odds of a large baby and of newborn intensive care stays [61], and in the 2023 AiDAPT trial automated insulin delivery improved time in range in pregnancy [62]. Folic acid is advised before conception, at a dose set by your doctor [60][5]. At Cure4Pain, pregnancy care is led by your endocrinologist and obstetrician, and vitamin D is given only at standard supplement doses during pregnancy.

Can children with type 1 diabetes live a normal life?

Yes, with support: the 2026 ISPAD position statement says students with type 1 diabetes have the right to equal opportunity at school, including sport and exams, with trained staff, access to glucose checks, insulin and glucagon, and exam adjustments [63]. The ADA advises offering automated insulin delivery to children who can use it safely [42]. Dr Krushal Pabari sees children and teenagers with type 1 diabetes together with a paediatric endocrinologist, and vitamin D, diet and all medicines for children are agreed with that specialist.

Is type 1 diabetes serious? Outlook

Type 1 diabetes is a lifelong condition, and “there’s currently no cure for type 1 diabetes, but it can be managed”, according to the NHS [7]. Without insulin it is life-threatening: the 2025 IDF estimates count 174,000 premature deaths a year from type 1 diabetes worldwide, 17.2% from not being diagnosed soon after onset [2]. With insulin, glucose sensors and good control, the risk of eye, kidney and nerve damage falls sharply [5]. At Cure4Pain, type 1 diabetes is lifelong management, with regular monitoring and reviews.

What should you do if your glucose goes low?

A low (hypoglycaemia) is glucose below 70 mg/dL (3.9 mmol/L), according to the 2026 ADA Standards of Care [19]; signs include sweating, a fast heartbeat and feeling anxious, irritable or confused, and a severe low can cause unconsciousness, according to the NHS [64].

  • What to do: take fast-acting glucose, check again after 15 minutes and repeat if still low [19].
  • Severe lows: glucagon is prescribed for everyone on insulin, and family, carers and school staff should know how to give it [19].
  • Watch for delayed lows: lows can come several hours after exercise, and alcohol can also cause delayed lows [9].

When should you get urgent help?

Get emergency help (call 112 in India and Europe, 911 in the US and Canada) for signs of diabetic ketoacidosis: stomach pain, feeling or being sick, breathing faster and more deeply than usual, fruity breath, feeling sleepy or confused, or blood ketones over 3 mmol/L, according to the NHS [14]. A severe low that causes confusion, a fit or unconsciousness needs glucagon and emergency help [19]. Cure4Pain does not treat emergencies.

Which doctor treats type 1 diabetes?

Type 1 diabetes is managed with a diabetes care team that builds a care plan with you, including courses on adjusting insulin, according to the NHS [65]; the specialists are endocrinologists and diabetologists, with paediatric endocrinologists for children. At Cure4Pain, Dr Krushal Pabari, whose training is in rheumatic and musculoskeletal diseases, prescribes and adjusts insulin and leads integrative care in Mumbai and online, in coordination with your endocrinologist or diabetologist.

Can I get type 1 diabetes care online from outside India?

Cure4Pain sees people with type 1 diabetes in person in Mumbai and online from any country, with consultations led by Dr Krushal Pabari.

  1. Register your case on our patient portal with your HbA1c, glucose sensor or meter reports, insulin plan and recent blood tests.
  2. Blood tests near you: the panel is done at a laboratory in your city or country and uploaded to the portal; in India, home collection is available.
  3. Consultation online or in Mumbai with Dr Krushal Pabari and AT. Chintan Dalal, N.D.; available appointments are shown on the portal.
  4. Ongoing care: reviews every 3 months, monthly glucose reports for some people, and your endocrinologist kept in the loop.
  5. Prescriptions outside India: Dr Krushal Pabari prescribes your insulin plan, and we coordinate with your consulting diabetologist or endocrinologist for a formal local prescription that can be filled and monitored where you live.

How do I book a consultation?

Please register your case on our patient portal with your HbA1c, glucose reports, insulin plan and medical history. We take patients on only after reviewing these reports. Consultations are in person in Mumbai or online worldwide. Registrations and appointments are made only through our patient portal.

