A back to basics review of Diabetes treatment
Posted by Eamonn Brady on
Diabetes (Basic Treatment)
Today I will discuss basic treatment rather than the causes and types diabetes which I discussed in the past in the Westmeath Topic . I also discussed Ozempic earlier this year
Diabetes treatment
The aim of diabetes treatment is to do what your body once did automatically, which is to mimic the insulin pattern you had before diabetes and to keep blood sugar under control.
Treatment of Type 1 Diabetes
There is no cure for type 1 diabetes but it can be kept under control. Type 1 diabetes is controlled by giving your body insulin. This allows glucose to be absorbed into cells and converted into energy, stopping it building up in the blood.
You may use one or more types of insulin depending on the control required. You may be on a combination of slow, medium, and fast acting insulin. Modern insulin such as Lantus® provide far better control than older types, meaning less injections and less chance of hypoglycaemic attacks.
There are two main methods of taking insulin.
- Insulin injections are the most common form of treatment, where insulin is injected under the skin (usually in the stomach). You will usually give these to yourself two to four times a day, using a pen-type syringe with refillable cartridges.
- Portable insulin pumps may be used if control of blood glucose with regular injections is difficult. Insulin pumps can be programmed to inject insulin at a rate that you can control.
Medicines
If lifestyle changes alone don't reduce your glucose levels, you may be prescribed medicines to increase insulin production and strengthen its effect.
Examples include:
- Metformin improves the effectiveness of insulin by reducing the amount of glucose released from the liver and improving the way glucose is used by muscles. It causes less weight gain than other diabetic medication.
- Sulphonylureas encourages your pancreas to produce more insulin and include gliclazide.
- DPP-4 inhibitors, such as sitagliptin (Januvia), help your body to produce more insulin in response to meals. They don't cause weight gain and only rarely cause hypos.
- Thiazolidine-diones reduce the body’s resistance to insulin and are sometimes used with metformin and sulphonylureas if other standard treatments aren't working or aren't tolerated. An example is pioglitazone (Actos). They are used less often nowadays due to increased risk of heart problems. Rosiglitazone was taken off the market a few years ago due to heart risk.
- Acarbose (Glucobay) lowers blood glucose by slowing the breakdown of some carbohydrates.
Two or more of the medicines listed here can be given in combination as they may give better control than one on its own. All diabetics, regardless of means (apart from Gestational Diabetes of pregnancy), are entitled to all medication related to diabetes for free in Ireland under the Long-Term Illness Scheme (including heart related meds). There are new diabetic drugs which I will discuss another day
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