Monday 31 August 2015

Diabetes Treatment and Guidelines

Okay, so assuming you finally know your Diabetes status, supposing it turns out to be positive, how should you go about treating it? What is the best course of action open to you? What would treatment involve and what would you need to do or refrain from doing to ensure that treatment is successful? All these questions and more will be answered in this article.
So here goes.

Generally since diabetes is referenced by an above normal presence of blood sugar (200 mg/dl or more-random plasma Glucose test or 126 mg/dl or more- fasting plasma glucose test), it is the aim of diabetes treatment to ensure that whether through medication, exercise, surgery, dietary adjustments, etc. or a combination of all these, blood sugar level is regularized and brought back to normal. However such treatment must make sure at the same time that the opposite doesn't happen-that blood sugar does not fall to abnormally low levels (hypoglycemia).

Accordingly, the monitoring of blood sugar is also an essential aspect of diabetes treatment. The first thing to note therefore, assuming you are diagnosed with diabetes is that diabetes treatment equates to diabetes management. For now strictly speaking, whether for Type 1(especially for Type 1) or Type 2 (depending on your take on reversal), there is no cure.
The second thing to note is that treatment would generally involve some life style changes. 

These changes will involve a combination of some or all of the following; dietary adjustments, exercise and the taking of diabetes medication like insulin and metformin.
Type 1 diabetes is treated with insulin, exercise and a diabetic diet. Type 2 on the other hand is treated first with weight reduction, a diabetic diet and exercise. And secondly in cases where this would not be enough, thereafter with diabetes medication or insulin therapy and Blood Sugar monitoring. As such training in self-management of diabetes is an indispensable part of diabetes management.

That said, it is important to note that treatment must be tailored to individual needs thereby catering to individual diabetic differences. Such treatment should therefore take into cognizance and address psycho-social, medical and lifestyle issues.

For the vast majority of people with Type 1 diabetes, insulin is the only form of medication they will need to take. For people with Type 2 diabetes however, available medication vary and depending on their circumstances, they may or may not need to take one or more of these drugs. Let's take a deeper look into treatment for Type 2 diabetes.

Healthy eating
Though there is no specific diabetes diet, since our aim is to reduce blood sugar, it is best to reduce the intake of carbohydrates, animal products, sugar and fats. Instead one should center his or her diet around vegetables, fruits and whole grains.
Foods with a low glycemic index (foods that don't raise your blood sugar quickly), typically high in fiber foods, can be helpful in assisting one to reach a stable blood sugar level.

Regular exercise
Here what is important is to incorporate regular exercise into our daily routine. Your doctor taking into cognizance your medical history would be able to suggest a balanced regimen for you. One which at once would be adequate, whilst not being strenuous.
A 30 minutes daily combination of aerobic, stretching and strength training exercise is suggested and has been found to be more effective than either type of exercise (aerobic and strength training) alone. Where you have been inactive for long, it is best to first start slowly before gradually building things up.

Blood Sugar Monitoring
Keeping your blood sugar within the target or desired range means that you must regularly monitor your blood sugar level. Your doctor should be able to give you a rough number of how many times a day you should take your blood sugar reading. Most people check their (blood) sugar level before most meals as well as before or after engaging in other forms of treatment such as exercise or the taking of medication. Illness and alcohol consumption is also known to affect blood sugar levels so one should watch out for these.

Medication
Whilst diet and exercise alone is sufficient for some people to enable them attain their target blood sugar levels, others may require medication. And though previously, insulin was the only diabetes medication available, today the number of diabetes medicine has greatly increased.

Commonly prescribed diabetes medicine today include insulin, metformin, januvia, actos, Victoza and Byetta. Lets look at some of these in detail.
Sulfonylureas; assists your body to secrete more insulin. The following drugs fall into this class, namely; glipzide (Glucotrol), glyburide (DiaBeta, Glynase) and glimepiride (Amaryl). Side effects may include weight gain and low blood sugar.

Metformin is the first drug of choice generally prescribed in diabetes cases of Type 2. This drug by improving the sensitivity of the bodies tissues to insulin, enables the body to use insulin more effectively. However since Metformin won't usually lower blood sugar enough on its own, it is advised that concerned individuals should couple its uptake with weight loss and more physical activity. Side effects common to Metformin are nausea and diarrhea but these usually disappear as the body adjusts to it.

Meglitinides
Working like sulfonylureas, these medications encourage the body to secrete more insulin. They differ from Sulfonylureas however in that they act faster and don't stay active in the body for as long. With these class of drugs too comes an associated risk of weight gain and hypoglycemia. However this latter risk is less than for that associated with Sulfonylureas.

DPP-4 inhibitors
DPP-4 inhibitors help to lower blood sugar levels. Although their effect is rather modest, they don't however cause weight gain. These type of drugs include linagliptin (Tradjenta), Saxagliptin (Onglyza) and Sitagliptin (Januvia).

Thiazolidinediones or glitazones are another set of medication used in the treatment of Type 2 diabetes. Like Metformin, they increase the body tissues sensitivity to insulin. This said though, they have been associated with increased risk of weight gain, heart failure, stroke and fractures. As such they are not first choice recommendation for diabetes treatment and in fact rosiglitazone a variant has been suspended from use in Europe by medical authorities precisely because of these difficulties.

Other classes of medication available for diabetes treatment include SGL T2 inhibitors and GLP-1 inhibitors. A feature of SGL T2 functioning is that sugar is excreted out through the urine, whilst GLP-1 works by slowing digestion and thus the amount of sugar released at any one time into the blood stream.

Having stated the above, it should be noted that insulin may also be prescribed for some type 2 sufferers of diabetes. These insulin types are; Insulin aspart (Novolog); Insulin Lispro; insulin isophane (Humulin N, Novolin N); Insulin glulisine (Apidra); Insulin determir (Levemir) and Insulin glargine (Lantus).

Ordinarily insulin is required to be injected because the digestive process may disrupt the workings of insulin taken orally. Apparatus used for insulin injections include needle and syringe or insulin pens.

Other means of treating Type 2 diabetes also include herbal treatment and bariatric surgery. But whatever the case and whatever form of treatment is contemplated, it is paramount you seek the advice of and work with a health care professional before taking it.

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