Evidence: key studies

StudyWhat it found
ADA Standards of Care, Diabetes Care 2026 [4]Insulin is essential; automated insulin delivery preferred; never stop basal insulin.
ADA and EASD adult consensus, Diabetologia 2026 [5]Carbohydrate counting, technology and education; metformin generally not recommended; SGLT2 inhibitors raise DKA risk.
ICMR guideline, 2022 [6]Insulin is the only effective treatment; Indian food exchanges.
India youth registry, Pediatric Diabetes 2021 [13]28.7% of Indian youth in DKA at diagnosis.
Teplizumab trial, N Engl J Med 2019 [25]Delayed the insulin-needing stage by about 2 years in stage 2.
Stem-cell islets, N Engl J Med 2025 [28]10 of 12 off insulin at 1 year, with immune suppression and 2 deaths; experimental.
Vitamin D meta-analysis, 2025 [32]No effect on HbA1c; low to very low certainty.
Autoimmune meta-analysis, Eur J Endocrinol 2019 [53]Thyroid disease and coeliac disease common in type 1 diabetes.
Insulin restriction study, Diabetes Care 2008 [58]Skipping insulin tripled the risk of death.
Amon et al., Nutrients 2022 [38]Average calcium and kidney results stayed normal in 319 supervised patients; single centre, no comparison group, no type 1 diabetes.

Type 1 Diabetes FAQs

Can type 1 diabetes be cured?

Not yet: as of October 2026, “there’s currently no cure for type 1 diabetes,” according to the NHS [7]. Stem-cell-derived islets are in early trials and need lifelong immune-suppressing medicines [28], and teplizumab can delay type 1 diabetes in people at stage 2 but does not treat established type 1 diabetes [25][4]. Insulin remains essential.

Can type 1 diabetes be treated without insulin?

No. People with type 1 diabetes need insulin every day to stay alive, according to NIDDK [1]. In a 1994 case series in Diabetic Medicine, people who reduced or stopped insulin for faith healing, diets or supplements developed ketoacidosis, in one case life-threatening [66]. At Cure4Pain, insulin is never stopped; only Dr Krushal Pabari adjusts doses, up or down, from your glucose data, to keep glucose in the target range, as in standard care.

Is type 1 diabetes an autoimmune disease?

Yes. In type 1 diabetes, the immune system destroys the insulin-making cells of the pancreas, according to NIDDK [1].

Can type 1 diabetes be prevented?

“Currently, type 1 diabetes can’t be prevented, but it can be treated effectively,” according to the CDC [8]; teplizumab can delay it in people found to be at stage 2 through antibody screening [25][26].

What is the life expectancy with type 1 diabetes?

It depends heavily on access to insulin and care: the 2025 IDF estimates put the remaining life expectancy of a 10-year-old diagnosed in 2025 at between 6 and 66 years depending on the country [2], and good glucose control lowers the risk of eye, kidney and nerve damage [5].

Is stem cell treatment for type 1 diabetes available in India?

Not as an approved treatment: stem-cell-derived islets are still in early trials [28], and India’s 2017 National Guidelines for Stem Cell Research state that “every use of stem cells in patients outside an approved clinical trial is unethical and shall be considered as malpractice” [29].

What is the difference between type 1 and type 2 diabetes?

Type 1 diabetes is an autoimmune loss of insulin and needs insulin from diagnosis; type 2 diabetes comes mainly from insulin resistance and is linked with lifestyle [1][15]. Diet and lifestyle do not cause type 1 diabetes [8].

What is the honeymoon phase in type 1 diabetes?

The honeymoon phase is a period soon after diagnosis when some people need very little insulin; NICE calls it a partial remission phase or honeymoon period [30]. It can last “as little as a week or even up to a year”, and it is temporary and not a cure: the pancreas eventually cannot make enough insulin, according to the ADA [31].

Can type 1 diabetics take vitamin D?

Correcting a low vitamin D level is reasonable, but the 2026 ADA Standards of Care do not recommend vitamin D for people with diabetes who are not deficient [9], and trials in newly diagnosed people are mixed and low certainty [32]. Cure4Pain goes further with supervised vitamin D therapy (Coimbra Protocol-based methods), which is clinic practice, not guideline care, given alongside insulin and never instead of it; no Coimbra Protocol study in type 1 diabetes was found in our October 2026 PubMed search.

Does low vitamin D cause type 1 diabetes?

Good evidence does not show that it does: in a 2021 Mendelian randomisation study in PLoS Medicine of 9,358 people with type 1 diabetes of European ancestry, genetically lower vitamin D was not linked with type 1 diabetes, and the authors concluded it is unlikely to have a large effect [34]. Less vitamin D in infancy was linked with type 1 diabetes in an observational Finnish study [33], and vitamin D is part of our blood panel.

What foods should a person with type 1 diabetes avoid?

