Treatment of Type 2 Diabetes

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diabetes
diabetes

Type 2 Diabetes Treatment

Type 2 diabetes which is referred as non-insulin dependent diabetes mellitus (NIDDM) in medical terms is said to be found predominantly in adults. Thus it is often called adult-onset diabetes. Unlike Type 1 diabetes wherein the patient lacks the ability to produce enough insulin due to malfunction of beta cells, in Type 2 diabetes though the pancreas is capable of producing insulin; the body is unable to utilize it. It can be said that the body becomes resistant to insulin. This disorder is termed as insulin resistance. Due to this condition the sugar or glucose is not able to get into the body’s cells, rather it starts building up in the blood streams and gives rise to high glucose condition.

Certain simple and basic monitoring is to be done in order to keep a check on the disease. These include;

  • Learn how to check your blood sugar level by using simple home blood sugar testing machine. Note that  during fasting blood sugar value should be 100 mg/dL or less than that
  • Keep a tab on what you are consuming as diet and in what quantity.
  • Make a proper diet chart spreading carbohydrates throughout the day
  • Be conversant with the names of the medicines you are taking and when to take them
  • Know that you might take insulin if the medication is not enough in lowering the sugar level
  • Various ways are there to identify low and high blood sugar level in the body. One should take necessary immediate actions so that the disease do not spread much
  • Prepare an exercise regime and stick to it to help yourself in loosing weight
  • One can even go for A1C testing, a test to indicate your average blood sugar level in past three months or so. It can be easily done on a periodic basis at a clinic

Continuous efforts at one’s end will help in significant improvements.

Self-monitoring

One can easily check their blood sugar level at home all by themselves, which is referred as home blood sugar monitoring (HBSM). With periodic monitoring, you will be aware of your sugar levels and will act promptly in any emergency.

A medical device called glucose meter or simply glucometer can provide an approximate blood sugar concentration. Usually, you prick your finger with a small needle called a lancet. This gives you a tiny drop of blood. You place the blood on a test strip and put the strip into the device. Results are available in 30 seconds. This particular device is accompanied with comparison charts and instructions. The result is are given out in either mmol/L or mg/dL

One can be easily tutored on how to use the device. One needs to do the test several times in a day initially. With time and proper control if your sugar level is fine then you can opt for the test a few times in a single week. However, it is necessary to check the level especially at night, if it is found to be low eat something to enhance it. A healthy range exists betwixt 100-140 mg/dL.

A Healthy Diet

The root cause of Type 2 diabetes is not following a proper healthy diet. Including too much of carbohydrates and saturated fats, junk food, no fiber can all contribute to high sugar level. Eating too much during a single meal is also not good. Following should be kept in mind while making a dietary plan for diabetics;

  • Eat smaller meals a day several times. Try sticking to the same time each day in order to avoid extremely low sugar (hypoglycemia) & high sugar (hyperglycemia) conditions
  • Ensure that the carbohydrates are spread throughout the day
  • Avoid saturated fats, high calorie junks and fizzy drinks like sodas
  • Eat at least five different varieties of fruits daily. Include a lot of citrus fruits
  • Drink water in plenty
  • Include legumes, vegetables, proteins and cereals in the meals
  • Include at least 20-35 grams of fiber in a single day
  • Dairy products can be included but in moderate quantities
  • Avoid smoking and consumption of alcohol

Physical Exercise and Weight Control

Obesity is another cause leading to diabetes. Sedentary lifestyle & lack of physical activity tend to weight gain, which ultimately proves detrimental. Practicing 45 minutes to an hour of cardio and yoga can be beneficial in burning excess calories. Blood circulation is improved as well as blood pressure is under control with regular exercise. Focus on weight control. Indulge in outdoor sports as not only they are interesting but also keep you fit and fine. With physical activity, even stress can be managed well. Always consult a trainer if you wish to go in for intense exercise regime as with exercise, your blood sugar level might vary and you might need to regulate medication & diet accordingly.

