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Monday, December 9, 2013
How advanced your diabetes may be affects how it is treated. Some diabetics may control their glucose levels with medicine. Others may control it with insulin injections. Regardless of how glucose is controlled, effectively treating diabetes starts with a dramatic lifestyle change, including the following:
The treatment of diabetes Types 1 and 2 diabetes begins with diet and exercise. But...
A well-balanced diet combined with exercise helps your body work as efficiently as possible.
In some cases, changes in diet and exercise patterns are enough to take the extra stress off the pancreas. When this happens, diabetes can be brought completely under control.
In other cases, a good diet and exercise go great lengths to bring glucose levels under better control. The rest can be supplemented with drug therapies.
The American Diabetes Association recommends that diabetics break their diet into the following:
Other considerations in developing a diabetic diet include the following:
1. Consistency - Eating regularly is key in a diabetic diet. Skipping or delaying meals can have drastic effects on blood glucose levels. Overindulging can have similar effects.
2. Having fun - You can enjoy the same meals, chosen carefully, as the rest of your family.
3. Balancing your food - A good diabetic diet is really no different than a good diet of a non-diabetic. It is complete with ample amounts of:
A reasonable exercise goal is 30 minutes a day of aerobic exercise. Exercise will have wide ranging effects across your body, including an increased ability to control blood glucose levels.
Although exercise is essential for health and well-being, often other activities are put ahead of it on the never-ending "to do" list. Common barriersthat get in the way of exercising are:
However, exercise can be worked into your daily life in the form of small bursts of time. The good news is that it does not require lots of money to achieve good results. Some easy ways to get more exercise include:
Ideally, maximum benefit occurs with intensive, prolonged activity. But more recent studies suggest that smaller amounts of less intense activity can lead to health benefits as well.
Diabetics must take care when changing exercise patterns. A sudden change can destabilize blood sugar levels.
Be aware of glucose levels. When starting exercise, monitor your glucose levels more frequently to observe responses to increased activity. Match your food intake, as well as insulin and oral medications, with current exercise levels.
There are medicines that help your body to manage glucose levels. These medicines can tell:
But the problem is much more complex than taking a pill.
Just increasing insulin production with drugs does not solve the problem since, this treatment will only work for a limited amount of time. Eventually, your pancreas will wear out. When it does, your body will require insulin injections to function.
1. Insulin Secretagogues. These medicines, also known as sulfonylureas, work by making the pancreas release more insulin. They are taken before meals and must be taken in proportion to the amount of food to be eaten. There is a danger of a hypoglycemic, or low blood sugar reaction, if too much medicine is taken.
Symptoms of low blood sugar include:
If these symptoms occur, blood sugar levels should be tested, and if low, something high in sugar should be eaten to raise the levels before they become dangerously low.
Medicines in this group include:
2. Meglitinides. These are similar medicines that signal the pancreas to produce more insulin. They act by a slightly different mechanism than sulfonylureas and are much faster acting. They:
3. Insulin Sensitizers are a class of drugs, also know as thiazolidinediones. They act by making the body cells more sensitive to insulin. Drugs included in this class include:
Glitazones can be very expensive, but tend to be very well tolerated by patients. They are not given to patients with congestive heart failure or active liver disease.
4. Glucose Absorption Inhibitors. These medications are also know as alpha-glucosidase inhibitors. They work in the digestive system to slow the digestion and absorption of carbohydrates. This decreases the jump in glucose levels associated with meals. Side effects include:
These effects can be minimized by slowly increasing the dosage to reach an effective level.
5. Biguanides are taken several times a day with meals. These drugs work to decrease the amount of glucose produced in the liver.
The groups of drugs above can be used individually or in combination with one another.
When diabetes reaches a level where treatment with these medications is not strong enough to control sugar levels, insulin may be added to the treatment regimen.
In Type 1 diabetes and advanced Type 2 diabetes, insulin is required for glucose management. It is important to note that insulin treatment is not failure. Some Type 2 diabetics may feel as though they have failed by having to use insulin, but this is not the truth. Every case is different, and each patient responds in different ways to treatment.
The natural course of diabetes is for it to continue to get worse until the pancreas wears out and insulin is required. How fast the pancreas wears out is dependent on a variety of factors,including:
Insulin must be injected. There are various ways to achieve this.
Insulin comes in several varieties and is tailored to the specific needs of the patient.
Millions of Americans have managed to control their diabetes and live very normal lives. Working with a team of healthcare professionals and never being afraid to ask questions or discuss treatment options, someone with diabetes can make the most of the situation.
Diabetes is not just about surviving the disease. It can be a tremendous opportunity to adopt a healthy lifestyle and thrive.
Many research studies are underway to help us learn about metabolic syndrome. Would you like to find out more about being part of this exciting research? Please visit the following links:
This article is a NetWellness exclusive.
Last Reviewed: Sep 12, 2013
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati
Bette K Idemoto, PhD, RN, ACNS-BC, CCRN
Clinical Nurse Specialist
Frances Payne Bolton School of Nursing
Case Western Reserve University