Diabetes Treatment

[Type I]
[Type II]
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People with diabetes typically see specialists such as ophthalmologists for eye examinations (due to increased risks of diabetes retinopathy), podiatrists for routine footcare (assessment of any lesions), dieticians, and endocrinologists.

Maintaining blood glucose levels within the normal range is important for all types of diabetes.  When blood glucose levels drop too low, a condition known as hypoglycemia, a person can become dizzy, nervous, confused, and develop impaired judgement.  Eventually, the person may faint.  Likewise, a high blood glucose level, hyperglycemia, can make a person very sick, as occurs in nondiagnosed diabetics.  Treatment should be customized to fit each individual's needs.

Plasma Glucose Monitoring-  Glucose levels must be consistently monitored by the patient.  A popular at-home technique involves the use of a spring-powered lancet to prick the fingertip and an analyzer.  Monitoring glucose levels is especially important before and after meals, but it is also done before bedtime.

Glycosylated Hemoglobin (Hb A1c)-  Physicians test Hb A1c levels in patients in order to estimate plasma glucose levels in patients during the preceding months.  The normal Hb A1c level is about 6%, though patients with poor plasma glucose monitoring show levels up to 12%.

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show glycosylation sites

Glycosylated hemoglobin forms much the same way as other glycosylated proteins.  The hydrophilic sugars tend to attach to the exterior portion of the hemoglobin via N-linked glycosidic bonds with the Asn residues (dark blue).  The presence of glucose in the blood forms an equilibrium of this glycosylation process, so it is an easy way to detect minor to moderately hyperglycimic conditions.

Type I- Healthy eating is perhaps one of the most obvious and effective ways to treat Type I diabetes, along with injections of insulin or an insulin pump.  It is important that blood glucose levels are consistently moniterd, nonroutine physical activity or food intake.

Pictured here is a standard lightweight electronic insulin pump which delivers insulin through a small syringe into the outer layers of skin of the abdomen at specified intervals.  (http://www.Minimed.com)

Type II- Also known as non-insulin-dependent-diabetes mellitus (NIDDM) Type II diabetes also requires healthy eating habits, physical activity, and frequent blood glucose level testing.  The pancreas produces enough insulin in patients with Type II diabetes, but for unknown reasons the body does not utilize its glucose (a disorder known as insulin resistance).  Thus many Type II patients use oral medications and/or insulin to regulate their blood glucose levels.

Gestational- Since the mother's hormones are acting to block the action of her insulin (insulin resistance) in gestational diabetes, she may need almost 3 times as much insulin as in a normal pregnancy.  Treatment usually involves special meal plans and regular physical activity, as well as blood glucose testing and insulin injections in order to maintain a normal blood glucose level

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page by Jeff Klomp