Treatments for Diabetes
Treatment list for Diabetes: The list of treatments mentioned in various sources for Diabetes includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
- Diet changes
- Weight loss
- Exercise - with care and under medical advice; take extra care if using diabetes pills or insulin.
- Diabetes control - ongoing monitoring and control of diabetic blood sugar levels:
- Diabetic blood sugar control
- Self monitored blood glucose testing
- Finger-prick blood glucose tests
- Urine glucose testing
- Urine ketone testing
- Diabetes treatment strategies
- Diet changes - usually part of any diabetes treatment plan
- Lifestyle changes only - i.e. the use of diet, exercise and weight loss only without medications.
- Diabetic blood sugar control - this is an important aspect of all diabetes treatment plans
- Diabetes pills
- Insulin
- Diabetes pills and insulin combined
- Brief insulin use then diabetes pills only - a "hit early" research strategy to normalize blood sugars quickly with insulin and then stop insulin after a few weeks; mainly for Type 2 diabetes
- Diabetes pills during honeymoon phase then insulin later - for early-stage treatment strategy for newly diagnosed Type 1 diabetes
- Regular checkups for diabetes complications
- Treatment of any diabetes complications
- Checkups for associated conditions of diabetes
- Diabetes pills - i.e. diabetes medications; mostly for Type 2 diabetes rather than Type 1 diabetes
- Sulphonylureas
- Metformin
- Combined diabetes pills and insulin
- Bedtime insulin daytime sulphonylureas (BIDS) - a combination of insulin and diabetes pills
- Insulin - and there are various types of insulin:
- Very rapid acting insulin
- Short-acting insulin
- Long-acting insulin
- Animal insulin
- Insulin combinations
- Very rapid acting insulins - usually acting within less than 30 minutes and not lasting long
- Insulin lispro
- Humalog
- Short-acting insulins - usually acting within 30 minutes and lasting a few hours only
- Regular insulin
- Humulin R
- Novolin R
- Rapidact insulin
- Long-acting insulins - usually acting for 12 to 24 hours
- NPH insulins
- Lente insulins
- Ultra-lente insulins
- Animal insulin - rarely used in modern days
- Beef insulin
- Pork insulin
- Insulin combinations
- Combined insulin R and insulin NPH
- Insulin delivery devices
- Insulin syringes
- Insulin pens
- Insulin automatic injectors
- Insulin pumps
- Insulin jet injectors
- Diabetes complication prevention treatments - there are numerous products claimed, often dubiously, to prevent diabetes complications; some such possibilities are:
- Vitamin E - some studies have shown some small benefits.
- Vitamin C - some studies have shown some small benefits.
- Antioxidants - because Vitamin C and Vitamin E are antioxidants.
- Low-dose aspirin - the preventive benefits against heart disease may be worthwhile in preventing diabetic heart disease
- Chromium - in our opinion probably of dubious benefit.
- See also treatment of Type 1 diabetes
- See also treatment of Type 2 diabetes
- See also treatment of gestational diabetes
Treatment statistics for Diabetes: The following are statistics from various sources about the treatment of Diabetes:
- 12% of diabetics take insulin and oral medications in the US 1999-2001 (National Diabetes Statistics fact sheet, NIDDK, 2003)
- 19% of diabetics take only insulin in the US 1999-2001 (National Diabetes Statistics fact sheet, NIDDK, 2003)
- 53% of diabetics take only oral medications in the US 1999-2001 (National Diabetes Statistics fact sheet, NIDDK, 2003)
- 15% of diabetics don’t take insulin or oral medications in the US 1999-2001(National Diabetes Statistics fact sheet, NIDDK, 2003)
Treatment of Diabetes: medical news summaries: The following medical news items are relevant to treatment of Diabetes:
- About Blackfan Diamond anemia
- Alternative drug for type 2 diabetes awaiting FDA approval
- Anti-diabetes drugs may be effective against myelomas
- Antioxidant in cherries and other colored fruit may increase insulin production by pancreatic cells
- Antipsychotic drugs linked to type 2 diabetes
- Botox proves effective against diabetic gastroparesis
- Chronic pain in diabetics compromises level of self-care
- Chronic pancreatitis can lead to diabetes
- Cinnamon extract benefits diabetics
- Cod liver oil may be a preventative measure for type 1 diabetes in children
- Diabetes risk linked to schizophrenia drugs
- Diabetes vaccine may prevent diabetes in children at risk
- Diabetic children need to use continuous glucose monitoring to achieve good control of their condition
- Diabetic injected with wrong medication in a nursing home
- Diabetic neuropathic pain alleviated with common nutrient
- Diabetic women don’t fare as well as diabetic men following a stenting procedure
- Diabetics face greater rates of mortality and post-surgical complications following coronary bypass
- Diabetics may benefit from Vitamin E supplements
- Diabetics may need Vitamin H supplements
- Diabetics need to be aware of possible complications
- Diabetics need to be more aware of benefits of aspirin
- Drug approved for treatment of diabetic peripheral neuropathy
- Early cessation of steroid following liver transplant increases rate of rejection
- Eating disorders can greatly increase the risk of complications in people with type 1 diabetes
- FDA warns consumers about dietary supplements that treat erectile dysfunction
- High blood pressure drugs slow kidney damage in diabetics
- HIV patients face increased risk of diabetes and dementia
- Hyperglycemia linked to increased mortality amongst critically ill patients
