Before the discovery of insulin in 1921, all people with type 1 diabetes died within a few years after diagnosis. Although insulin is not considered a cure, it was the first major breakthrough in diabetes treatment. Today, healthy eating, physical activity, and treatment with insulin are the main treatments for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities.
Blood sugar levels must be monitored closely with frequent blood glucose monitoring. People with diabetes also monitor blood glucose levels several times a year with a laboratory test called the A1C. Results of the A1C test reflects average blood sugar levels over a 2 – to 3-month period.
Healthy diet, physical activity, and blood glucose test the basic management tools for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both, to control their blood sugar.
Adults with diabetes are at high risk for cardiovascular disease (CVD). In fact, die at least 65 percent of people with diabetes to heart disease or stroke. Managing diabetes is more than keeping blood sugar under control – it is also important to manage blood pressure and cholesterol levels through healthy eating, physical activity, and the use of medication (if needed). In this way, people with diabetes can reduce the risk. Aspirin therapy if recommended by the health care team, and smoking cessation can also help lower risk.
People with diabetes need to accept responsibility for the day-to-day care. A large part of daily care involves managing the blood glucose levels so that they do not go too low or too high. When blood sugar drops too low – a condition known as hypoglycemia – a person can get nervous, insecure and confused. A person may be ill if blood glucose levels rise too high, a condition known as hyperglycemia.
People with diabetes must have a doctor who will help them learn all about keeping their diabetes under control, and who will monitor the diabetes control. Most people with diabetes receive care by primary care physicians – internists, family physicians or pediatricians. However it can often be managed with a team of providers to improve diabetes care. A team can include: – a primary care provider, such as an internist, a family practice physician or pediatrician, an endocrinologist (a specialist in Diabetes Care) – a nutritionist, nurse or other health care providers, who are certified diabetes educators – experts in providing information about managing diabetes. The team also can include a podiatrist (for foot care) – an optometrist or optician (for eye care) and other health professionals, such as cardiologists and other specialists.
In addition, the team for a pregnant woman with Type 1, Type 2 or gestational diabetes should include an obstetrician who specializes in the care of women with diabetes. The team can also be a pediatrician or a neonatologist with experience will take care of children born with diabetes.
The goal of diabetes management is to keep blood sugar levels, blood pressure, and cholesterol as close to the normal range as safely possible. A large study showed, the Diabetes Control and Complications Trial (DCCT), sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), that reduces the maintenance of blood glucose close to normal, the risk of developing major complications of Type 1 diabetes.
The 10-year study completed in 1993, included 1441 people with type 1 diabetes. The study compared the effect of two treatment approaches – intensive management and standard management – on the development and progression of the eyes, kidneys, nervous system and cardiovascular complications of diabetes. Intensive treatment aimed to HbA 1c as close to normal (6 percent) believe as possible. The researchers found that study participants managed to lower blood glucose through intensive management had significantly lower rates of complications. Recently, a follow-up study of DCCT participants showed that the intense scrutiny from the complications of diabetes, kept the complications lower for more than 10 years after the process had finished.
The United Kingdom Prospective Diabetes Study, a European study in 1998 has been completed, and showed that intensive control of blood sugar and reduced blood pressure the risk of blindness, kidney disease, stroke and myocardial infarction in patients with type 2 diabetes. I am sure that you will see that control of blood sugar and blood pressure is very helpful to stay healthy.
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