Diabetes Mellitus

Diabetes is treated with meal planning, exercise, medication, and blood glucose monitoring. Meal planning involves eating the right amount of food at the right time. Carbohydrates have the greatest impact on blood sugars. Keeping track of carbohydrates and spreading them throughout the day helps to control blood sugars. Exercise helps to reduce stress, control blood pressure and blood fats, and improves insulin resistance.

Diabetes medications include oral agents and insulin. There are several classes of oral medications. Sulfonylureas and meglitinides help the pancreas to produce more insulin. Alpha-glucosidase inhibitors slow down the digestion and absorption of starches and sugars. Biguanides stop the liver from releasing extra sugar when it is not needed. Thiozolidinediones treat insulin resistance.

Various types of insulin are available and have different action times designed to match to physiological needs of the body for persons who no longer make enough insulin. The body requires a continuous, low level of insulin acting to meet baseline needs. Long-acting insulins provide the baseline or basal insulin needs. The body also requires insulin to cover carbohydrates eaten. Short-acting insulins provide coverage for meal boluses. With the wide variety of diabetes medications, the physician can determine a treatment plan that works best for the individual.

Blood glucose monitoring serves as the cornerstone tool for measuring the effects of food, exercise, and diabetes medications. Patients can check their blood sugars at various times of the day to keep track of how well the current treatment plan is keeping the sugars are under control. Results of tests are recorded and taken to MD office visits for the MD to evaluate trends and adjust the treatment plan.

Additional management of diabetes is geared toward prevention of complications. Eye problems may have no symptoms in their early, treatable stages; therefore annual dilated eye exams are needed. Urine should be checked annually for the protein microalbumin. Poor circulation, nerve damage, and difficulty fighting infections can make foot problems serious considerations for people with diabetes. Daily self-foot exams and foot exams at each physician visit can help identify problems early. Blood fat (lipids–cholesterol and triglyceride) levels should be checked annually.