Treatment Of Diabetes
To control sugar level in diabetic patient is very much crucial for them. Some of them may control by diet change or by daily exercise. While some of them have to depend on the medication and insulin.
First Step:For the treatment of diabetic patient, once the diabetes is diagnosed the first step is to change their lifestyle.
• Change in diet: A healthy diet helps in monitoring, controlling and preventing diabetes complication. For diabetic patient it is good to eat more fruit, vegetables, whole grains and the food which contains low amount of fats and calories. Eat in proportion, reliable diet that is rich in fiber, low in saturated fat and concentrated sweets.
• Daily exercise: Physical activities like jogging, brisk walking, gardening, swimming etc aids in controlling the blood glucose level. These activities help in transporting the glucose to the cells and hence take care of glucose level of the body.
• Drinking alcohol: Alcohol drinking should be lowered because it may decrease or increase the blood glucose level.
• Overweight/Obesity: Especially it is very much important for the Type 2 diabetic patient to lose the weight because it is the major risk factor for them. If they lose their weight then the insulin starts again binding to the receptor.
Second Step: If the diabetic patient is not achieving the tight glycemic control then they are kept on Oral Hypoglycemic Drugs (OHA).
Secretagogues: Help in secreting more insulin
1. Sulphonylureas: It acts on Beta cell hence helps in increasing the insulin secretion.
2. Meglitinides: It also acts on Beta cell hence helps in increasing the insulin secretion. It has faster onset of action than Sulphonylureas.
Sensitizers: Reduce Insulin resistance (Increase Sensitivity)
1. Biguanides: It acts on liver and helps in inhibiting the conversion of hepatic glucose
2. Thiazolidinediones (TZD/ Glitazones): It acts on insulin receptor and hence increasing the insulin receptor sensitivity.
Absorbtion Inhibitors: Decrease postprandial glucose absorption
1. Alpha Glucosidase Inhibitor: It acts on alfa glucosidase enzyme which helps in absorption of the glucose from the gut.
Third Step: If still the glycemic control is not achieved then he/she is kept on combination therapy of OHA.
Fourth step: When he is not achieving the goal from combination therapy then he is kept on OHA and Insulin.
1. Basal Insulin: The basal insulin takes care of the normal glucose fluctuation taking place in the body.
2. Bolus insulin: The bolus insulin takes care of sudden increase in blood glucose level after having meal or snacks.
3. Premixed Insulin: Premixed insulin contains both basal as well as bolus insulin.
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