Treatment of Diabetes
The treatment of diabetes can be divided into the treatment for Type I diabetes and that for Type II diabetes for specific medications, though general good advice about lifestyle adaptations is important for both.
Lifestyle Adaptations in Diabetes
Diabetes is a chronic condition for which there is no cure. However, control can be optimised by an adaptation of lifestyle involving an appropriate diet, weight control, exercise, compliance with treatment, regular monitoring of blood glucose (with the aim of having good control) and regular checks with the Diabetes Specialist Nurse and/or the GP.
The Diabetes Specialist Nurse can provide education about the condition to the family and patients, who may find it difficult initially to accept the diagnosis and comply with treatment. For this reason, their supportive and educative role is invaluable.
The whole aim of the treatment is for the blood sugar levels to remain as near normal as possible and the tighter the control the less likely complications are to develop in later life.
People with Type II Diabetes may be able to control their condition by diet and exercise alone.
As well as blood sugar control, cholesterol levels should be kept within the normal range (by medication), and blood pressure should be regularly checked and kept under control to prevent complications in the future.
"Hypo's" usually occur with warning signs and the person can mostly manage to cope with it him/ herself, but sometimes they need further treatment by the GP or in the hospital setting. The time scale for "hypo's" is sudden - minutes.
"Hyper's" build up over a period of time and normally are a less urgent situation to deal with but this is not to say that they should not be dealt with.
There are 3 main types of coma or loss of consciousness in diabetics:
- Hypoglycaemic
- Ketoacidosis
- Non-ketotic hyperglycaemic hyperosmolar coma
A diabetic would be advised to carry a card advising of their condition or wear an SOS bracelet or necklace, in case of collapsing or becoming unconscious away from family and friends who are aware of their condition. This applies especially to those who are very active, who do a lot of driving.
An elderly person, living alone, on the other hand, whose condition is not well controlled would feel more secure with an alarm, which links in to the warden (if in sheltered accommodation) or the local ambulance station.
Any patient who arrives unconscious in a Casualty department has a blood sugar done or is tested in the ambulance by a Paramedic. These people usually have a card on their person.
Care of diabetic patients is shared by the GP, hospital specialists, nurse specialists, dieticians, ophthalmologist and chiropodists. It is essential that the patient is well educated in management and treatment of the condition as well as the avoidance of future complications.
