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-Diabetes Facts -Diabetes Mellitus Symptoms Type 1 Diabetes Type 2 Diabetes Gestational Diabetes Juvenile Diabetes Diabetes Insipidus Diabetes Symptoms Glucose
Diabetes Diet Diabetes Supply Diabetes Treatment Insulin Diabetes Care Diabetes is the No. 6 leading causes of deaths in the United States, according to 2001 data from the United States National Center for Health Statistics. |
Diabetes Treatment
Controlling your blood sugar is essential to feeling healthy and avoiding
long-term complications of diabetes. Some people are able to control their blood
sugar with diet and exercise alone. Others may need to use insulin or other
medications in addition to lifestyle changes. In either case, monitoring your
blood sugar is a key part of your treatment program. A healthy diet and exercise should be placed as a priority for
diabetes treatment. Second, you might also try some of the
diabetes treatment using
alternative medicine. Third, follow your doctor's prescriptions.
And last, pancreas or islet cell transplantation may be an option for people whose
kidneys are failing or who aren't responding to other treatments. Monitoring blood sugar The best range for you depends on your age and the type of diabetes you have.
For younger adults who don't have complications of diabetes, a typical target
range might be 80 to 120 mg/dL before meals, and below 180 mg/dL after eating.
Older adults who have complications from their disease may have a fasting target
goal of 100 to 140 mg/dL and below 200 mg/dL after meals. That's because blood
sugar that falls too low in older adults can be more dangerous than in younger
people. How often you test your blood sugar depends on the type of diabetes you have.
If you take insulin, test your blood sugar at least twice a day, and preferably
three or four times a day. But if you have type 2 diabetes and don't use
insulin, you may need to test your blood sugar levels only once a day or as
little as twice a week. Keep in mind that the amount of sugar in your blood is constantly changing.
Self-monitoring helps you learn what makes your blood sugar levels rise and
fall, so you can make adjustments in your treatment. Factors that affect your
blood sugar include: Food. Food raises your blood sugar
level ? it's highest one to two hours after a meal. What and how much you eat,
and the time of day, also affect your blood sugar level. Exercise and physical activity. In
general, the more active you are, the lower your blood sugar. Physical
activity causes sugar to be transported to your cells, where it's used for
energy, thereby lowering the levels in your blood. Aerobic exercises such as
brisk walking, jogging or biking are especially good. But gardening, housework
and even just being on your feet all day also can lower your blood sugar. Medications. Insulin and oral
diabetes medications deliberately work to lower your blood sugar. But
medications you take for other conditions may affect glucose levels.
Corticosteroids, in particular, may raise blood sugar levels. Medications such
as thiazides, used to control high blood pressure, and niacin, used for high
cholesterol, also may increase blood sugar. If you need to take certain high
blood pressure medications, your doctor will likely make changes in your
diabetes treatment. Illness. The physical stress of a
cold or other illness causes your body to produce hormones that raise your
blood sugar level. The additional sugar helps promote healing. But if you have
diabetes, this can be a problem. In addition, a fever increases your
metabolism and how quickly sugar is utilized, which can alter the amount of
insulin you need. For these reasons, be sure to monitor your glucose levels
frequently when you're sick. Alcohol. Even a small amount of
alcohol ? about 2 ounces ? can cause your sugar levels to fall too low. But
sometimes alcohol can cause sugar levels to rise. If you choose to drink, do
so only in moderation. And monitor your blood sugar before and after consuming
alcohol to see how it affects you. Also, keep in mind that alcohol counts as
carbohydrate calories in your diet. Fluctuations in hormone levels. The
female hormone estrogen typically makes cells more responsive to insulin, and
progesterone makes cells more resistant. Although these two hormones fluctuate
throughout the menstrual cycle, the majority of women don't notice a
corresponding change in blood sugar levels. Those who do are more likely to
experience changes in blood sugar during the third week of their menstrual
cycle, when estrogen and progesterone levels are highest. Hormone levels also fluctuate during perimenopause ? the time before
menopause. How this affects blood sugar varies, but most women can control any
symptoms with additional exercise and changes in their diet. If your symptoms
are more severe, your doctor may recommend oral contraceptives or hormone
replacement therapy (HRT). After menopause, many women with diabetes require
about 20 percent less medication because their cells are more sensitive to
insulin. A healthy diet Yet understanding what and how much to eat can be a challenging task.
