Diabetes Treatment
Guidelines For Treating Type 1 And Type 2 Diabetics

Guide to treating diabetics

insulin pen

Injecting with an insulin pen

Treating Diabetes

Contents

How Is Diabetes Treated?
How Is Type 1 Diabetes Treated?
How Is Type 2 Diabetes Treated?
Who Needs Insulin Injections?
Who Can Take Oral Medications?
How Much Exercise Will I Need To Take?
Will My Diet Be Really Restrictive?


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Diabetic Guidelines

How Is Diabetes Treated?

There is no cure for diabetes, instead the condition is managed in 3 ways:

1. Diet
2. Exercise
3. Diabetic Medications (oral pills and/or injections)

Depending on the diabetes diagnosis you receive, you may be able to manage your symptoms with lifestyle changes alone, or you may require medications. Type 1 diabetics always require medication, while type 2 diabetics may be able to manage their condition with exercise and diet alone. The aim of any treatment will be to keep blood glucose levels as near as possible to normal. Training in monitoring and self-management should be given to all newly diagnosed patients. This will be provided by your diabetes healthcare team which may consist of:

Primary Physician and/or Nurse: 92 percent of diabetics in the U.S. are handled by general doctors, only 8 percent are regularly seen by a specialist. When choosing a doctor, do ask if they are experienced in handling patients with diabetes. This is important because they need to know which diabetes tests you will need from time to time, and when they should send you to see a specialist.
Endocrinologist/Diabetologist: An endocrinologist is a specialist in diabetes care, but they also see patients with thyroid and other glandular problems. A diabetologist is an endocrinologist who only specializes in diabetic patients. These doctors will be informed about the newest treatments available and will recommend which medications you should take (if any). If your specialist changes your drugs, be sure to inform your primary care doctor - don't assume your medical team is communicating separately; unfortunately lack of communication between doctors is all too common.
Dietitian: As type 2 diabetes is greatly worsened by obesity, a dietician will play an important role in providing you with a healthy eating plan and setting weight loss goals (if necessary). By recommending the right sorts of foods, they will help you manage your blood glucose and control diabetes symptoms. A person with type 1 diabetes will be taught how food interacts with insulin injections. For example, they will be taught how to count carbs so that they know how much insulin to take with their meals.

Diabetes Educator: These are healthcare workers specially qualified in training people on how to manage their disease. Trainers should have the letters CDE after their name (Certified Diabetes Educator), so be sure to look out for this. An educator can teach you how to take your medications and test your glucose levels. They will also be given instruction about blood glucose monitoring. Most trainers are accessed through a Diabetes Education Program - ask your primary care doctor to refer you to a program if they don’t mention it.
Eye Doctor: An optometrist will test your eyes once a year to ensure the disease does not cause any damage. For more details see, diabetes problems - you may also need to visit a podiatrist to help with any minor foot problems.

In summary, your healthcare team will help you:

1. Choose a suitable eating plan and tell you how much and when to eat.
2. Give you advice on exercise, how long and how often to exercise.
3. Learn how to check your blood glucose level (if the doctor says it's necessary)
4. Take your medicines and learn about dosages, if you are prescribed them.

Do be sure to read our article on the causes of diabetes.

How Is Type 1 Diabetes Treated?

For type 1 diabetics, treatment is a daily task. As their pancreas does not produce (or not enough) insulin it can be particularly difficult to manage. You will need to follow a stricter diet plan than you are probably used to and plan any physical activity in advance. Also, you will need to take multiple daily insulin injections and check your glucose levels at home several times a day with a glucose monitor. See our guide to buying glucose monitors.

How Is Type 2 Diabetes Treated?

Typically treatment for type 2 diabetics includes diet control, taking regular exercise, performing home blood glucose testing, and in some cases taking oral diabetes drugs and/or insulin shots. Approximately 40 percent of type 2 diabetics require insulin injections - but injections are only usually necessary if the disease has progressed after a number of years. Even then, it may only consist of one injection at night time, and is managed during the day with oral meds. It is not common for newly diagnosed patients to need insulin injections.

Who Needs Insulin Injections?

Type 1 diabetics cannot control blood sugar levels with oral medications - they need to take insulin shots several times a day. Type 2 diabetics are only prescribed insulin injections if their condition has progressed to the point where oral medications have stopped working. Insulin cannot be taken as a pill - it has to be injected. While many diabetics continue to use the old syringe and vial method to inject their insulin, fortunately today there are some alternatives. The most widely used alternative is an insulin pen (image) - while pens do not eliminate the need for a needle, the needles are shorter and less scary, and they have the added advantage of helping you to manage your dosage. If a person has real problems sticking a needle into themselves everyday, they might try using an insulin jet injector (image). It looks like a fat pen and is held against the skin. When a button is pressed, it emits a powerful jet of air which forces insulin into the skin. These delivery devices are not commonly used because they cost around $1,000 or more. For patients who cannot achieve good glucose control with any of these devices, they may need to consider using an insulin pump (image). This is an external device, about the size of a pager. It is attached to a small syringe which is held is inserted under the skin and held in place with a patch. It emits regular doses of insulin automatically. These devices can cost more than $4,000.

Who Can Take Oral Medications?

Only type 2 diabetics can use oral pills to manage their disease. While many manage to reduce their blood glucose levels by lifestyle changes, others require oral pills to do this. But even then, pills do not work for everyone. If you've had type 2 diabetes for 10 years or more and pills don't control your blood sugar levels you may need to progress to insulin injections. Occasionally pills can stop working after a few months or years - but this is not necessarily an indication that your diabetes has worsened - doctors don't always know why it happens. Sometimes they recommend a combination of oral meds to kick-start the process again. There are quite a few different types of diabetes pills, your doctors will recommend the best one or combination for you.

How Much Exercise Will I Need To Take?

Taking daily physical activity will help to regulate your blood sugar levels. Your doctor or dietician will provide a personal plan for you. Typically patients are recommended 30 minutes of aerobic activity at least 5 days a week. This includes walking, cycling and swimming. If you need to lose weight you may be told to exercise for longer.

Will My Diet Be Really Restrictive?

In the past, diabetics were faced with a very restrictive eating plan. Fortunately things have loosened up a bit in recent years, with doctors recognizing that one size doesn't necessarily fit all. While you may have to make some adjustments in what, when and how often you eat - the news isn't all bad. You should still have some flexibility in deciding which foods you eat and can still include the odd treat. Usually, you will be told to:

1. Eat a variety of foods, including vegetables, fruits, whole grains, non-fat dairy foods, healthy fats, and lean meat.
2. Avoid eating too much food. Trying not to eat too much food.
3. Space your meals evenly throughout the day.
4. Avoid skipping meals.

Related Topical Questions
Are there blood glucose monitors that don't require strips?
What is a normal blood sugar count?
What to do in case of diabetic coma

  Related Articles on Diabetes Treatment

For more related to the condition, see the following:

Stroke in Women
Diabetes Facts - Statistics and how to prevent complications.
Diabetes Resources - Our list of recommended websites.

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