Diabetes Self-Management Articles

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What is Diabetes?

by Belinda O’Connell, MS, RD, CDE, and Laura Hieronymus, MSEd, APRN, BC-ADM, C.DE

Treating Type 2 diabetes
Treating Type 2 diabetes involves treating both underlying problems (insulin resistance and inadequate insulin production). An individual’s treatment may change over time as his degree of insulin resistance or ability to produce insulin changes. Many people still make a fair amount of insulin when they are initially diagnosed with Type 2 diabetes, so their treatment may focus mainly on decreasing insulin resistance. Ways to decrease insulin resistance include increasing physical activity, following a healthy meal plan, and losing weight (even losing as little as 10 pounds can make a difference). Certain drugs are also targeted to treat insulin resistance. Metformin (brand name Glucophage) decreases the amount of glucose made by the liver, and pioglitazone (Actos) and rosiglitazone (Avandia) make fat and muscle tissues more sensitive to insulin.

Other drugs address insulin deficiency by stimulating the pancreas to release more insulin or by slowing the digestion of carbohydrate in foods. Using one or more of these medicines and keeping carbohydrate intake moderate and spread out over the day can help the pancreas keep up with insulin needs. Ultimately, however, it is not unusual for many people with Type 2 diabetes to eventually need to take insulin injections to supply their bodies with enough insulin.

Many people with Type 2 diabetes see the progression to using insulin as a negative reflection on their ability to follow their meal plan, lose weight, or otherwise take care of their diabetes. But while there are always additional steps anyone could take to further improve their health, for most people, the need to use insulin to control their diabetes does not mean they lack willpower or the desire to take good care of their diabetes. It is simply a matter of disease progression and the decreased ability of their pancreas to continue producing supernormal levels of insulin.

Not just blood glucose
Diabetes is diagnosed based on blood glucose level, and keeping your blood glucose level in a near-normal range has been shown to prevent common complications of diabetes such as eye disease, kidney disease, and nerve disease. But blood glucose level is not the only concern in diabetes. High blood pressure and high blood fats (such as cholesterol and triglycerides) often occur along with high blood glucose and can also lead to complications, including heart disease. All of these concerns — blood glucose, blood pressure, and blood fats — should be addressed in a comprehensive diabetes treatment plan for good health today and to prevent diabetes-related complications down the road.

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