How Can I Control My Diabetes
Depending on what type of diabetes you have, blood sugar monitoring, insulin and oral medications may play a role in your treatment. Eating a healthy diet, maintaining a healthy weight and participating in regular activity also are important factors in managing diabetes.
Life style
No matter what type of diabetes you have:
- Make a commitment to managing your diabetes. Learn all you can about diabetes. Establish a relationship with a diabetes educator, and ask your diabetes treatment team for help when you need it.
- Choose healthy foods and maintain a healthy weight. Losing just 7 percent of your body weight if you’re overweight can make a significant difference in your blood sugar control. A healthy diet is one with plenty of fruits, vegetables, whole grains and legumes, with a limited amount of saturated fat.
- Make physical activity part of your daily routine. Regular exercise can help prevent prediabetes and type 2 diabetes, and it can help those who already have diabetes to maintain better blood sugar control. Thirty minutes of moderate exercise — such as brisk walking — most days of the week is recommended. A combination of exercises — aerobic exercises, such as walking or dancing on most days, combined with resistance training, such as weightlifting or yoga twice a week — often helps control blood sugar more effectively than does either type of exercise alone.
Diabetes Medications
Sulfonylureas, Metformin, Alpha Glucosidase Inhibitors, Insulins, Insulin Pumps
Summary of Medications
There are a variety of medications along with insulin formulations which help people with diabetes achieve better blood glucose control.
The Diabetes Medication Summary describes these drugs, their actions and the role they play in helping people with diabetes attain a healthy blood glucose range.
As is true with any medication those for diabetes are only effective when taken as prescribed. Be sure to learn about your medications and how and when to take them. Any side effects and how to respond to them should also be well understood.
Sulfonylureas – Orinase, Tolinase, Diabenase, Micronase, Glynase, Glucotrol, Diabeta, Dymelor and Amaryl stimulates insulin production in pancreas and increases insulin sensitivity at the cellular level.
– Side Effects – Skin rash, jaundice, sensitivity to sunlight hypoglycemia (may be profound). Caution Renal or liver disease allergies to sulfa.
– Contraindication Pregnancy Type I DM
– Dosing Up to 30 minutes before meals Actual mg s vary with drug strength
Metformin (Glucophage)
- Increases insulin sensitivity at the cellular level with no effect on pancreas therefore there is no danger of hypoglycemia from this drug.
- Side Effects: Gastro intestinal usually nausea, vomiting, bloating, diarrhea (up to 30% of patients). These symptoms may lessen after 2 3 weeks of therapy.
- Contraindications: Renal or liver disease; excessive alcohol intake; pregnancy; Type I DM. The drug should be withheld 48 hours before after any X ray studies using Iodine containing contrast media.
- Dosing: 500 mg bid (with meals) increasing by 500 mg per week to a maximum of 2500 mg
Alpha Glucosidase Inhibitors – Acarbose (Precose)
Works in small intestine to slow carbohydrate and delay glucose absorption It binds to carbohydrate and so some is not digested.
- Side Effects: Nausea diarrhea flatulence (77%)
- Caution: Renal disease
- Contraindications: Type I DM, cirrhosis, inflammatory bowel disease, colonic ulcerations, partial intestinal obstruction.
- Dosing: 25 mg 3 times daily with the first bite of food. Titrate to 50 mg three times daily. Maintenance dose is 50-100 mg three times daily.
Insulin
Insulin therapy is necessary to treat all people with Type 1 diabetes and for others who do not produce enough of their own insulin to keep blood sugar levels within target ranges. The type of insulin preparation and the schedule selected for each individual depends upon total insulin needs blood sugar management goals age lifestyle and other factors.
- Short Acting Lispro (Humalog) works within 15 minutes and peaks in 30-90 minutes; gone 2 hours.
- Regular insulin works in 30 minutes and peaks in 90-120 minutes, gone in 3-3.5 hours.
- Intermediate Acting NPH (Lente) begins 2 hours after injection, peaks in 6-10 hours, gone in 20-24 hours.
- Lente and Regular should not be mixed generally. If they are mixed it must be used immediately.
- 70:30, 60-40, 50-50 Combinations of NPH and Regular premixed – Their effect is that of Regular and NPH combined.
- Long Acting Ultralente – Begins action in 4-6 hours and lasts for up to 36 hours at a low level. Used in conjunction with doses of Regular insulin at mealtime. Ultralente is usually given at suppertime or bedtime.
The Insulin Pump
The insulin pump is a small battery- operated device that supplies a continuous amount of insulin to the body. The pump contains a battery a motor and a supply of insulin The pump is connected to the body by tubing and a single needle or soft cannula. The insertion site is rotated every 1 to 3 days Insulin that is delivered continuously is called the basal dose The dose given before meals is called a bolus dose The decision to use an insulin pump requires careful consultation with your diabetes care team.
Oral Medications
For people with type 2 diabetes who produce insulin of their own oral medications may be used alone or in combination with a small amount of supplemental insulin