- Inhaled insulin provides competition for injected insulin
- Migraines frequently misdiagnosed and underdiagnosed
- More and more children are being diagnosed with type 1 diabetes
- New appetite suppressant has good results
- New beta blocker safer for treating high blood pressure in diabetics
- New diabetes drug improves existing treatments
- New diabetes type 1 vaccine to begin human trials
- New drug approved for treatment of nerve damage pain
- New drug approved for treatment of pain associated with diabetic neuropathy
- Newborn size determined by level of sugar control in diabetic mothers
- Obesity surgery carries risks
- Pancreatic cancer surgery less common in black men
- PCOS alleviated by diabetes drug
- Picotamide may be more effective in diabetics than aspirin
- Poor glucose monitoring in diabetic women during pregnancy reduces the chances of a good outcome
- Scientists find exercise secrets in order to develop a pill to take the place of exercise
- Some antipsychotic drugs linked to increased risk of developing type 2 diabetes
- Statin drugs carry low risk of muscle damage leading to kidney failure
- Surgery delivers better weight loss than dieting
- Symptoms of old age may be similar to many other treatable conditions
- Traditional herbal remedies being studied provide positive results
- Vioxx tended not to be used by targeted group
- Vitamin D deficiency increases diabetes risk
- Vitamin D essential for more than just bone health
Treatments of Diabetes discussion: Before the discovery of insulin in 1921, everyone with type 1 diabetes died within a few years after diagnosis. Although insulin is not considered a cure, its discovery was the first major breakthrough in diabetes treatment.
Today, healthy eating, physical activity, and insulin via injection or an insulin pump are the basic therapies for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose checking.
Healthy eating, physical activity, and blood glucose testing are the basic management tools for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication and insulin to control their blood glucose levels.
People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves keeping blood glucose levels from going too low or too high. When blood glucose levels drop too low from certain diabetes medicines--a condition known as hypoglycemia--a person can become nervous, shaky, and confused. Judgment can be impaired. If blood glucose falls too low, a person can faint.
A person can also become ill if blood glucose levels rise too high, a condition known as hyperglycemia.
People with diabetes should see a doctor who helps them learn to manage their diabetes and monitors their diabetes control. An endocrinologist is one type of doctor who may specialize in diabetes care. In addition, people with diabetes often see ophthalmologists for eye examinations, podiatrists for routine foot care, and dietitians and diabetes educators to help teach the skills of day-to-day diabetes management.
The goal of diabetes management is to keep blood glucose levels as close to the normal range as safely possible. A recent major study, the Diabetes Control and Complications Trial (DCCT), sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), showed that keeping blood glucose levels as close to normal as safely possible reduces the risk of developing major complications of type 1 diabetes.
The 10-year study, completed in 1993, included 1,441 people with type 1 diabetes. The study compared the effect of two treatment approaches--intensive management and standard management--on the development and progression of eye, kidney, and nerve complications of diabetes. Intensive treatment aimed at keeping hemoglobin A-1-c as close to normal (6 percent) as possible. Hemoglobin A-1-c reflects average blood sugar over a 2- to 3-month period. Researchers found that study participants who maintained lower levels of blood glucose through intensive management had significantly lower rates of these complications. More recently, a followup study of DCCT participants showed that the ability of intensive control to lower the complications of diabetes persists up to 4 years after the trial ended.
The United Kingdom Prospective Diabetes Study, a European study completed in 1998, showed that intensive control of blood glucose and blood pressure reduced the risk of blindness, kidney disease, stroke, and heart attack in people with type 2 diabetes. 1
Diabetes knowledge, treatment, and prevention strategies advance daily. Treatment is aimed at keeping blood glucose near normal levels at all times. Training in self-management is integral to the treatment of diabetes. Treatment must be individualized and must address medical, psychosocial, and lifestyle issues.
- Treatment of type 1 diabetes: Lack of insulin production by
the pancreas makes type 1 diabetes particularly difficult to control.
Treatment requires a strict regimen that typically includes a carefully
calculated diet, planned physical activity, home blood glucose testing
several times a day, and multiple daily insulin injections.
- Treatment of type 2 diabetes: Treatment typically includes diet control, exercise, home blood glucose testing, and, in some cases, oral medication and/or insulin. Approximately 40 percent of people with type 2 diabetes require insulin injections.
Many types of diabetes pills can help people with type 2 diabetes lower their blood glucose. Each type of pill helps lower blood glucose in a different way. The diabetes pill (or pills) you take is from one of these groups. You might know your pill (or pills) by a different name.