Fortunately, a registered dietitian can help you put together a meal plan that
fits your health goals, food preferences and lifestyle. Once you've decided on a
meal plan, keep in mind that consistency is extremely important. To keep your
blood sugar at a consistent level, try to eat the same amount of food with the
same proportion of carbohydrates, proteins and fats at the same time every day. But even with all the information you need and the best intentions, sticking
to your diet can be one of the most challenging parts of living with diabetes.
The key is to find ways to stay motivated. Don't let others undermine your
determination to eat in the healthiest way possible. You have to believe that
what you're doing matters ? and that you're worth it. Exercise See your doctor before beginning any exercise program. Once you have the
go-ahead, take some time to think about which activities you enjoy and are
likely to stick with. Walking, hiking, jogging, biking, tennis, cross-country
skiing and swimming are all good choices. Aim for at least 30 minutes of aerobic exercise most days. But if you haven't
been active for a while, start slowly and build up gradually. For the best
results, combine your aerobic activity with stretching and strength-training
exercises. Healthy weight Yet losing even 10 pounds can be a challenge for most people. Fortunately,
you don't have to do it alone. A registered dietitian can help you develop a
weight-loss plan that takes into account your current weight, activity level,
age and overall health. Ultimately, however, the motivation has to come from
you. Medications An insulin pump is a pumping device about the size of a deck of cards. You
wear it outside your body. A small tube connects the reservoir of insulin to a
catheter that's inserted under the skin of your abdomen. The pump dispenses the
desired amount of insulin into your body and can be adjusted to infuse more or
less insulin depending on meals, activity and glucose level. Insulin pumps
aren't for everyone. But for some people they provide improved blood sugar
control and a more flexible lifestyle. The most widely used form of insulin is synthetic human insulin, which is
chemically identical to human insulin but manufactured in a laboratory.
Unfortunately, synthetic human insulin isn't perfect. One of its chief failings
is that it doesn't mimic the way natural insulin is secreted. But newer types of
insulin, known as insulin analogs, more closely resemble the way natural insulin
acts in your body. Among these are lispro (Humalog), insulin aspart (NovoLog)
and glargine (Lantus). A number of drug options exist for treating type 2 diabetes, including: Sulfonylurea drugs. These medications
stimulate your pancreas to produce and release more insulin. For them to be
effective, your pancreas must produce some insulin on its own.
Second-generation sulfonylureas such as glipizide (Glucotrol, Glucotrol XL),
glyburide (DiaBeta, Glynase PresTab, Micronase) and glimepiride (Amaryl) are
prescribed most often. The most common side effect of sulfonylureas is low
blood sugar, especially during the first four months of therapy. You're at
much greater risk of low blood sugar if you have impaired liver or kidney
function. Meglitinides. These medications, such
as repaglinide (Prandin), have effects similar to sulfonylureas, but you're
not as likely to develop low blood sugar. Meglitinides work quickly, and the
results fade rapidly. Biguanides. Metformin (Glucophage,
Glucophage XR) is the only drug in this class available in the United States.
It works by inhibiting the production and release of glucose from your liver,
which means you need less insulin to transport blood sugar into your cells.
One advantage of metformin is that is tends to cause less weight gain than do
other diabetes medications. Possible side effects include a metallic taste in
your mouth, loss of appetite, nausea or vomiting, abdominal bloating, or pain,
gas and diarrhea. These effects usually decrease over time and are less likely
to occur if you take the medication with food. A rare but serious side effect
is lactic acidosis, which results when lactic acid builds up in your body.
