Diabetes Treatment Educating
Controlling blood sugar levels successfully takes time and effort. Your Diabetes Treatment may affect relationships with your partner, other family members, friends, and colleagues, and you cannot take a holiday from your illness. All of these things can be overwhelming, but with a strong team, you can manage your Diabetes Treatment.
Diabetes Treatment Medical Team
Your medical team will provide individual assessment and instruction. Depending on the type of diabetes you have, the resources in your community, and your health plan, your medical team will consist of your primary care physician, a nutritionist, a diabetes educator, a podiatrist, an ophthalmologist, an endocrinologist, and a psychologist or clinical social worker.
Know The Network for Diabetes Treatment Support
With careful planning, a positive attitude, and support from Diabetes Treatment medical team and your friends and family, you can manage your diabetes and live well. Your medical support team includes:
Your physician, who will diagnose and monitor your diabetes, prescribe medicines, and refer you to other specialists as necessary.
The nutritionist, who will explain how food affects your sugar levels, teach carbohydrate counting, and help with weight-loss strategies.
The diabetes educator, who will teach you how to inject insulin, monitor blood sugar, and treat low sugar reactions.
The podiatrist, who will screen you for diabetic nerve damage and teach you how to avoid foot injury.
The ophthalmologist, who will screen you for diabetic eye disease.
The endocrinologist, if you have type 1 diabetes or an unusual form of diabetes, or if you are having lots of problems controlling your diabetes.
The psychologist or clinical social worker, if you’re having trouble adjusting emotionally to the demands of your disease.
Your social support team includes:
Family and friends who can provide emotional support and help you with your care.
The wider diabetes community—other people with diabetes in your neighborhood, the Internet community, and advocacy groups.
Home blood sugar monitoring allows you to Assess your sugar levels in response to food, exercise, and medications
Adjust your insulin and avoid dangerously low sugar reactions
Continuous sugar monitoring systems measure sugar levels every five minutes around the clock, and you can see the trends in your sugar levels in response to food, exercise, and medications.
Your HbA1c level is an assessment of overall sugar control, and your doctor will measure it every three to four months.
To keep the complications of diabetes at bay, your doctor will
If you have type 2 diabetes, your Diabetes Treatment will involve:
Oral medicine:
Those that stimulate the beta cells to produce insulin (sulfonylureas, meglitinides, and D-phenylalanine derivatives)
Those that regulate glucose production in the liver (biguanides, such as metformin)
Those that slow the breakdown of starches (alpha-glucosidase inhibitors such as acarbose and miglitol)
Those that sensitize the tissues to the effects of insulin (insulin sensitizers) such as rosiglitazone and pioglitazone
Those that inhibit DPP-IV (the gliptins or incretin enhancers), for example, sitagliptin and vildagliptin
Injected medicine:
Exenatide, an incretin mimic, stimulates insulin release.
Pramlintide (Amylin) slows stomach emptying and lowers glucagon levels.
Insulin—all the currently available insulins are human insulins. They differ in the onset and duration of action. The newer fast-acting insulin analogs (lispro, aspart, and glulisine) and the two long-acting insulin analogs (glargine and detemir) have better absorption characteristics after subcutaneous injection, allowing for better regulation of glucose levels with less risk of hypoglycemia.
If you have type 1 diabetes, Diabetes Treatment will need to replace the insulin that the body no longer makes by using insulin injections or an insulin pump.
If you have good diabetes self-management skills, an insulin pump offers a
number of advantages:
Hypoglycemia, or low glucose reactions, can occur in people with both type 1 diabetes and type 2 diabetes.
The autonomic symptoms of shaking, sweating, anxiety, and racing heart occur at a glucose level of around 54 mg/dl. If the glucose falls to around 49 mg/dl, the brain is starved of energy and you may feel tired or confused or have blurred vision (neurogenic symptoms). If the glucose falls even further into the 30s you can become comatose or have seizures.
Hypoglycemia occurs principally because of
Overestimation of carbohydrate intake, failure to adjust insulin for exercise, or being overaggressive with insulin dosing
Impairment of the counterregulatory mechanisms, especially glucagon with long-standing diabetes
To prevent hypoglycemia:
• According to the ADA, a normal, healthy diet for people with diabetes should consist of
• 45 to 65 percent of total daily kilocalories from carbohydrates
• 25 to 35 percent of total daily kilocalories from fat
• 10 to 35 percent of total daily kilocalories from protein
• The glucose rise after eating is due to the carbohydrates in the meal, and therefore all people with diabetes should learn carbohydrate counting.
• If you are on insulin, your dose should be based on the amount of carbohydrates in your meal.
• When taken on an empty stomach, alcohol can lower glucose levels.
• Dietary recommendations include:
Exercise has many benefits for people with diabetes. Before embarking on an exercise plan, visit your physician and diabetes educator for guidance on how to exercise safely.
• In type 1 diabetes, you may need to adjust your insulin and carbohydrate intake before, during, and after exercise. You will also need to monitor your glucose levels more frequently.
• During exercise, you usually need less insulin. If you are on a pump you can cut back on the basal insulin. If you are on injections you may need to take additional carbohydrate.
• Several hours after intense or prolonged exercise, your glucose level can go low, so check your glucose and cut back on the basal insulin or eat a snack.
• With exercise training, you will become more insulin sensitive, and you will need less basal and bolus insulin.
• In type 2 diabetes, you may need to cut back on the insulin or oral medicines that can cause hypoglycemia when you exercise.
• If you have complications of diabetes, additional modifications of the exercise plan may be necessary:
• If you have severe peripheral neuropathy and foot deformity, non weight-bearing exercises like swimming and cycling are safer.
• Avoid vigorous exercise, weight lifting, or boxing if you have active retinal bleeding.
• If you are normally sedentary and plan to start a vigorous exercise program, you may need to get a cardiac stress test.
There is good evidence that combined intervention of a low-calorie diet, behavioral therapy, and increased physical activity provide the best weight loss and weight-maintenance results.
High-protein, low-carbohydrate, and low-fat diets do work, but in the long term they are no more effective than conventional diets. Long-term safety of the high-protein, low-carbohydrate diets is lacking. Very low calorie diets can cause weight loss over the short term, but the weight goes up over the subsequent one to two years.
Medications for weight loss are only modestly effective, and their main use is in conjunction with diet and exercise weight-loss interventions. The weight is regained once the drugs are stopped.
Bariatric surgery is the most effective weight-loss approach, but there are side effects from the surgery. At this time it may only be appropriate for those people with a BMI greater than 35 who, despite their best efforts, are not able to lose weight, whose diabetes is not well controlled, and who are developing complications. Diabetes Treatment Now in Your Hand????
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