What is the ideal treatment for diabetes?

There are two types of diabetes. The IDDM (insulin-dependent diabetes mellitus) and the NIDDM (non-insulin-dependent diabetes mellitus)

Type 1 diabetes is secondary to destruction of beta cells in the islets of Langerhans in the pancreas resulting in little or no insulin production. It requires insulin injections and it usually occurs in children or in non obese adults.

Type 2 diabetes may result from a partial deficiency of insulin production and/or an insensitivity of the cells to insulin. It usually occurs in obese adults over 40.

It can also be associated with other conditions or syndromes like the Cushing's syndromes, ( a disease caused by increased production of cortisol ,or by excessive use of cortisol or other steroid hormones) example: pancreatic disease, Cushing's syndrome,use of certain drugs (steroids, thiazide diuretics, (used to treat high blood pressure) and oral contraceptives.

Treatment for Diabetes:

Type 1 diabetes: insulin, diet and exercise

Exercise is a helpful adjunct to therapy as exercise decreases the body's need for insulin

Consistency is imperative to avoid hypoglycemia

There are three types of insulin used for type 1 diabetes

a. Short acting: used in treating ketoacidosis during surgery,infection, trauma,management of poorly controlled diabetes; to supplement longer acting insulin.

b.Intermediate: used for maintenance therapy

c.Long acting: used for maintenance therapy in clients who experience hyperglycemia during the night with intermediate-acting insulin

Insulin preparations can consist of a mixture of beef and pork insulin,pure beef, pure pork, or human insulin. Human insulin is the purest insulin and has the lowest antigenic effect.

Human insulin is recommended for all newly diagnosed type 1 diabetics.

Type 2 diabetes:

Ideally managed by diet and exercise

May need oral hypoglycemics or occasionally insulin if diet and exercise are not effective in controlling hyperglycemia

Insulin needed for acute stress, example: surgery and infection.

Weight loss is important since it decreases insulin resistance

High fiber, low fat diet also recommended.

For patients who need short-term insulin therapy, the pregnant clients, and diabetic clients with insulin allergy or severe insulin resistance.

Oral hypoglycemic agents for type 2 diabetics who are not controlled by diet and exercise. They increase the ability of the islet cells of the
pancreas to secrete insulin.

May have some effect on cell receptors to decrease resistance to insulin

You can also try Insulin pumps; they are small, externally worn devices that closely mimic normal pancreatic functioning. It contains a 3ml syringe attached to a long (42) inch, narrow-lumen tube with a needle or Teflon catheter at the end. The needle or Teflon catheter is inserted into the subcutaneous tissue (usually on the abdomen) and secured with tape or a transparent dressing.

The needle or catheter is changed at least every 3 days. The pump is worn either on a belt or in a pocket.The pump uses only regular insulin. Insulin can be administered
via the basal rate (usually 0.5-2.0 units/hr ) and by a bolus dose(which is activated by a series of button pushes) prior to each meal.

source: mdinfo