Treatment for Diabetes
All treatment strategies should emphasize on cardiovascular risk reduction focusing on control of blood pressure, smoking cessation and correction of dyslipidemia. Consumption of healthy diet, exercise and maintenance of optimal weight should be the cornerstone of management.
According to the American Diabetes Association (ADA), the goals of diabetic treatment are the following:
- Maintain a near normal level of blood glucose
- Achieve and maintain optimal blood cholesterol levels
- Achieve and maintain optimal weight
- Prevent or treat complications of diabetes
Type 1 Diabetes mellitus
Type 1 DM is managed with insulin injections along with a healthy diet. Diabetic patients are educated on how to inject themselves with insulin. Injections should be given subcutaneously. The amount of insulin must be balanced with food intake and daily activities. In addition, blood glucose levels must be closely monitored through frequent blood glucose checking.
A significant number of diabetics now resort to using an insulin pump as it provides an effective, easy-to-use and convenient method of insulin administration. Inhaled insulin is the latest addition in the management of diabetes and may be a viable alternative to subcutaneous insulin.1 The insulin schedule and dosing should be reviewed at each consultation to review diabetes.
Type 2 Diabetes mellitus
Diet modification and physical activity are the basic management strategy for T2DM. As the total amount of carbohydrateconsumed is a strong predictor of glycemic response, monitoring of total carbohydrate intake is the key strategy in achievingglycemic control. Foremost, people with DM should eat healthily food as recommended for the whole population, which is a balanced diet based on starchy foods, plenty of fruit and vegetables and food low in fat, salt and sugar.
Gestational Diabetes mellitus
The commonly accepted treatment goal for GDM patients is to maintain a fasting blood glucose level of <95– 105 mg/dL and a postprandial blood glucose level of <140 mg/dL at 1 h and <120 mg/dL at 2 h. Patients not achieving these targets with dietary changes should be started on insulin therapy. In general, OHAs are not used during pregnancy because of the potential adverse effects on the fetus.
Women who have had GDM previously should be encouraged to maintain an optimal weight and to exercise regularly. They should be tested for diabetes once in 2 years basis. In women of reproductive age with T2DM, the menstrual history is very significant as some of them may also have polycystic ovarian syndrome. Treatment with metformin or a glitazone for their diabetes may help to restore the menstrual cycle as well as fertility.
Written by: Healthplus24 team
Date last updated: July 27, 2012