What is the treatment for Diabetes?
As diabetes is a multi-organ disorder due to damaging effects of high blood glucose of several vital organs, the ideal approach for diabetes treatment is to have a comprehensive, structured and individualised diabetes care plan. This care plan should take into account the patient’s age at diagnosis, work profile, education level, motivation for health, current lifestyle, economic condition, presence/absence of any associated medical condition and family support.
Usually, the diagnosis of diabetes itself is a huge shock for many people and it takes them long to accept that they have diabetes. It is important that these people receive proper counselling by the attending clinician to educate them about diabetes and its related complications and allay their fears by stressing the importance of keeping the blood glucose in control to prevent development of diabetic complications. The aim is to keep the blood glucose in normal range, which is 70 – 110 mg/dl in the fasting state and 70 – 140 mg/dl after meals.
The important pillars of diabetes management are:
Diabetes Education
All people with diabetes should receive detailed information on signs and symptoms, diagnosis, disease progression, self monitoring of blood glucose (SMBG), recognition and management of hypoglycemia (low blood sugar level), sick day routine, clinical monitoring, essential investigations, types of medical treatment, and prevention of various diabetic complications.
In addition, the importance of lifestyle modification (quitting smoking, reducing stress), customised diet, daily exercise, disease monitoring through biochemical tests and clinical assessments (weight, blood pressure, foot assessment, peripheral neuropathy, retinopathy and systemic examination), at regular intervals and adherence to prescribed diabetes treatment, to achieve best possible health with diabetes and prevent/delay diabetic complications, should be emphasized.
Customized Diet
Every person with diabetes should be seen by a dietician for a healthy and customized meal plan to suit the needs of the individual in order to prevent erratic blood glucose fluctuations and maintain optimum blood glucose levels. The diet needs to be reviewed during clinical visits to assess compliance to the agreed diet plan and address any dietary concerns.
Regular Exercise
Some form of daily physical activity is an important pillar of diabetes management for burning calories and thus reducing blood glucose levels, and to maintain good health. A proper clinical evaluation should be carried out for an appropriate exercise regimen for a person with diabetes. Although a customized exercise program is preferred, even simple activity such as 30 minutes of brisk walking or swimming, five to six days a week may be beneficial for overall fitness.
Lifestyle Management
It is important to work towards and maintain a healthy lifestyle for optimum management of diabetes. This includes keeping stress levels in control, having positive attitude towards life, quitting smoking, having adequate sleep, small and frequent meals, optimum weight management, adherence to prescribed medications and regular physical activity.
Medication
Along with diet and exercise, appropriate medications are important to keep diabetes in control. Daily multiple Insulin injections are the mainstay of treatment in those with type 1 diabetes. In type 2 diabetes patients, blood glucose can be initially controlled with diet, exercise and above lifestyle changes. However, with passage of time they require one or more tablets (usually in combination) or insulin, for optimum diabetes control.