Treatments for Diabetes


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Treatment list for Diabetes: The list of treatments mentioned in various sources for Diabetes includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Treatment statistics for Diabetes: The following are statistics from various sources about the treatment of Diabetes:

  • 12% of diabetics take insulin and oral medications in the US 1999-2001 (National Diabetes Statistics fact sheet, NIDDK, 2003)
  • 19% of diabetics take only insulin in the US 1999-2001 (National Diabetes Statistics fact sheet, NIDDK, 2003)
  • 53% of diabetics take only oral medications in the US 1999-2001 (National Diabetes Statistics fact sheet, NIDDK, 2003)
  • 15% of diabetics donít take insulin or oral medications in the US 1999-2001(National Diabetes Statistics fact sheet, NIDDK, 2003)

Treatment of Diabetes: medical news summaries: The following medical news items are relevant to treatment of Diabetes:

Treatments of Diabetes discussion: Before the discovery of insulin in 1921, everyone with type 1 diabetes died within a few years after diagnosis. Although insulin is not considered a cure, its discovery was the first major breakthrough in diabetes treatment.

Today, healthy eating, physical activity, and insulin via injection or an insulin pump are the basic therapies for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose checking.

Healthy eating, physical activity, and blood glucose testing are the basic management tools for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication and insulin to control their blood glucose levels.

People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves keeping blood glucose levels from going too low or too high. When blood glucose levels drop too low from certain diabetes medicines--a condition known as hypoglycemia--a person can become nervous, shaky, and confused. Judgment can be impaired. If blood glucose falls too low, a person can faint.

A person can also become ill if blood glucose levels rise too high, a condition known as hyperglycemia.

People with diabetes should see a doctor who helps them learn to manage their diabetes and monitors their diabetes control. An endocrinologist is one type of doctor who may specialize in diabetes care. In addition, people with diabetes often see ophthalmologists for eye examinations, podiatrists for routine foot care, and dietitians and diabetes educators to help teach the skills of day-to-day diabetes management.

The goal of diabetes management is to keep blood glucose levels as close to the normal range as safely possible. A recent major study, the Diabetes Control and Complications Trial (DCCT), sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), showed that keeping blood glucose levels as close to normal as safely possible reduces the risk of developing major complications of type 1 diabetes.

The 10-year study, completed in 1993, included 1,441 people with type 1 diabetes. The study compared the effect of two treatment approaches--intensive management and standard management--on the development and progression of eye, kidney, and nerve complications of diabetes. Intensive treatment aimed at keeping hemoglobin A-1-c as close to normal (6 percent) as possible. Hemoglobin A-1-c reflects average blood sugar over a 2- to 3-month period. Researchers found that study participants who maintained lower levels of blood glucose through intensive management had significantly lower rates of these complications. More recently, a followup study of DCCT participants showed that the ability of intensive control to lower the complications of diabetes persists up to 4 years after the trial ended.

The United Kingdom Prospective Diabetes Study, a European study completed in 1998, showed that intensive control of blood glucose and blood pressure reduced the risk of blindness, kidney disease, stroke, and heart attack in people with type 2 diabetes. 1

Diabetes knowledge, treatment, and prevention strategies advance daily. Treatment is aimed at keeping blood glucose near normal levels at all times. Training in self-management is integral to the treatment of diabetes. Treatment must be individualized and must address medical, psychosocial, and lifestyle issues.

  • Treatment of type 1 diabetes: Lack of insulin production by the pancreas makes type 1 diabetes particularly difficult to control. Treatment requires a strict regimen that typically includes a carefully calculated diet, planned physical activity, home blood glucose testing several times a day, and multiple daily insulin injections.

  • Treatment of type 2 diabetes: Treatment typically includes diet control, exercise, home blood glucose testing, and, in some cases, oral medication and/or insulin. Approximately 40 percent of people with type 2 diabetes require insulin injections.
2

Many types of diabetes pills can help people with type 2 diabetes lower their blood glucose. Each type of pill helps lower blood glucose in a different way. The diabetes pill (or pills) you take is from one of these groups. You might know your pill (or pills) by a different name.

  • Sulfonylureas (SUL-fah-nil-YOO-ree-ahs). Stimulate your pancreas to make more insulin.

  • Biguanides (by-GWAN-ides). Decrease the amount of glucose made by your liver.

  • Alpha-glucosidase inhibitors (AL-fa gloo-KOS-ih-dayss in-HIB-it-ers). Slow the absorption of the starches you eat.

