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About Diabetes
What causes Diabetes
Do you have Diabetes?
Are you at risk for Diabetes?
Screening for Diabetes
Complications of Diabetes
Treating Diabetes
Treating Diabetes
The most important aspect of treating diabetes is controlling
blood sugar levels. Whether blood sugar levels are controlled
through diet and exercise, insulin, other medications or any
combination of these, it is an essential component to
maintaining good health and avoiding both the potential short
term and long term health complications associated with
diabetes.
For more advanced, complicated cases of diabetes where kidney
failure is present or an inability to respond to common
treatments is present, organ transplantation may be the only
option.
Treatment of Diabetes
1) Monitor Blood Sugar
Continual blood sugar monitoring is essential in the treatment
of diabetes. This task can be quite easily learned, and
becomes part of daily life once a patient is comfortable with
the process. Your doctor will inform you of the safe range for
your blood sugar level, depending on your age, the type of
diabetes you have and any complications that may exist. The
doctor will also inform you as to how often testing should be
done. The frequency will largely depend on whether or not you
use insulin.
Blood sugar ranges will vary between patients. Younger adults
without complications usually target a range of 80-120 mg/dL
before meals, and under 180 mg/dL after meals. Older adults
with complications related to diabetes usually target 100-140
mg/dL before eating, and under 200 mg/dL after eating. It is
important to note that low blood sugar in older adults
presents more grave dangers than in younger adults.
An added benefit to patients who regularly monitor their own
blood sugar is that over time they learn about what increases
and decreases their blood sugar levels, enabling them to
adjust their diet for targeted outcomes. Patients learn that
many variables affect blood sugar levels.
Factors affecting blood sugar levels
a) Food
Food raises your blood sugar and peaks 1 or 2 hours after food
has been consumed. What you eat, how much you eat, when you
eat - all of these variables will affect blood sugar.
b) Exercise
Physical activity moves sugar into cells, where it can be used
up as energy instead of being stored in blood. Generally
speaking, the more physically active a person is, the lower
their blood sugar will be. Any physical activity can help to
lower blood sugar, particularly aerobic exercise, such as
jogging, walking, biking and swimming.
c) Medications
Medications such as insulin and oral diabetes medications act
by lowering blood sugar levels. Those patients taking
medications for unrelated conditions can affect blood sugar
levels. Steroids often raise blood sugar levels. High blood
pressure medications (ex. thiazides) and high cholesterol
medications (ex. niacin) can increase blood sugar levels. A
doctor should be aware of every medication a patient takes, so
as to modify diabetes medications or treatment.
d) Illnesses
The physical stress that an illness exerts on the body causes
it to produce hormones that act to raise blood sugar levels in
order to facilitate healing. Fevers increase a body's
metabolism and will impact the rate at which blood sugar is
used by the body. Always carefully monitor blood sugar levels
when suffering from any illness.
e) Alcohol
Diabetics should consume only moderate amounts of alcohol and
will sometimes be instructed to avoid alcohol altogether.
Alcohol can either decrease or increase blood sugar levels, so
it is important to monitor blood sugar levels before and after
consuming alcohol to learn how alcohol affects your levels.
f) Hormones
The fluctuations of hormones can affect blood sugar levels and
the body's responsiveness to insulin. Estrogen usually causes
cells to become more responsive to insulin, while progesterone
causes cells to become less responsive. Although most people
do not experience a change in blood sugar levels due to these
hormones, those people who do experience such changes will
likely see them in the 3rd week of the menstrual cycle when
both these hormones are typically at their highest levels.
Before reaching menopause, hormones can affect blood sugar
levels. A corresponding decrease in these effects is seen post
menopause.
2) Maintain a healthful diet
Adjusting your diet can be one of the simplest and most
effective ways to control diabetes. A diet rich in vegetables,
fruits and whole grains and low in fat, calories and animal
products is essential. For those already eating a healthful
diet, few dietary changes will be required as a good 'diabetes
diet' reflects a diet that all people should be eating.
Important for those with diabetes is understanding when and how
much to eat. Often, patients with diabetes will visit a
dietician to create a meal plan effective for them. The goal
then is to consistently follow the meal plan to aid the body
in keeping blood sugar levels consistent.
