The main goal of diabetes treatment is to keep blood glucose levels as close to normal as safely possible. Since diabetes may greatly increase the risk for heart disease and peripheral artery disease, measures to control blood pressure and cholesterol levels are an essential part of diabetes treatment as well.
Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas.
This release of insulin promotes the uptake of glucose into body cells. In patients with diabetes, the absence of insufficient production or lack of response to insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.
People with diabetes must take responsibility for their day-to-day care. This includes monitoring blood glucose levels, dietary management, maintaining physical activity, keeping weight and stress under control, monitoring oral medications and, if required, insulin use via injections or pumps.
Diabetes Treatment Insulin therapy
People with type 1 diabetes require multiple insulin injections each day to maintain safe insulin levels. Insulin is often required to treat type 2 diabetes too. Using an insulin pump is an alternative to injections. The pump is about the size of a pager and is usually worn on your belt. Insulin is delivered through a small tube (catheter) that is placed under the skin (usually in the abdomen).
If you have type 1 diabetes, your pancreas no longer makes the insulin your body needs to use blood sugar for energy. You will need insulin in the form of injections or through the use of a continuous pump. Learning to give injections to yourself or to your infant or child may at first seem the most daunting part of managing diabetes, but it is much easier than you think.
Some people with diabetes use a computerized pump called an insulin pump, which gives insulin on a set basis. You and your doctor program the pump to deliver a certain amount of insulin throughout the day (the basal dose). Plus, you program the pump to deliver a certain amount of insulin based on your blood sugar level before you eat (bolus dose).
Injectable insulin comes in five types:
- Rapid-acting (taking effect within a few minutes and lasting 2-4 hours)
- Regular or short-acting (taking effect within 30 minutes and lasting 3-6 hours)
- Intermediate-acting (taking effect in 1-2 hours and lasting up to 18 hours)
- Long-acting (taking effect in 1-2 hours and lasting beyond 24 hours)
- Ultra-long-acting (taking effect in 1-2 hours and lasting 42 hours)
A rapid-acting inhaled insulin (Afrezza) is also FDA-approved for use before meals. It must be used in combination with long-acting insulin in patients with type 1 diabetes and should not be used by those who smoke or have chronic lung disease. It comes as a single dose cartridge. Premixed insulin is also available for people who need to use more than one type of insulin.
Diabetes Treatment Drugs
Some people with diabetes will need oral medication to keep the disease under control. These drugs work in different ways to bring blood sugar levels back to normal. They include:
Metformin is a biguanide drug that increases the sensitivity of the body’s cells to insulin. It also decreases the amount of glucose produced by the liver. In addition, metformin tends to suppress appetite, which may benefit people who are overweight.
Metformin often does not reduce blood glucose enough on its own and maybe given with other medications such as other oral drugs or insulin. Possible side effects of metformin include nausea and diarrhea. These usually resolve over time.
Medications that increase insulin output by the pancreas belong to the class of drugs called sulfonylureas. Older generations of these drugs include chlorpropamide (Diabinese) and tolbutamide were abandoned due to association with a higher risk of cardiovascular events.
The newer sulfonylurea drugs include glyburide (DiaBeta), glipizide (Glucotrol), and glimepiride (Amaryl). These drugs rapidly lower blood sugar but can cause abnormally low blood sugar (called hypoglycemia). In addition, sulfonylureas contain sulfa and should be avoided by those who are allergic to sulfa. Weight gain is a possible side effect of the sulfonylurea drugs
Like the sulfonylureas, meglitinides are a class of drugs that work by promoting insulin secretion from the pancreas. Unlike the sulfonylureas, which last longer in the body, repaglinide (Prandin) and nateglinide (Starlix) are very short acting, with peak effects within one hour.
For this reason, they are given up to three times a day just before meals. Since these drugs increase circulating insulin levels they may cause hypoglycemia. Weight gain is also a possible side effect.
Thiazolidinedione drugs lower blood glucose by increasing the sensitivity of the cells to insulin (improving target cell response to insulin). Examples include pioglitazone (Actos) and rosiglitazone (Avandia)
These drugs have been linked to serious side effects like an increased risk of heart failure and bone fractures. Weight gain is another possible side effect. These medications are not usually given as first-line treatment but may be helpful for some people.
Drugs of this class decrease the absorption of carbohydrates from the intestine. Before being absorbed into the bloodstream, enzymes in the small intestine must break down carbohydrates into smaller sugar particles, such as glucose.
One of the enzymes involved in breaking down carbohydrates is called alpha-glucosidase. By inhibiting this enzyme, carbohydrates are not broken down as efficiently, and glucose absorption is delayed.
The alpha-glucosidase inhibitors available in the U.S. are acarbose (Precose) and miglitol (Lexicomp). These drugs have gastrointestinal side effects such as abdominal pain, diarrhea, and gas.
Diabetes Treatment Diet
Eating a balanced diet is vital for people who have diabetes, so work with your doctor or dietitian to set up a menu plan. If you have type 1 diabetes, the timing of your insulin dosage is determined by activity and diet.
When you eat and how much you eat are just as important as what you eat. Usually, doctors recommend three small meals and three to four snacks every day to maintain the proper balance between sugar and insulin in the blood.
