MANAGEMENT OF DIABETES MELLITUS

Glucose meter blood levels diabetes mellitus patients

The starting point for living well with diabetes is an early diagnosis – the longer a person lives with undiagnosed and untreated diabetes, the worse their health outcomes are likely to be.

Diabetes is being combated through aggressive treatment directed at lowering circulating blood glucose and inhibiting postprandial hyperglycemic rise. To prevent complications, good management of diabetes should be to monitor blood glucose and lactate levels, blood pressure and blood fats (including cholesterol and triglycerides). The risk of diabetic complications can be greatly reduced by simple lifestyle changes which include healthier diets and increased physical activity.

For those who are diagnosed with diabetes, a series of cost-effective interventions can improve their outcomes, regardless of what type of diabetes they may have. These interventions include blood glucose control, through a combination of diet, physical activity and, if necessary, medication; control of blood pressure and lipids to reduce cardiovascular risk and other complications; and regular screening for damage to the eyes, kidneys and feet, to facilitate early treatment. Diabetes management can be strengthened through the use of standards and protocols.

Managing Diabetic with Complementary and Alternative medicine

Some people with diabetes use complementary or alternative therapies to treat diabetes. Although some of these therapies may be effective, others can be ineffective or even harmful. Patients who use complementary and alternative medicine need to let their health care providers know what they are doing.

Complementary and alternative medicine (CAM) describes a diverse group of medical and health care systems, practices, and products not currently considered to be part of conventional medicine. Inadequacies in current treatments for diabetes have led 2 to 3.6 million Americans to use CAM for diabetes treatment, despite limited studies of safety and efficacy of CAM methods. Several CAM practices and herbal remedies are promising for diabetes treatment, but further rigorous study is needed in order to establish safety, efficacy, and mechanism of action. In the meantime, it is important to be aware that many patients with diabetes may be using CAM and to consider potential interactions with conventional medicines being used.

DIAGNOSIS

The routine laboratory diagnostic indicators for the control and management of diabetes include:

  1. Glucose determination

The simplest diagnostic indicator of a patient with diabetes is the blood glucose concentration. The glucose concentration reflects the immediate status of the concentration of circulating sugar level.

Glucose is measured in different specimens, including

  1. Whole blood (capillary or venous blood)

  2. Hemolysate

  3. Plasma

  4. Serum

  5. De-proteinized blood

  6. Urine

  7. CSF

 

  1. Glycated haemoglobin

The life span of haemoglobin in the body is 90 to 120 days. During this time glycated haemoglobin A (HbA1c) is formed by combination of haemoglobin A and glucose. HbA1c serves as a retrospective indicator of the average glucose concentration over the previous 8 to 10 weeks (3 months).

TREATMENT

The ideal treatment for type 2 diabetes should be to correct insulin resistance, β-cell dysfunction, and normalize hepatic glucose output, as well as prevent, delay, or reverse diabetic complications. 

Primary prevention of diabetes is an important aspect. The specific pharmacological agents acting at the various targets are listed below. Some of these conventional drugs offers the best chance of controlling diabetes and it’scomplications.

  1. Reducing insulin resistance using glitazones.

  2. Supplementing insulin supplies with exogenous insulin.

  3. Increasing endogenous insulin production with sulfonylureas and meglitinides.

  4.  Stimulating insulin secretion with Gliptins

  5. Reducing hepatic glucose production through biguanides

  6. And limiting postprandial glucose absorption with alpha-glucosidase inhibitors.

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