Treatment of Type II Diabetes (NIDDM)
Firstly, diet, exercise and weight control should be tried. The diet should be normal and healthy and made up as follows:
- Fat - Ideally should be limited to 30% of energy intake and predominantly unsaturated; and of vegetable rather than animal origin. (This is to reduce the risk of coronary and cerebrovascular disease)
- Protein -15% (lean meat, grilled fish).
- Carbohydrate - 50 - 55%. Ordinary sugar should be avoided, and the carbohydrates taken in the form of complex carbohydrates (like pasta beans and wholegrain bread.)
The energy intake during the day should be spread out evenly to prevent swings in blood glucose. Snacks in between meals may be needed for those on insulin, but this depends on the type of insulin used, and on exercise levels.
If diet alone is not successful tablet treatment is given.
At first, one class of medication should be used. Broadly speaking, metformin should be used for the initially overweight/obese. If underweight, they will often need insulin.
If tablet medication and diet are not sufficient, insulin may be used instead of, or in conjunction with the oral hypoglycaemic.
When insulin is used instead of an oral regimen, it can be used in twice - daily injections of an insulin mixture.
When it is used in conjunction with oral medication, one injection of a long-acting insulin is sometimes used.
