How is diabetes treated?
Diabetes is treated in two ways:
Diet and diabetes
A special diet used to be recommended for diabetes. It's now thought a normal, well-balanced diet is best.
But calorie intake is still important. People with diabetes who are overweight need to think of weight loss as part of their treatment.
But calorie intake is still important. People with diabetes who are overweight need to think of weight loss as part of their treatment.
- a combination of healthy diet and exercise
- medication with tablets and/or
insulin.
Insulin injectionsincrease the amount of insulin in your body and bring down the blood sugar
level. Insulin injections are used in Type 1 diabetes and in some cases of Type 2.
These can be given once a day as a long-acting insulin, or as shorter-acting injections given more frequently through the day, and can be used in combination with tablet treatment if necessary.There are different types of oral medication for treating Type 2 diabetes:
- some increase the amount of insulin secreted by the
pancreas - some increase the action of insulin in the body
- some delay the absorption of glucose from the digestive
system - some suppress a hormone called glucagon, which is secreted by
the pancreas and stops insulin from working.
Treatment for diabetes depends on the individual. It starts the first time you give yourself an insulin injection
or take a diabetes tablet, and continues through eating a well-balanced diet and starting an exercise programme. To help you get the most out of treatment, consult your GP or hospital healthcare team, which should include a diabetes nurse specialist.
Blood sugar levels
Monitoring blood sugar levels is an important aspect of treatment, especially in Type 1 diabetes where levels
can change markedly.This can be done easily at home with a small blood glucose meter.
Depending on the reading, you may need to adjust your diet, the amount you exercise or your insulin intake.
Managing diabetes
In the long term, diabetes is monitored through routine check-ups by your doctor and/or annual check-ups at the hospital on an outpatient basis.Their purpose is to determine if treatment is satisfactory and to look out for any evidence of longer-term complications such as eye or kidney disease.
Tests for these complications are usually done at the annual check-up, while routine check-ups may be carried out every three to six months.
Routine check-ups
- Blood sample to check the level of HbA1c (a measure of long-term glucose) in the blood.
- Evaluation of home glucose readings.
- Discussion of diet.
- Blood pressure.
- Weight check.
- Other tests and examinations as determined by your doctor.
Annual check-ups
- Blood sample to check the amount of HbA1c in the blood.
- Blood sample to determine the amount of fats in the blood.
- Blood sample to check kidney function and various salts in the blood (mainly sodium and potassium).
- Blood pressure.
- Urine sample to determine the presence of protein (albuminuria). The appearance of protein can indicate that the small blood vessels (capillaries) in the kidneys are beginning to be affected by the
diabetes. - Foot examination, including a check of various pulse points on the foot to assess circulation, and a check for vibration sensation to determine if there's any neuropathy (nerve damage) to the foot.
- Weight check.
- Measuring the waistline.
- Discussion of exercise habits.
- Discussion of smoking habits.
Long-term prospects
Both types of diabetes have the risk of complications.
Acute complications
- Low glucose level, caused by treatment with insulin or oral Hypoglycaemic drugs that increase insulin secretion from the pancreas.
- Diabetic acidosis, a life-threatening condition caused by the lack of insulin.
Late-stage diabetic complications
- Retinopathy (eye disease) that can cause blindness.
- Diabetic kidney disease that can lead to kidney failure.
- Diabetic neuropathy (nerve disease) that can cause foot ulcers and foot infections.
- Atherosclerosis (hardening of the arteries), particularly in smokers and those with high blood pressure and abnormal fat levels in the blood.
Late-stage complications do not usually develop for 10 to 15 years with Type 1 diabetes.
In Type 2 diabetes, however, symptoms can appear close to the time of actual diagnosis because the disease may go undetected for longer. Many studies now show that good glucose control can significantly reduce or even stop complications. This means keeping the blood sugar level as close to normal as possible.Recent studies have also confirmed the need for people with diabetes to reduce their risk of atherosclerosis (fatty deposits in your arteries). This is because if you have Type 2 diabetes, you have a four to five times greater risk of developing serious problems with your circulation that can lead to a heart attack or a stroke.
The main factors that increase your risk are:
- smoking
- high blood pressure
- raised levels of fats such as Cholesterol in the blood.
By taking measures to address these issues, you will reduce your
chance of developing complications such as heart disease.
