The Treatment And Management of Diabetes.
So you have been diagnosed with diabetes! - Where do you go from here?
We are all individuals and there is no one size fits all where the treatment of diabetes is concerned. Your doctor will have come up with a treatment plan that he feels is right for you.
This will not be set in stone. He or a diabetic nurse will check up on you, usually by phone, either daily or a few times a week to start with, then less often as you get to grips with this disease and learn to control it. This is so they can evaluate how their suggested treatment is working and make any changes that may be necessary.
Once you are stable they will ask you to come into the surgery a number of times a year for check ups and to do certain tests.
There is one main aim in diabetes treatment - get ones blood glucose down.
There is a certain amount of dissension about exactly where it should be.
The established norm is
between 4 and 7 mmol/l (72 & 126mg/dl) before meals, and
less than 10 mmol/l (180mg/dl) two hours after meals.
However there are proponents of the idea that, as normal people have BGs which range from 4.4mmols/l (80mg/dl) to 5.2 mmol/l (95mg/dl) the established norms are too high and need to be addressed.
Daily BG checking is necessary to see how your treatment is working.
Another type of blood test, done every 2-6 months by a laboratory, is called the HbA1c. The results of this will tell your doctor how the treatment has worked over the last few months and whether he needs to change anything.
Immunisation
It is suggested that all diabetics get an injection against winter flu each year. This is generally available in autumn. In some countries it is offered free to people at risk.
If you are at all allergic to eggs do not have this injection as the flu vaccine is cultivated in eggs.
Although told that few people suffer side effects from this shot, be warned that there are those of us who do fit into this chosen few.
In our case symptoms range from pain, redness and swelling around the injection site to all the normal complications of an attack of flu - aching body, streaming cold and fever.
As flu strains differ from year to year it is necessary to have this injection on a yearly basis to get protection against the current most virulent strains. It may not prevent you catching colds or even flu but it will make the symptoms of the latter much less dire.
An immunisation shot against the pneumococcus bacteria is also a good idea, especially for those who tend towards chesty infections. The infections associated with these bacteria - pneumonia, blood poisoning and meningitis, can really be unpleasant for diabetics.
Unlike the flu jab this is a once in a life time immunisation. It can be given at the same time as the flu injection, and of course there are supposed to be no side effects, but be warned!! Some can expect an incredibly sore arm muscle and fever symptoms.
If they insist on giving the two injections on the same day in different arms and you are one of those people who react to them you will now have two very sore arms and end up having to sleep on your back for a few days - good luck!
The type of treatment regime you are on will vary depending on the type of diabetes you have.
We will deal with them each in their own section.
Please follow the link below to the section of your choice.
Type 1 Treatment. There is no choice for a type 1 diabetic, they are going to require insulin, administered either by subcutaneous injection or by pump.
Type 2 Treatment. Unlike type 1's there are a number of treatment options available to type 2's. As they have insulin resistance rather than no beta cells they usually do not require external insulin.
LADA Treatment. Because LADA is often misdiagnosed as Type 2, treatment usually starts of with the classic one of diet & exercise.
Pre-diabetes Treatment. Whether one accepts this as a disposition towards diabetes or actual early diabetes itself, the prediabetes treatment remains the same.
Gestational Diabetes Treatment. Treatment for gestational diabetes is much the same as Type 2. The aim is to control blood glucose levels.
MODY Treatment. If there is a suspicion that a patient may have MODY then genetic testing can be used to establish a firm diagnosis.
Steroid Diabetes Treatment. Depending on the severity this will be the same as for other types of diabetes, either by diet, oral medication or insulin.