- Sulfonylureas (SUL-fah-nil-YOO-ree-ahs). Stimulate
your pancreas to make more insulin.
- Biguanides (by-GWAN-ides). Decrease the amount of
glucose made by your liver.
- Alpha-glucosidase inhibitors (AL-fa gloo-KOS-ih-dayss
in-HIB-it-ers). Slow the absorption of the starches you eat.
- Thiazolidinediones(THIGH-ah-ZO-li-deen-DYE-owns).
Make you more sensitive to insulin.
- Meglitinides (meh-GLIT-in-ides). Stimulate your
pancreas to make more insulin.
- D-phenylalanine (dee-fen-nel-AL-ah-neen)
derivatives. Help your pancreas make more insulin
quickly.
- Combination oral medicines. Put together different kinds of pills.
Your doctor might prescribe one pill. If the pill does not lower your blood glucose, your doctor may
- ask you to take more of the same pills, or
- add a new pill or insulin, or
- ask you to change to another pill or insulin.
Your doctor may ask you to take more than one diabetes medicine at a time. Some diabetes medicines that lower blood glucose work well together. Here are examples: 3
Your doctor might ask you to take insulin and one of these diabetes pills:
- a sulfonylurea
- metformin
- pioglitazone
In March 2001, the U.S. Food and Drug Administration (FDA) approved a noninvasive blood glucose monitoring device for adults with diabetes. Noninvasive monitoring means checking blood glucose levels without puncturing the skin for a blood sample. The GlucoWatch Biographer, manufactured by Cygnus Inc., was approved to detect glucose level trends and patterns in adults age 18 and older with diabetes. It must be used along with conventional blood glucose monitoring of blood samples. The device, which looks like a wristwatch, pulls body fluid from the skin using small electric currents. It checks blood glucose levels every 20 minutes.4
Your doctor might ask you to take a medicine called an ACE inhibitor (in-HIB-it-ur). This medicine helps control blood pressure. ACE inhibitors also help people with diabetes to slow down kidney damage by keeping the kidneys from cleaning out too much protein. New medicines now being tested may also hold promise. 5
Diabetes treatment is focused on keeping blood sugar in a normal range every day. A recent major study showed that keeping blood glucose levels as close to normal as safely possible reduces the risk of developing major complications of type 1 diabetes.
If you have diabetes, a good blood sugar range is from about 70 to 150 (before a meal) and less than 200 about two hours after your last meal. Ask your health care provider what the best range of blood sugar is for you, how to test your blood sugar and how often. Careful meal planning and exercise to control your weight are important to control your diabetes. Your health care provider will evaluate if you need diabetes pills or insulin shots. 6
Diabetes cannot be cured, but it can be controlled. Good control requires a careful blend of diet, exercise, blood sugar monitoring, and medication. People with type 1 diabetes control their blood sugar with insulin injections and frequent self-monitoring of blood glucose. People with type 2 diabetes generally control their blood sugar with oral medications. In some cases, insulin injections are needed to keep type 2 diabetes under control.
Diet is very important to lowering blood glucose levels. In planning a diet, the doctor considers the patient's weight and daily physical activity. For overweight patients, a weight loss plan is a must for proper blood glucose control. Food exchange lists to help with meal planning are available from your doctor and the American Diabetes Association.
Exercise is very important because it helps the body burn off some of the excess glucose as energy. Taking part in a regular fitness program has been shown to improve blood glucose levels in older people with high levels. A doctor can help plan an exercise program that balances the diet and medication needs and your general health.
Drugs may not be needed for type 2 diabetes if good control can be achieved through diet and exercise. But when these measures fail, oral drugs, insulin, or a combination of the two may be prescribed. A person who normally does well without drugs will need to take medication during acute illnesses.
Foot care is very important for people with diabetes. The disease can lower blood supply to the limbs and reduce feeling in the feet. People with diabetes should check their feet every day and watch for any redness or patches of heat. Sores, blisters, breaks in the skin, infections or buildup of calluses should be reported right away to a podiatrist or family doctor.
Skin care is very important. Because people with diabetes may have more injuries and infections, they should protect their skin by keeping it clean, using skin softeners to treat dryness, and taking care of minor cuts and bruises.
Teeth and gums need special attention to avoid serious
infections. People with diabetes should tell their dentist about
their condition and schedule regular checkups.7
Footnotes:
1. excerpt from Diabetes Overview: NIDDK
2. excerpt from Diabetes Statistics in the United States: NIDDK
3. excerpt from Medicines for People With Diabetes: NIDDK
4. excerpt from Noninvasive Blood Glucose Monitors: NIDDK
5. excerpt from Keep your kidneys healthy: NIDDK
6. excerpt from Diabetes: NWHIC
7. excerpt from Dealing With Diabetes - Age Page - Health Information: NIA
Last revision:
April 10, 2003
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