Symptoms include tiredness, weakness, muscle aches, dizziness and drowsiness.
Lactic acidosis is especially likely to occur if you mix this medication with
alcohol or have impaired kidney function. Alpha-glucosidase inhibitors. These
drugs block the action of enzymes in your digestive tract that break down
carbohydrates. That means sugar is absorbed into your bloodstream more slowly,
which helps prevent the rapid rise in blood sugar that usually occurs right
after a meal. Drugs in this class include acarbose (Precose) and miglitol (Glyset).
Although safe and effective, alpha-glucosidase inhibitors can cause abdominal
bloating, gas and diarrhea. If taken in high doses, they may also cause
reversible liver damage. Thiazolidinediones. These drugs make
your body tissues more sensitive to insulin and keep your liver from
overproducing glucose. Side effects of thiazolidinediones, such as
rosiglitazone (Avandia) and pioglitazone hydrochloride (Actos), include
swelling, weight gain and fatigue. A far more serious potential side effect is
liver damage. The thiazolidinedione troglitzeone (Rezulin) was taken off the
market in March 2000 because it caused liver failure. If your doctor
prescribes these drugs, it's important to have your liver checked every two
months during the first year of therapy. Contact your doctor immediately if
you experience any of the signs and symptoms of liver damage, such as nausea
and vomiting, abdominal pain, loss of appetite, dark urine, or yellowing of
your skin and the whites of your eyes (jaundice). These may not always be
related to diabetes medications, but your doctor will need to investigate all
possible causes. Drug combinations. By combining drugs
from different classes, you may be able to control your blood sugar in several
different ways. Each class of oral medication can be combined with drugs from
any other class. Most doctors prescribe two drugs in combination, although
sometimes three drugs may be prescribed. Newer medications, such as Glucovance,
which contains both glyburide and metformin, combine different oral drugs in a
single tablet. Transplantation Pancreas transplantation. Pancreas
transplants have been performed since the late 1960s. Most are done in
conjunction with or after a kidney transplant. Kidney failure is one of the
most common complications of diabetes, and receiving a new pancreas when you
receive a new kidney may actually improve kidney survival. Furthermore, after
a successful pancreas transplant, many people with diabetes no longer need to
use insulin. Unfortunately, pancreas transplants aren't always successful.
Your body may reject the new organ days or even years after the transplant,
which means you'll need to take immunosuppressive drugs the rest of your life.
These drugs are costly and can have serious side effects, including a high
risk of infection and organ injury. Because the side effects can be more
dangerous to your health than your diabetes, you're usually not considered a
candidate for transplantation unless your diabetes can't be controlled or
you're experiencing serious complications. On the other hand, pancreas
transplantation may be an option if you are age 45 or younger, have type 1
diabetes and need or have had a kidney transplant, or if insulin doesn't
control your blood sugar. Islet cell transplantation. Your
pancreas contains about 1 million islet cells, 75 percent to 80 percent of
which produce insulin. The beta cells that produce insulin reside in the
islets. Although still considered an experimental procedure, transplanting
these cells may offer a less invasive, less expensive and less risky option
than a pancreas transplant for people with diabetes. In islet cell
transplantation, doctors infuse fresh pancreas cells into the liver of the
person with diabetes. The cells spread throughout the liver and soon begin to
produce insulin. The liver, not the pancreas, is the site of the transplant
because it's easier to access the large portal vein in your liver than it is
to access a vein in your pancreas. What's more, cells that grow in the liver
secrete insulin much like cells in the pancreas do. (from Mayo Clinic)
Diabetes Mellitus Note: This diabetes
health education project is supported
by Chong's Health Care at http://www.cljhealth.com, one of the leading companies in the discovery of
alternative
medicines for diabetes.
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