Diabetes is a metabolic disorder which may be caused due to defective insulin production or due to impaired response to insulin production . Diabetes is mainly of chronic nature and there is unfortunately no definite cure for this disease. However, diabetes can be managed by keeping the blood glucose levels in control to stay at the optimal levels without causing hypoglycemia.
This can be achieved by use of medications or by correcting the underlying causes such as maintaining a healthy diet and regular exercise. The first and foremost step is to make a proper and accurate diagnosis of the specific type of diabetes and then move on to the possible methods of treatment.
It is the most important management measure that keeps a check on the blood glucose level. A diabetic individual or people who are susceptible to encountering the disease should always take a balanced diet including different types of nutrition in order to maintain the short-term as well as the long-term blood glucose levels under control. Following a diabetic diet is a necessary aspect for diabetics. The ADA or The American Diabetics Association has issued appropriate diet guidelines with low fat and carbohydrates spread over three meals.
Diabetic individuals are recommended to have foods that are rich in fiber and also those which release carbohydrates slowly. Examples of such types of foods include whole grains, rolled oats, green leafy vegetables, peas and bran flakes.
Foods should be consumed such that the glycemic index of the diet remains low. A lower glycemic index indicates a lower blood sugar level. Some foods are slow to be digested and as such, sugar is released into the blood stream at a much slower rate than usual. Some of these foods are also more filling and diabetics feel fuller for a longer period of time after consuming such foods. The basic principles that are to be observed in following a low glycemic diet include:
- Eating foods which have undergone minimal processing
- Eating foods which have a low starch content
- Refined food produces should be avoided as far as possible
- Sweet eating should be highly limited
- Healthy proteins obtained from fish or seeds and legumes should be consumed
- Foods with healthy fats such as those found in fish and in some nuts and oils may be consumed
- Meals should never be skipped
- Meals should be taken at a slow speed and stopped once the individual feels full
In general, all foods are classified into three different categories as per their glycemic index. These categories are:
- Coal Foods: This class of foods represents all the foods that have a low glycemic index and should be preferred for use in a diabetic diet. Some examples of coal foods include brown rice, whole grains, lean meat, sea food, nuts and seeds and legumes.
- Water Foods: This class of foods represents all foods that have a neutral glycemic index. As such, these foods are generally considered safe to be included in a diabetic’s diet. Water foods include whole cut fresh vegetables and fresh fruits. They do not, however, include any processed form of fruits and vegetables and even freshly squeezed fruit juice is excluded from this category.
- Fire Foods: Fire food is used to classify any food item which has a high glycemic index. Such foods are both high in carbohydrate content and are quick to be digested by the body as well. These foods are to be avoided as far as possible by diabetics and also people who are at a risk of contracting the disease. Examples of foods which lie in this category include sweets, fried foods, chips, white rice, white bread, white pasta and also most baked and processed foods.
Any food which is packaged and manufactured contains the nutritional information along with it. Diabetics must carefully always choose out the foods which lie in the coal and water food categories.
Following a healthy and strict diabetic diet is the foremost thing that people suffering from the disease must follow. Any wrong type of food or any indulgence in sweets or fried foods can greatly raise the blood sugar levels and cause severe complications such as a stroke.
Diabetics are also at a risk of a number of cardiovascular diseases and as such, no diabetic individual can afford to smoke. If people are prone to encountering the disease and are smokers, smoking should be stopped at the earliest.
When it comes to drinking alcohol, diabetics must make sure to drink only within the recommended limits as both the alcohol and the mixer can prove to upset the calorie count as well as the nutritional balance that a diabetic’s diet requires. The recommended limit for consumption of alcohol is one drink a day for a woman and two drinks a day for men.
Any type of unhealthy fat present in a diet will need to be replaced with healthy fats such as those found from fish, nuts and seeds. A diabetic must refrain from having sweets and sugary foods and should always maintain a daily steady calorie count. As such, diabetics are recommended to never skip a meal and to regularize meals as far as possible. Diabetics are also urged to have as many meals as they can in a day, preferably up to six meals.
Diabetics are also urged to consume as much water as possible in order to make up for the loss due to excess urination.
Physical activity proves to be the second most important thing to be done in order to manage as well as to prevent diabetes especially in Type II Diabetes mellitus sufferers, which is caused due to obesity or being overweight . Physical activities stimulate the cells of the body to be more responsive to the effects of insulin and the cells absorb glucose from the blood stream better. This proves to be of great help to diabetics and all patients and also people who are at a risk of contracting the disease are urged to get as much physical activity as possible. Physical activity also improves the circulatory functions of the body and prevents individuals from gaining unnecessary weight. Regular exercise also offers the added benefits of strengthening the immune system of the body and this helps keep away any infections that may indirectly lead to diabetes in susceptible individuals.
It is quite important for people who are prone to the disease to lose weight as soon as possible. Studies have linked diabetes to people who are obese. Moderate to aggressive physical activity on a daily basis is recommended for people in order to effectively prevent onset of the disease.
Medications for Diabetes
There are many different types of medications available which can prove to be of great help in controlling the different types of diabetes. However, the medications for Type I Diabetes are quite different to that of Type II Diabetes and Gestational Diabetes. As such, proper diagnosis of the type of diabetic disease should be confirmed before proceeding on to medication and treatment.
Type I Diabetes can be treated with the insulin therapy where combinations of NPH and regular insulin or synthetic insulin analogues are administered to the patients with diabetes. Insulin will need to be administered externally to patients and as such, Type I Diabetes sufferers will always need to keep an insulin syringe or an insulin pump handy.