Bariatric (weight loss) surgery may be considered for very overweight patients who are not well managed with diet and medications. See:

  • Gastric bypass surgery
  • Laparoscopic gastric banding

Medications and Drugs

It might happen that even after a healthy diet and exercise routine the blood sugar level is not in control. In such situations, doctors generally prescribe medicines to combat the increased level of sugar. Generally, insulin shots and oral medicines (pills) are recommended in adverse situations. There exist five different categories of drugs to lower the sugar level.

  • Biguanides (Metformin). It potentially helps in alleviating the level of glucose produced by the liver and makes the muscle tissue extra sensitive towards absorption of glucose.
  • Sulfonylureas (like glimepiride, glyburide, and tolazamide) trigger the pancreas to generate more insulin. They are generally consumed orally.
  • Thiazolidinediones (such as rosiglitazone) help muscle and fat cells and the liver absorb more blood sugar when insulin is present. Rosiglitazone may increase the risk of heart problems. Consult you doctor.
  • Meglitinides (including repaginate and nateglinide) trigger the pancreas to produce more insulin in relation to the level of glucose in the blood.
  • Alpha-glycosidase inhibitors (such as acarbose) decrease the absorption of carbohydrates & starches from the digestive tract to lower after-meal glucose levels. Generally they are to be taken with the very first bite of any meal

The previously mentioned drugs might be taken in combination as well as prescribed by a doctor.

If you still tend to suffer from high level of glucose, your doctor will prescribe you to take insulin shots. Injecting it directly under the skin being the most common and effective method. This aids the insulin in getting absorbed in the blood stream and reaching out to body cells that require it. However, shots are the most extensively used method but other means of insulin administration is by use of inhalable insulin and insulin pumps. Your doctor will prescribe you the type of insulin needed by your depending on your blood sugar level. It may be;

  • A rapid- acting insulin
  • Intermediate- or short acting insulin
  • Long-acting insulin also known as Lantus

The rapid and intermediate acting insulin tends to extinguish almost immediately after it lessens the blood sugar level. Long acting insulin woks only when the first two types of insulin have finished their work and are on the verge of exhausting. Long lasting insulin will be effective for the next 24 hours after it has been consumed. All the three types of insulin can be taken in combination with each other under the prescription of a doctor. In addition, one should be careful enough to protect the insulin to retain its effectiveness and store it properly.

Medications to prevent complications

Since those with diabetes have a much higher chance of developing heart disease, kidney disease, and other medical problems, they may need to take certain medicines to treat these problems or prevent them from happening.

An ACE inhibitor (or ARB) is often recommended:

  • As the first choice medicine for treating high blood pressure in persons with diabetes
  • For those who have signs of early kidney disease

ACE inhibitors include captopril (Capoten), enalapril (Vasotec), quinapril (Accupril), benazepril (Lotensin), ramipril (Altace), perindopril (Aceon), and lisinopril (Prinivil, Zestril).

Statin drugs are usually the first choice to treat an abnormal cholesterol level. Aim for LDL cholesterol level less than 100 mg/dL.

Aspirin to prevent heart disease is most often recommended for persons with diabetes who:

  • Are 40 or older
  • Have a history of heart problems
  • Have a family history of heart disease
  • Have high blood pressure or high cholesterol
  • Smoke

Foot and Gum care

People with diabetes are more likely to have foot & gum problems. Diabetes can damage nerves, which means you may not feel an injury to the foot until a large sore or infection develops. It is with the gums. The teeth on becoming loose might pull away from gums. Diabetes can also damage blood vessels.

  • Special care is given to our teeth and the gum
  • Brushing & flossing the teeth twice daily is recommended. In addition, one should go for dental checkups periodically.
  • Washing the feet in lukewarm water and thereafter application of a good moisturizing lotion after drying can be effective against blisters and sores.

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