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All abOut Diabetes Melitus

Diabetes Treatment

Treatment

The goal of diabetes management is to keep blood glucose levels as close to normal as safely possible. Since diabetes may greatly increase risk for heart disease and peripheral artery disease, measures to control blood pressure and cholesterol levels are an essential part of diabetes treatment as well.

People with diabetes must take responsibility for their day-to-day care. This includes monitoring blood glucose levels, dietary management, maintaining physical activity, keeping weight and stress under control, monitoring oral medications and, if required, insulin use via injections or pump. To help patients achieve this, UCSF's Diabetes Teaching Center offers self-management educational programs that emphasize individualized diabetes care. The program enables patients to make more consistent and appropriate adjustments in their therapy and lifestyle.

Dietary Management and Physical Activity

Modifying eating habits and increasing physical activity are typically the first steps toward reducing blood sugar levels. At UCSF Medical Center, all patients work with their doctor and certified dietician to develop a dietary plan. Our Teaching Center conducts workshops that provide patients with information on food nutrient content, healthy cooking and exercise.

Insulin Therapy

People with type 1 diabetes require multiple insulin injections each day to maintain safe insulin levels. Insulin is often required to treat type 2 diabetes too. Using an insulin pump is an alternative to injections. The pump is about the size of a pager and is usually worn on your belt. Insulin is delivered through a small tube (catheter) that is placed under the skin (usually in the abdomen).

There are four major types of insulin:

• Rapid-acting
• Short-acting
• Intermediate-acting
• Long-acting

Your doctor will determine your dose and how often you need to take insulin. There is no standard insulin dose as it depends on factors such as your body weight, when you eat, how often you exercise and how much insulin your body produces.

Oral Medications

Sometimes blood sugar levels remain high in people with type 2 diabetes even though they eat in a healthy manner and exercise. When this happens, medications taken in pill form may be prescribed. The medications work in several different ways. These include improve the effectiveness of the body's natural insulin, reduce blood sugar production, increase insulin production and inhibit blood sugar absorption. Oral diabetes medications are sometimes taken in combination with insulin.

Diabetes ManifestatiOns~ signs&symptOms~

The classical symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). Symptoms may develop rapidly (weeks or months) in type 1 diabetes while in type 2 diabetes they usually develop much more slowly or maybe absent.

Prolonged high blood glucose causes glucose absorption, which leads to changes in the shape of the lenses of the eyes, resulting in vision changes; sustained sensible glucose control usually returns the lens to its original shape. People (usually with type 1 diabetes) may also present with diabetic ketoacidosis, a state of metabolic dysregulation characterized by the smell of acetone; a rapid, deep breathing known as Kussmaul breathing; nausea; vomiting and abdominal pain; and an altered states of consciousness.

Weight loss happened due to burning of fat to produce and also provide energy to the body cells because diabetic patients cannot produce insulin to convert glucose to glucagon and provide energy to the body cells. So , diabetic patients will experience weight loss.

Disease Complication

Stroke/ heart attack happened


when the blood high with glucose,it will slow down the blood flow (sticky blood).build up sticky plaque and worsen the stenosis (if any) and can lead to TIA/stroke/atherosclerosis,PAD and so on.

Eye damage : Diabetes retinopathy 

high blood glucose sugar will damage the tiny blood vessels in the retina while the proliferative retinopathy is new blood vessels grow along the retina, and without treatment-bleed,blurr vission-lead to blindness.

Kidney damage 

 When blood high with glucose, the excessive material will be passing-out through the kidney. So, when it is too sticky,it will depress the nephrons which functions to filtrit the excessive material and can cause the kidney damage/impotence.

Numbness and reduce blood supply

Hyperglycemia(high glucose level in blood) will lower the blood flow especially to the peripheral vessels. This can lead to numbness and nerve damage.

Pheripheral Vascular Disease

 Blood vessel damage in the feet may cause tissue damage. High glucose level will disturb the healing process  infections,foot ulcers,foot gangrene.