Type II Diabetes can be treated effectively with the use of oral hypoglycemic drugs out of which metformin is the most commonly prescribed oral hypoglycemic. There are other medications as well which include angiotensin converting enzyme inhibitors (ACEIs) or the angiotensin receptor blockers (ARBs).
Insulin Lispro, Insulin Aspart, Insulin Glargin and Insulin Determir are some of the insulin analogues which are given in gestational as well as Type I Diabetes mellitus .
Sometimes, additional medication is prescribed along with diabetes medication in order to protect other parts and organs of the body. These medications include drugs to lower the blood pressure, drugs to reduce the levels of bad cholesterol in the body, drugs such as aspirin to protect the heart and also drugs which prove to slow down the process of digestion.
Prediabetes usually does not require any medication and the disease can be controlled by following a healthy diet with lots of daily physical activity.
If medications have been prescribed they must be thoroughly followed. In case the patient suffers from any other disorder and requires other medication, then it must be made sure that there is no reaction between the drugs. Some of the medications for diabetes are also known to have side effects and allergies. Patients ought to proceed with extreme care in order to avoid potential complications while using medications for diabetes.
Pancreatic and Renal Transplant
These are the last resort of treatments for diabetic patients with severe complications who have already undergone all the other treatment options. Since the pancreas contain the main insulin producing beta cells, thus any highly damaged pancreas which has undergone fibrosis needs to be replaced with the donor pancreas. In case of failure of both the kidneys, even renal transplant is recommended in patients with severe diabetes. Usually, a pancreatic transplant is only carried out if a renal transplant is being carried out as well.
In the recent past, there has been active medical and biological research in the domains of cell transplantation . If these new and emerging results prove to be conclusive, the world may see newer and more effective cures for diabetes.
Some of the cell transplantation techniques that are actively being researched include transplantation of the islet cells of the pancreas and also stem cell transplantation.
Amputation of Limbs
Diabetic individuals are more prone to damaging their limbs, especially the feet and the hands. This is because of the excess glucose in the blood stream, which puts a lot of pressure on the delicate nerves and the blood tissues and often ends up damaging them. As such, infections are also common in areas which receive a lot of stress, such as the ankles. Infections can lead to some serious complications if not treated on time. Cases of gangrene occurring in the hands and feet of diabetic patients are a common and major complication. In such cases, the affected limbs of the diabetic are amputated to prevent any further spread of infection.
A diabetic must ensure to take good care of the hands and the feet. Any signs of problems or infections should be attended to at the earliest. Many diabetics also resort to frequent medical checkups including eye checkups and tests for infections. Diabetics must also make sure to get vaccinated and also on time.
Managing to live with a chronic disease like diabetes can prove to be very frustrating. Very often, diabetics find that despite following strict routines and procedures, sometimes the smallest of mistakes or changes can cause the blood sugar levels to rise.
It is important for diabetics to have a good and healthy support system consisting of close friends and family . While the diabetic patients are urged to learn as much about the disease as possible, the members of their support system should also know the basics of the disorder. There may be a case of emergency at any point of time in a diabetic’s life, and it is important that the support system knows how to effectively deal with the situation.
Addressing the concerns of the diabetic patient and supporting them also helps in faster and better recovery of patients. It is necessary to take into consideration the other factors like stress that acts as a triggering factor.
Diabetes unfortunately has no definitive cure and controlling the disease and managing its symptoms are the best that a diabetic individual can do. However, by following a strict diabetic diet and by maintaining a healthy lifestyle with regular physical activity, a diabetic individual can greatly improve on the quality of life. In some cases, medications can also prove to be of great help to diabetics. In Type I Diabetes patients however, insulin therapy medication must always be kept handy in case of emergencies.
 Barriers to Buying Healthy Foods for People With Diabetes: Evidence of Environmental Disparities, Carol R. Horowitz,Kathryn A. Colson, Paul L. Hebert, and Kristie Lancaster; 94, No. 9, pp. 1549-1554 – September 2004 – DOI: 10.2105/AJPH.94.9.1549, http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.94.9.1549
 The Evidence for the Effectiveness of Medical Nutrition Therapy in Diabetes Management, Joyce Green Pastors, Hope Warshaw, Anne Daly, Marion Franz, Karmeen Kulkarni; vol. 25 no. 3 608-613 – March 2002 – DOI: 10.2337/diacare.25.3.608, http://care.diabetesjournals.org/content/25/3/608.short
 Fruit and Vegetable Consumption and Diabetes Mellitus Incidence among U.S. Adults, Earl S. Ford, M.D., M.P.H.1, Ali H. Mokdad, Ph.D.; Volume 32, Issue 1, 33-39 – January, 2002 – DOI: doi:10.1006/pmed.2000.0772, http://www.sciencedirect.com/science/article/pii/S0091743500907722
 Effect of intensive diabetes management on macrovascular events and risk factors in the diabetes control and complications trial, DCCT Research Group, Bethesda, Maryland, USA,; Volume 75, Issue 14, Pages 894–903 – May 1, 1995 – DOI: 1016/S0002-9149(99)80683-3, http://www.sciencedirect.com/science/article/pii/S0002914999806833
 A critical review of the literature on fear of hypoglycemia in diabetes: Implications for diabetes management and patient education, Diane Wild,Robyn von Maltzahna,Elaine Brohana, Torsten Christensenb, Per Clausonb, Linda Gonder-Frederick,; Volume 68, Issue 1, Pages 10–15 – September 2007 – DOI: 1016/j.pec.2007.05.003, http://www.sciencedirect.com/science/article/pii/S0738399107001760