Diabetes: Treatment & Management

Friday, May 15, 2015

Your diabetes may be controlled through diet or a combination of diet and medication. Follow your doctor's instructions on diet and/or medication.


Diabetes Treatment and Management

Diabetes can be detected through a blood glucose test.

You have diabetes mellitus if your

  • Random Blood Glucose is 11.1 mmol/L or higher
  • Fasting Blood Glucose is 7.0 mmol/L or higher

Treatment

Diabetes is a life-long disease. It can be controlled if you do the following:

Your diabetes may be controlled through healthy diet or a combination of diet and medication. Follow your doctor's instructions on diet and/or medication.

  • Type 1 Diabetes

    Type 1 Diabetes results when the pancreas no longer produces insulin. Hence, persons with Type 1 Diabetes need insulin injections daily. Besides insulin, treatment also includes a carefully planned diet, physical activity and regular monitoring of blood glucose.

  • Type 2 Diabetes

    Type 2 Diabetes requires a lifelong commitment of blood sugar monitoring, healthy eating, regular physical activity and, sometimes, oral medication or insulin therapy. Although many would require diabetes medication or insulin therapy, some people with Type 2 Diabetes can control their blood glucose with diet and exercise alone. For overweight or obese individuals, weight reduction is also important for good control of diabetes.

Your doctor may also recommend regular HbA1c testing to gauge the control of your diabetes for the past two to three months. Based on the results, your doctor will make adjustment on your medication or meal plan if necessary.

Oral medication for diabetes acts in various ways to improve your blood glucose level. Some medication helps to:

  • stimulate your pancreas to produce and release more insulin
  • inhibit the production and release of glucose from your liver
  • block the action of stomach enzymes that break down carbohydrates

Oral medication

All medicines must be taken regularly at the correct dosages at the given times as advised by your doctor

  • Sulphonylureas (SUs)
  • Non-SU Secretagogues
  • Biguanides
  • Alpha-Glucosidase Inhibitors
  • Thiazolidinediones

As in all medicines, sometimes side effects such as skin rashes, eye swelling, vomiting, diarrhoea may occur and these have to be reported to your doctor at once.


How to manage your condition

Being aware and knowing about the condition is an essential step in coping with diabetes. Here are some measures you can take to better manage and keep your diabetes under control:

Follow-Up with Your Doctor

Have regular check-ups with your family doctor to detect complications early and discuss measures to delay its progression. Your doctor will also be able to screen for other medical problems. It is important to keep to one family doctor.

Keep Your Blood Pressure and Cholesterol Under Control

Diabetes puts you at risk of developing cardiovascular diseases like heart failure and stroke. Good control of your blood pressure and cholesterol are important in managing your diabetes. By eating healthily and engaging in regular physical activity, you can improve your blood pressure and cholesterol levels. Medication may be needed, too.

Quit Smoking

Smoking increases the risk of heart attack, stroke, nerve damage, kidney disease and amputation. If you are a smoker, call Quitline at 1800 438 2000 to speak to Quit Advisors for help and support to quit.

Learn to Relax

Stress will make your condition worse. The hormones your body produces in response to prolonged stress may prevent insulin from working properly, which only makes matters worse. Engage in activities that you enjoy such as deep breathing, meditation, yoga or a favourite hobby/sport that will help you to relax. Get enough sleep too. Remember your health is more important than whatever immediate stress that is worrying you.

Set Realistic Goals

Be optimistic and set yourself up to succeed by making small lifestyle changes at a time. Often when people try to change too much at one go, they are more likely to give up. Don't forget to celebrate when you achieve each goal!

Join a Support Group

You may find this helpful as you will be able to meet people with diabetes who understand how you feel and know what you are going through. At these groups you will be able to pick up tips on diabetes management and encouragement from your peers.

Insulin

There are different types of insulin. Some are short-acting and others are long-acting, while still others are a mixture of both. Your doctor will prescribe the exact amount of the specific types of insulin you would need.

  • Follow instructions carefully and do not make any changes without consulting your doctor
  • Always keep all insulin bottles plus an extra spare bottle in the refrigerator when not in use
  • Short acting insulins by themselves or as part of a mixture need to be injected about 30 minutes before a meal

Self-care

A diabetic person has to take extra care of his body to maintain good health.

Foot care

People with diabetes are prone to develop foot complications, such as foot ulcers and gangrene, which may lead to amputation. Taking care of your feet is very important:

  • Wash your feet daily with soap and water
  • After washing, dry them fully, especially in between the toes
  • Keep your toe nails short, trimming them straight across to avoid ingrown toenails
  • Moisturise your feet daily to prevent dryness and cracking of the skin
  • Examine your feet daily for scratches, cuts, blisters and corns. Use a mirror to check the sole of your feet
  • Use shoes that fit well and wear clean cotton socks which have loose fitting elastic tops
  • Go for foot screening at least once a year and consult your doctor immediately if you have a sore or other foot problem that doesn't heal within a few days

Eye care

Diabetes can cause severe eye problems where the small blood vessels in the eyes become damaged (diabetic retinopathy) and can lead to blindness.

It is important to have regular eye check-ups at least once a year.

You can get your retinae (inside surfaces of your eyes) photographed by a procedure called retinal photography to detect any damage to small blood vessels. The doctor might also perform laser photocoagulapathy, a form of highpowered light and heat energy, to prevent further damage.


Skincare

Avoid skin injury as diabetes makes the skin more prone to many problems such as rashes, infections and colour changes.

  • Wash every part of the body while bathing using mild soap and warm water
  • Dry all parts of the body using a clean towel
  • Pay attention when washing and drying skin folds in areas such as under the breasts, abdominal folds and groin area
  • Apply moisturizing cream to keep skin moist and soft
  • Treat all cuts and scratches at once, wash with soap and water and then apply mild antiseptic lotion
  • See a doctor if the skin injury does not heal in 2-3 days

Dental care

Dental care is important as many infections start in the mouth.

  • Brush your teeth twice a day – after breakfast and before bedtime
  • Use a soft toothbrush to prevent gum injury
  • Rinse your mouth after every meal or snack
  • Floss your teeth gently after meals to remove food particles between your teeth
  • Dental check-ups: Inform your dentist that you have diabetes and visit him at least once a year.

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Contributed By: Health Promotion Board (HPB)
Source: http://www.healthhub.sg/
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