A healthy balance of carbohydrates, proteins, and fats in your diet will help keep your blood glucose on target. How much of each will depend on many factors, including your weight and your personal preferences.
Watching your carbohydrates, knowing how much you need and how many you are eating, is key to blood sugar control. If you are overweight, either a low-carbohydrate, low-fat/low calorie, or Mediterranean diet may help you get your weight to goal. No more than 7% of your diet should come from saturated fat, and you should try to avoid trans fats altogether.
Diabetes Treatment Alternative medicine
Vitamins and Minerals
Vitamins and minerals are some of the alternative treatments for diabetes, however, they should not be used alone for treatment. In addition to vitamins and minerals, there should be the help of proper diet and regular exercise, together all these can help control the blood sugar and thereby preventing the complications of diabetes.
Vitamins B6 and B12 may help treat diabetic nerve pain if you have low levels of these vitamins and that is contributing to the nerve pain. But otherwise, there is no proof that taking these vitamins will help.
Vitamin C may make up for low blood levels of insulin, which normally works to help cells absorb the vitamin. Proper amounts of vitamin C may help the body maintain a good cholesterol level and keep blood sugar levels under control. But too much can cause kidney stones and other problems. Check with your doctor to see if a vitamin C supplement is right for you.
Vitamin E may help limit damage to the blood vessels and help protect against kidney and eye disease. But too much can lead to serious problems, such as a higher risk of stroke. Talk to your doctor before adding this supplement.
Magnesium helps control blood sugar levels. Some people with diabetes have a serious magnesium deficiency. Magnesium supplements, in this case, may improve the action of insulin.
Guided imagery, biofeedback, meditation, hypnotherapy, and yoga reduce stress hormones, which in turn may help stabilize blood sugar levels. Biofeedback may also help lower blood pressure, but more research is needed to discover its role in the treatment of diabetes and high blood pressure.
Capsaicin cream. This is a topical ointment made with cayenne, has been reported by some patients to help lower pain in the hands and feet from diabetic neuropathy. But people with loss of sensation in the hands or feet should use caution when using capsaicin, as they may not be able to fully feel any burning sensation. Check with your doctor if you are thinking of trying this product.
Evening primrose oil is thought to help diabetic nerve pain, but no conclusive evidence has yet been found.
Ginkgo, garlic, holy basil leaves, fenugreek seeds, ginseng, and hawthorn are other herbals that have been promoted by some as remedies for diabetic symptoms. More research is needed to see what, if any, role these herbals may play. Check with your doctor before trying any herbal product.
Diabetes Treatment FAQs
Can diabetes be cured completely?
No cure for diabetes currently exists, but the disease can go into remission. Complete remission is when the blood glucose level returns to normal levels completely outside of the range of diabetes or prediabetes and stays there for at least 1 year without any medications.
How we can control diabetes without medicine?
- Exercise Regularly. Regular exercise can help you lose weight and increase insulin sensitivity.
- Control Your Carb Intake.
- Increase Your Fiber Intake.
- Drink Water and Stay Hydrated.
- Implement Portion Control.
- Choose Foods With a Low Glycemic Index.
- Control Stress Levels.
- Monitor Your Blood Sugar Levels.
What is the first-line treatment for diabetes?
Metformin: Metformin should be the first-line drug for managing type 2 diabetes. Insulin and sulfonylureas should be the second line, and glitazones should be reserved for the third line. Metformin is the only drug for type 2 diabetes that does not cause weight gain, which is an important advantage.
Are bananas good for diabetics?
Bananas contain Fiber, Which May Reduce Blood Sugar Spikes. In addition to starch and sugar, a medium-sized banana contains 3 grams of fiber. However, fiber is especially important for people with diabetes, as it can help slow the digestion and absorption of carbs.
How long can you live with diabetes?
People with type 1 diabetes, on average, have shorter life expectancy by about 20 years. People with type 2 diabetes, on average, have shorter life expectancy by about 10 years.
Can diabetes kill you?
People with type 1 diabetes are more likely to get heart disease, stroke, kidney failure, high blood pressure, blindness, nerve damage, and gum disease. Untreated type 1 diabetes can cause a coma. It can even kill you. The good news is that treatment can help you prevent these problems.
Is turmeric good for diabetics?
A 2013 review of studies suggests that curcumin can decrease the level of glucose in the blood, as well as other diabetes-related complications. Other research suggests that turmeric extract could help stabilize blood sugar levels and make diabetes more manageable. This extract can be found in over-the-counter supplements.
What is the best treatment for diabetes?
Insulin remains the mainstay of treatment for patients with type 1 diabetes. Insulin is also an important therapy for type 2 diabetes when blood glucose levels cannot be controlled by diet, weight loss, exercise, and oral medications.
What fruit should diabetics avoid?
It is best to avoid or limit the following:
- Dried fruit with added sugar.
- Canned fruit with sugar syrup.
- Jam, jelly, and other preserves with added sugar.
- Sweetened applesauce.
- Fruit drinks and fruit juices.
- Canned vegetables with added sodium.
- Pickles that contain sugar or salt.
Can diabetics eat chocolate?
Yes, people with diabetes can eat chocolate. The main thing is to not get carried away. It has high cocoa solids and a lower amount of carbs so it won’t affect your sugar levels as much as standard milk chocolate.
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