| Treatment There is no cure for diabetes. The immediate goals of treatment are to stabilize the blood sugar and to eliminate the symptoms of high blood sugar. The long-term goals of treatment are to prolong life, improve the quality of life, relieve symptoms, and prevent long-term complications such as heart disease and kidney failure. Education, diet, exercise, weight control, medication, blood glucose self-testing, and foot care are vital for good control of diabetes and prevention of its complications. EDUCATION: Diabetes education is an important part of a treatment plan. People can learn many skills, including: ? How to recognize and treat low and high blood sugar ? How to select the right foods and when to eat them ? How to take insulin or oral medication ? How to test and record blood glucose ? Urine ketone testing (for type I diabetes only) ? How to adjust insulin and/or food intake when changing exercise and eating habits ? How to handle sick days ? Where to buy diabetes supplies and how to store them After patients learn the basics of diabetes care, many go on to learn how their diabetes started and how it can cause long-term health problems. People with diabetes need to review and update their knowledge, because new research and improved ways to treat diabetes are constantly being developed. DIET: The American Diabetes Association (ADA) currently recommends that 50-60% of a person�s diet should come from carbohydrates (starches and sugars), 10-20% from protein, and less than 30% from fats. Specific meal plans are based on an individual�s usual food intake. People with Type 1 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugars from becoming extremely high or low. Type 2 diabetics should eat diets that are well-balanced and low fat. A registered dietician can be very helpful in planning a diabetic�s dietary needs. EXERCISE: Regular exercise is especially important for the person with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. The Nurses Health Study has shown that diabetics who exercise are less likely to experience a heart attack or stroke than diabetics who do not exercise regularly. A diabetic should be evaluated by his or her physician before starting an exercise program. Here are some exercise considerations: ? Choose an enjoyable physical activity that is appropriate for the current fitness level. ? Exercise every day and at the same time of day if possible. ? Monitor blood glucose levels by home testing before and after exercise. ? Carry food that contains sugar in case blood glucose levels get too low during or after exercise. ? Carry a diabetes identification card and change for a phone call in case of an emergency. ? Drink extra fluids that do not contain sugar during and after exercise. ? Changes in exercise intensity or duration may require changes in diet or medication dose to keep blood sugar levels from going too high or low. MEDICATION: Medications to treat diabetes include insulin and glucose-lowering pills. People with Type 1 diabetes cannot make their own insulin, so they must take insulin injections every day to survive. People with Type 2 diabetes make insulin, but they do not use it effectively. They can survive without insulin injections, but many take insulin shots to achieve control of their blood sugar levels. Insulin must be injected under the skin using a needle and syringe, or in some cases, an insulin pump. Insulin is not available in oral form. There are several types of insulin preparations. They differ in how fast they start to work and how long they work. Insulin injections may be required only once a day or several times a day. Sometimes different types of insulin are mixed together in a single injection. The types of insulin to use, insulin doses, and number of daily injections are chosen by a healthcare professional trained to provide diabetes care. People needing insulin are taught to give themselves their injections by their healthcare providers or diabetes educators. Unlike Type 1 diabetes, Type 2 diabetes may respond to treatment with exercise, diet, or oral medications. There are several oral medications that lower blood glucose in Type 2 diabetes. They fall into one of three groups: ? Medications that increase insulin production by the pancreas. These include Amaryl, Glucotrol and Glucotrol XL, Micronase, Diabeta, Glynase, Prandin, and Starlix. ? Medications that increase sensitivity to insulin. These include Glucophage, Avandia, and Actos. ? Medications that delay absorption of glucose from the gut. These include Precose and Glyset. Occasionally, people with Type 2 diabetes no longer need medication if they exercise, restrict their diet, and lose weight. However, most Type 2 diabetics will require more than one medication for good blood sugar control within three years of starting their first medication. Different groups of oral medications may be combined, or insulin and oral medications may be used together. Presently, oral medications are not used to treat diabetes occurring in pregnancy. Gestational diabetes is treated with diet and insulin. SELF-TESTING: Blood sugar testing, also called "self-monitoring," is done using a special meter called a glucometer to check the amount of glucose in a drop of blood. Testing is usually done before meals and at bedtime, though more frequent testing may be needed during times of illness or stress. If it is done on a regular basis, testing informs the diabetic patient and their healthcare provider how well diet, exercise, and medication are working together to control their diabetes. Blood sugar testing results can be used to adjust meals, activity, or medications to keep blood sugar levels within an appropriate range. They allow healthcare providers to recommend changes in diabetes treatment. Testing will identify high blood sugar and low blood sugar levels before serious problems develop. Ketone testing is a second test that is used in Type 1 diabetes. Ketones build up in the blood when there is not enough insulin in Type 1diabetes and eventually "spill over" into the urine. The ketone test is done on a urine sample. High levels of blood ketones may result in a serious condition called ketoacidosis. Ketone testing is usually done: ? When the blood sugar is over 240 milligrams per deciliter ? During acute illness (for example, pneumonia, heart attack, or stroke) ? When nausea or vomiting occur ? During pregnancy To Continue ... |