Treatment and Management of Diabetes

Diabetes is a chronic condition characterized by increased levels of sugar in the blood. It is caused by the inability of the pancreas to produce the hormone insulin, which is responsible for maintaining normal levels of sugar in the blood, or the insensitivity of the body to the amount of insulin produced. There are two main types of diabetes:

• Type 1 diabetes: The pancreas produces little or no insulin, and diabetes develops when the body’s immune system destroys the pancreas cells. It is also called insulin-dependent diabetes or juvenile-onset diabetes as it is commonly seen in children.
• Type 2 diabetes: The pancreas usually produces normal levels of insulin, but the body becomes resistant to the hormone. It is associated with inactivity, obesity and genetic factors. Also called adult-onset diabetes, it occurs mainly in adults, but is becoming more common in children because of the increase of childhood obesity.

The common symptoms of diabetes mellitus are increased thirst, frequent urination, extreme hunger, weight loss, fatigue, blurred vision and frequent infections.

Treatment of diabetes involves diet, exercise, medications and other lifestyle improvements. These will help to maintain normal blood sugar levels, and prevent or minimize complications of diabetes.

• Diet: Eat a consistent well balanced diet that is high in fiber, and low in saturated fats and concentrated sweets. Meals should be taken on a regular schedule and long periods between eating should be avoided.
• Exercise: Regular exercise in any form can help maintain a healthy weight and blood sugar levels within the normal range.
• Smoking and alcohol use: Stop smoking and limit consumption of alcohol.
• Medical treatment: Medicines are prescribed based on the type of diabetes, presence of associated medical problems, complications of diabetes, age and general health. The treatment usually involves daily injection of a combination of insulin. It is given in two or three injections per day, generally around meal times. There are other drugs that can be taken orally.
• Treating comorbidities: Your doctor will also include medications and treatments to prevent, control and treat other associated conditions.

Effective treatment can prevent long-term damage to other organs such as the heart (cardiovascular problems), nerves, kidneys, eyes, feet and skin, which can be life-threatening. Treatment involves lifelong management of blood sugar levels through healthy eating, exercising, oral medications and insulin. In the course of treatment, one may develop hypoglycemia (low blood sugar) as a result of skipping a meal, excess physical activity or injecting excess insulin, or alternately, hyperglycemia (high blood sugar) by overeating or not taking enough insulin. These complications should be managed by adjusting your food and insulin intake as well as activity level.

The treatment plan may need to be optimized over time. A new meal plan may be advised, or a change in medication or type of insulin. Diabetes mellitus management should be a constant collaboration between you and your doctor.