Diet is vital in managing diabetes and will always have a
profound impact on the degree to which diabetes affects your
life and your health.
3) Exercise
Consult with your doctor to ensure that you are following an
exercise regime that works for your body and your diabetes.
All and any activity is good, but it is vital that a diabetes
patient get a sufficient amount of aerobic exercise. A good
target for most people is 30 minutes a day of aerobic
activity, such as walking, biking, swimming or jogging.
4) Maintaining a healthy weight
The number one risk factor in the development of Type 2
diabetes is being overweight, as fat causes the body's cells
to be resistant to insulin. Loosing weight reverses this
resistance. Any weight loss in an overweight person is good
and will have a positive effect on blood sugar levels.
Dieticians often assist those needing to lose weight with
healthful diet plans effective for an individual's lifestyle
and food preferences.
5) Diabetes medications
Diet and exercise are sometimes not effective enough in
controlling diabetes. Insulin is one kind of medication used
to treat diabetes. All those with Type 1 diabetes must take
insulin daily. Some patients with Type 2 diabetes must take
insulin every day. Insulin cannot effectively be taken orally
and must be injected or pumped.
Insulin can be injected using a syringe or an 'insulin pen
injector'. An insulin pump that provides a continuous supply
of insulin negates the need for injections. The pump is a
small device that is worn outside the body with a catheter
inserted into the abdomen connected to a supply of insulin.
The pump can be adjusted to ensure the correct amount of
insulin is pumped into body.
Medications used for Type 2 diabetes treatment
a) Sulfonylurea drugs
These medications act by stimulating the pancreas to both
produce and release more insulin into the body. These
medications are only effective if the pancreas is able to
produce some insulin on its own. Low blood sugar is a common
side effect of sulfonylurea drugs and these risks are
heightened in patients with liver or kidney function
impairment.
b) Meglitinides
Meglitinides act similarly to sulfonylureas except that they
act very quickly, and the effects fade very quickly, but
patients are less likely to experience low blood sugar levels.
c) Biguanides
These medications work by inhibiting the production and
release of glucose from the liver, causing less insulin to be
required for moving blood sugar into the body's cells. Side
effects of this group of medications can include loss of
appetite, abdominal bloating, nausea and diarrhea. These side
effects can be partly controlled by taking the medication with
food. Lactic Acidosis is an uncommon, but very serious side
effect. Lactic acid can build up in the body, leading to
weakness, dizziness, muscle ache and fatigue.
d) Alpha-glucosidase inhibitors
This medication slows down the absorption of sugar into the
bloodstream by blocking the action of enzymes that break down
carbohydrates in the digestive tract. The outcome is a smaller
increase in blood sugar after a meal. Side effects can include
abdominal bloating and diarrhea. Taking too high doses of this
medication can result in permanent liver damage.
e) Thiazolidinediones
These medications cause your body to become increasingly
sensitive to insulin and stop the liver from producing an
abundance of glucose. Side effects can include weight gain,
fatigue and swelling. Liver damage can result from use of
these medications. Anyone taking these medications must have
their liver checked every month or two.
Some doctors treating diabetes will rely on a combination of
many medications to control blood sugar.
6) Organ transplant
a) Pancreas transplants
Usually, pancreas transplants are carried out at the same time
or following a kidney transplant. Pancreas transplants are not
always successful, but many patients whose pancreas
transplants are successful no longer require insulin. Those
patients who receive a new pancreas at the same time as a
kidney transplant may experience greater success in kidney
survival.
Only those whose diabetes cannot be controlled or who
experience severe complications associated with diabetes are
considered candidates for pancreas transplant.
b) Islet cell transplantation
Over 70% of the approximately 1 million islet cells in the
pancreas produce insulin. Beta cells reside in the islets.
Transplanting these cells is an experimental procedure but may
provide a less risky and less invasive procedure than pancreas
transplants. This procedure involves transplanting fresh
pancreas cells into the liver. These cells then spread
throughout the liver and begin to produce insulin.
Read more from the
National
Institute of Diabetes. For Americans living with
diabetes, the
American Diabetes Association offers useful information,
resources and support. |