  • Thiazolidinediones(THIGH-ah-ZO-li-deen-DYE-owns). Make you more sensitive to insulin.

  • Meglitinides (meh-GLIT-in-ides). Stimulate your pancreas to make more insulin.

  • D-phenylalanine (dee-fen-nel-AL-ah-neen) derivatives. Help your pancreas make more insulin quickly.

  • Combination oral medicines. Put together different kinds of pills.
3

Your doctor might prescribe one pill. If the pill does not lower your blood glucose, your doctor may

  • ask you to take more of the same pills, or
  • add a new pill or insulin, or

  • ask you to change to another pill or insulin.
3

Your doctor may ask you to take more than one diabetes medicine at a time. Some diabetes medicines that lower blood glucose work well together. Here are examples: 3

Your doctor might ask you to take insulin and one of these diabetes pills:

  • a sulfonylurea
  • metformin
  • pioglitazone
3

In March 2001, the U.S. Food and Drug Administration (FDA) approved a noninvasive blood glucose monitoring device for adults with diabetes. Noninvasive monitoring means checking blood glucose levels without puncturing the skin for a blood sample. The GlucoWatch Biographer, manufactured by Cygnus Inc., was approved to detect glucose level trends and patterns in adults age 18 and older with diabetes. It must be used along with conventional blood glucose monitoring of blood samples. The device, which looks like a wristwatch, pulls body fluid from the skin using small electric currents. It checks blood glucose levels every 20 minutes.4

Your doctor might ask you to take a medicine called an ACE inhibitor (in-HIB-it-ur). This medicine helps control blood pressure. ACE inhibitors also help people with diabetes to slow down kidney damage by keeping the kidneys from cleaning out too much protein. New medicines now being tested may also hold promise. 5

Diabetes treatment is focused on keeping blood sugar in a normal range every day. A recent major study showed that keeping blood glucose levels as close to normal as safely possible reduces the risk of developing major complications of type 1 diabetes.

If you have diabetes, a good blood sugar range is from about 70 to 150 (before a meal) and less than 200 about two hours after your last meal. Ask your health care provider what the best range of blood sugar is for you, how to test your blood sugar and how often. Careful meal planning and exercise to control your weight are important to control your diabetes. Your health care provider will evaluate if you need diabetes pills or insulin shots. 6

Diabetes cannot be cured, but it can be controlled. Good control requires a careful blend of diet, exercise, blood sugar monitoring, and medication. People with type 1 diabetes control their blood sugar with insulin injections and frequent self-monitoring of blood glucose. People with type 2 diabetes generally control their blood sugar with oral medications. In some cases, insulin injections are needed to keep type 2 diabetes under control.

Diet is very important to lowering blood glucose levels. In planning a diet, the doctor considers the patient's weight and daily physical activity. For overweight patients, a weight loss plan is a must for proper blood glucose control. Food exchange lists to help with meal planning are available from your doctor and the American Diabetes Association.

Exercise is very important because it helps the body burn off some of the excess glucose as energy. Taking part in a regular fitness program has been shown to improve blood glucose levels in older people with high levels. A doctor can help plan an exercise program that balances the diet and medication needs and your general health.

Drugs may not be needed for type 2 diabetes if good control can be achieved through diet and exercise. But when these measures fail, oral drugs, insulin, or a combination of the two may be prescribed. A person who normally does well without drugs will need to take medication during acute illnesses.

Foot care is very important for people with diabetes. The disease can lower blood supply to the limbs and reduce feeling in the feet. People with diabetes should check their feet every day and watch for any redness or patches of heat. Sores, blisters, breaks in the skin, infections or buildup of calluses should be reported right away to a podiatrist or family doctor.

Skin care is very important. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean, using skin softeners to treat dryness, and taking care of minor cuts and bruises.

Teeth and gums need special attention to avoid serious infections. People with diabetes should tell their dentist about their condition and schedule regular checkups.7

Footnotes:
1. excerpt from Diabetes Overview: NIDDK
2. excerpt from Diabetes Statistics in the United States: NIDDK
3. excerpt from Medicines for People With Diabetes: NIDDK
4. excerpt from Noninvasive Blood Glucose Monitors: NIDDK
5. excerpt from Keep your kidneys healthy: NIDDK
6. excerpt from Diabetes: NWHIC
7. excerpt from Dealing With Diabetes - Age Page - Health Information: NIA

Last revision: April 10, 2003

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