The goal of treatment is to be able to eat well-balanced, nutritious meals while still achieving healthy blood glucose levels that reduce, delay or prevent acute problems and chronic complications.
Treatment for type 1 and type 2 diabetes always includes:
- Diabetes education
- Healthy eating
- Physical activity
- Glucose monitoring
Type 1 diabetes (zero insulin production):
- Always requires outside insulin to live (delivered by injection or a pump).
- Incretin “helper” hormones are sometimes added
- Positive urine ketones require intervention to prevent DKA
Type 2 diabetes (insulin production gradually decreases over time):
- Treatment strategies change over time to meet blood glucose goals
- Meal planning, physical activity and weight loss may achieve goals initially
- Oral medications are added when necessary
- Insulin may be used with oral medications or alone
- Incretin hormones can be added to oral medication or insulin
Self-management education or training is a key step in improving health outcomes and quality of life. It focuses on self-care behaviors, such as healthy eating, being active, and monitoring blood sugar. It is a collaborative process in which diabetes educators help people with or at risk for diabetes gain the knowledge and problem-solving and coping skills needed to successfully self-manage the disease and its related conditions.
Many people with diabetes also need to take medications to control their cholesterol and blood pressure.
Why physical activity and weight loss?
Increasing physical activity and/or losing a small amount of weight (7 percent) improves blood glucose levels by reducing insulin resistance ("rusty locks").
- "Oils" your cell receptors; it makes it easier for your insulin to open the "locks" and let in the glucose
- Benefits from the "oiled" locks can last eight to 10 hours after increased activity
- Heavy exercise isn’t required to achieve this benefit
Increases the number of receptors on your cells.When you gain weight, some of the locks disappear.As you lose weight they reappear.
A do-able 7 percent weight loss can increase the number of your "locks." Blood glucose goals for good control
Fasting: 70-110 mg
After meals: 70-140 mg (two hours after the start of a meal)
Type 1 bedtime goal: over 100 mg
When you fairly consistently meet the above daily goals you will achieve the A1C levels proven to give you the best outcomes:
A1C (HgbA1C): less than 6.5 percent*
* If your A1C is above 7 percent and you have existing heart disease and/or other serious medical conditions, your doctor may recommend 7 percent.