No food is banned outright: the ADA advises water instead of sugary drinks and juices, and high-fibre, minimally processed carbohydrate [9]. What matters most is matching insulin to the carbohydrate eaten [5]. As clinic practice, Cure4Pain prefers jowar and millets over wheat for adults and counts fruit rather than banning it.

Is there a type 1 diabetes diet chart for Indian food?

The 2022 ICMR guideline gives carbohydrate exchanges for Indian foods such as roti, rice, dosa and fruit, to help match insulin to meals [6]. At Cure4Pain, the plan is adjusted to your insulin, activity and glucose data.

Is there an Ayurvedic or natural treatment for type 1 diabetes?

No treatment replaces insulin. We found no randomised trial of Ayurveda in type 1 diabetes in October 2026, and a 2020 review of herbal trials in type 1 diabetes found only 4 small trials and could make no recommendation [67]. In a 2024 North Indian study, 36.6% of children with type 1 diabetes had used alternative medicine, mostly Ayurveda or homoeopathy, 62.7% of them hoping to end the diabetes, and 40% reported worse glucose control [68]. Cure4Pain does not use Ayurvedic medicines for type 1 diabetes; please tell your doctor about any herbal products you take, and never stop insulin.

What is LADA?

LADA, latent autoimmune diabetes in adults, is type 1 diabetes that starts slowly in adults; antibody tests and C-peptide help separate it from type 2, and many people with LADA need insulin sooner or later [11][5].

What are insulin pumps and glucose sensors?

A glucose sensor (continuous glucose monitor) reads glucose every few minutes, and an insulin pump gives insulin through a small tube; automated insulin delivery links the two so the pump adjusts insulin from the sensor readings [20]. The ADA recommends a sensor from diagnosis and prefers automated insulin delivery for people with type 1 diabetes [20].

What is teplizumab?

Teplizumab is an immune medicine that delayed the start of insulin-needing type 1 diabetes by a median of about 2 years in people with stage 2 type 1 diabetes [25]; it is approved in the US, UK and European Union, and is not used once type 1 diabetes is established [27][4].

Do you use acupuncture for type 1 diabetes?

No. Cure4Pain does not use acupuncture or needling for type 1 diabetes, and we never needle diabetic feet.

Do I have to stop or change my insulin?

No. Never stop or reduce insulin on your own; background insulin is not stopped even when you are not eating [19]. At Cure4Pain, Dr Krushal Pabari, with his team of experts on the clinic panel, prescribes and adjusts insulin as per guidelines, and vitamin D therapy is added alongside it.

What is type 1 diabetes called in Hindi and Marathi?

In Hindi it is टाइप 1 डायबिटीज या टाइप 1 मधुमेह (शरीर में इंसुलिन बनना बंद हो जाना, the body stops making insulin); in Marathi it is टाइप 1 मधुमेह (शरीरात इन्सुलिन तयार होणे थांबते).

Who is the best doctor for type 1 diabetes in Mumbai?

Type 1 diabetes is managed with a diabetes care team, according to the NHS [65], led by an endocrinologist or diabetologist, with a paediatric endocrinologist for children. At Cure4Pain in Malad West, Mumbai, and online worldwide, Dr Krushal Pabari (MD, PGCP Rheumatic & Musculoskeletal Diseases) prescribes and adjusts insulin and leads integrative care, with AT. Chintan Dalal, N.D., in coordination with your endocrinologist.

Do you treat children with type 1 diabetes?

Yes. Dr Krushal Pabari sees children and teenagers with type 1 diabetes together with a paediatric endocrinologist.

How much does type 1 diabetes care cost at Cure4Pain?

The consultation fee is shown when you book on our patient portal. Blood tests are done at a laboratory near you; in India, the panel is available at a lower cost through the portal.

Who treats you

  • Dr Krushal PabariMD, PGCP - Rheumatic & Musculoskeletal Diseases. Assistant Professor, Cooper Hospital; Guest Professor, CMP Homoeopathic Medical College.
  • AT. Chintan Dalal, N.D.BNYS, R.AP. Functional nutrition and Coimbra Protocol practitioner.

Consultations look at the whole person: alongside the medical and nutritional plan, we bring a strong interest in behavioural science to counselling on stress, sleep and lasting lifestyle change.

How consultations work: Mumbai or online worldwide

Book through our patient portal. You can see us in person at our clinic in Malad West, Mumbai, or online from anywhere. Your first consultation reviews your history and tests; we then agree a plan together and set the monitoring schedule.

Book Appointment

Related conditions and articles

This page is for education and does not replace medical advice. Do not start, stop or change any medicine or supplement without medical guidance.

References

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