Diabetes (Mellitus, Type 1 and Type 2) (cont.)
What Are Medical Treatments for Diabetes?
Treatment of diabetes is highly individualized, depending on the type of diabetes, whether the patient has other active medical problems, whether the patient has complications from diabetes, and the age and general health of the patient at time of diagnosis.
- A health-care professional will set goals for lifestyle changes, blood sugar control, and treatment.
- Together, the patient and the health-care professional will formulate a plan to help meet those goals.
Education about diabetes and its treatment is essential in all types of diabetes.
- When the patient is first diagnosed with diabetes, the diabetes care team will spend a lot of time educating the patient, teaching them about their condition, treatment, and tools to care for themselves on a daily basis.
- The diabetes care team includes the health-care professional and his or her staff. It may include specialists in foot care, neurology, kidney diseases, and eye diseases. A professional dietitian and a diabetes educator are usually part of the team.
The health-care team will encounter the patient at appropriate intervals to monitor their progress and evaluate goals.
Type 1 diabetes
Treatment of type 1 diabetes involves multiple daily injections of insulin, usually a combination of short-acting insulin (for example, lispro [Humalog] or aspart [NovoLog]) and a long-acting insulin (for example, NPH, Lente, glargine [Lantus], detemir [Levemir]).
- Insulin must be given as an injection just under the skin. If taken by mouth, insulin would be destroyed in the stomach before it could get into the blood where it is needed.
- Most people with type 1 diabetes give these injections to themselves. Even if someone else usually gives the patient injections, it is important that the patient knows how to do it in case the other person is unavailable.
- A trained professional will show the patient how to store and inject the insulin. Usually this is a nurse who works with the health-care professional or a diabetes educator.
- Insulin is usually given as three or four injections per day, generally around mealtimes. Dosage is individualized and is tailored to the patient's specific needs by the health-care professional. Longer-acting insulin formulations are typically administered once or twice each day.
- Some people have their insulin administered by continuous infusion pumps to provide adequate blood-glucose control. Supplemental mealtime insulin is programmed into the pump by the individual as recommended by his or her health-care professionals.
- It is very important to eat after the taking insulin, as the insulin will lower blood sugar regardless of whether the person has eaten. If insulin is taken without eating, the result may be hypoglycemia. This is called an insulin reaction.
- There is an adjustment period while the patient learns how insulin affects them and how to time their meals and exercise with insulin injections to keep blood sugar levels as even as possible.
- Keeping accurate records of blood sugar levels and insulin dosages is crucial for the patient's diabetes management.
- Eating a consistent, healthy diet appropriate for the patient's size and weight is essential to control blood-sugar levels.
Type 2 diabetes
Depending on how elevated the patient's blood sugar was at diagnosis of type 2 diabetes, they may be given a chance to lower blood sugar levels through lifestyle changes, without medication.
- For obese patients with type 2 diabetes, the best approach is to lose weight and begin an exercise program under the supervision of a physician.
- This course will generally be tried for three to six months, then blood sugar and glycosylated hemoglobin will be rechecked. If they remain high, the patient will be started on an oral medication to help control blood sugar levels, usually a sulfonylurea or biguanide (metformin [Glucophage]).
- Even while on medication, it is still important to eat a healthy diet, lose weight if they are overweight, and engage in moderate to vigorous physical activity as often as possible.
- The health-care professional will initially monitor the patient's progress on medication carefully. It is important to receive the right dose of the right medication, in order to regulate blood sugar levels in the recommended range with the fewest side effects.
- The doctor may decide to combine different medications to achieve blood sugar levels control.
- Gradually, even people with type 2 diabetes may require insulin injections to control their blood sugar levels.
- It is becoming more common for people with type 2 diabetes to take a combination of oral medication and insulin injections to control blood sugar levels.
Medically Reviewed by a Doctor on 3/3/2016
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