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What Are The Treatment Options For Diabetes?

Type 1 Diabetes Treatments

Type 1 Diabetes Treatments

People with type 1 diabetes (T1D) can live long, happy lives with proper care and disease management. Advancements in medication types and delivery methods give people the freedom to choose which treatment options work best with their particular circumstance. T1D prognoses can be greatly improved with a combination of treatments and lifestyle choices. Insulin and other medications Insulin Type 1 diabetes is managed through use of a variety of insulins. People with T1D must work closely with their medical team to find the right insulin treatment for their condition. Further information about the types of insulin and their effects are available on our insulin page. Insulin can be delivered via syringes or pens, pumps or new artificial pancreas systems. Though the administration method, frequency and type of insulin dosage vary on a case-by-case basis, injections may be needed multiple times per day. Metformin and other medications Metformin: Combined with insulin, diet and exercise, type 2 diabetes (T2D) drug metformin is sometimes prescribed to people with T1D to help treat their diabetes. Metformin helps control the body’s blood-sugar levels and how the liver processes sugar. Pramlintide (Symlin): Used in conjunction with insulin, pramlintide is often prescribed after other medications prove not as effective as needed. It acts as a hormone to help the body better control blood sugar. Blood pressure drugs, cholesterol medications and aspirin: Medications for high blood pressure and high cholesterol as well as aspirin can be prescribed with insulin to help the overall health and treatment of diabetes. Since people with diabetes have an increased chance of cardiovascular disease, these drugs are used in combination with other diabetes medications. Side effects of medicat Continue reading >>

Treating Diabetes Mellitus In Dogs

Treating Diabetes Mellitus In Dogs

Goals of Treating Diabetes in Dogs Once a veterinarian confirms that a dog has diabetes mellitus, she will establish a personalized treatment plan. The primary goals of treatment are to reduce or eliminate symptoms of the disease and return the dog to a happy, comfortable and active state. In most cases, the course of treatment will involve daily insulin therapy and strict dietary management. Treatment Options for Diabetes in Dogs If a diabetic dog presents in very serious condition, such as with profound dehydration, weakness and shock, it will be admitted to the hospital and probably started immediately on intravenous fluids to restore fluid and electrolyte balance. Once the dog is stabilized, dietary modification will become important to prevent or correct the obesity that often is associated with early diabetes mellitus, as well as to stabilize blood glucose levels. Diets must be customized to each patient, but in general diabetic dogs should be fed a diet high in fiber to help reduce the rate of glucose absorption from food into the blood. A diet high in soluble and insoluble fiber, including complex carbohydrates, slows down absorption of food particles and facilitates management of the blood sugar peaks and troughs that accompany diabetes mellitus. Dogs with diabetes should be fed multiple small meals rather than a single large meal daily. One of those small meals should be fed at the time of each insulin injection. Most experts recommend that semi-moist packaged foods be avoided, because many of them contain ingredients that can exacerbate hyperglycemia (high blood glucose). If appropriate, owners should start a daily exercise regimen for diabetic dogs, after discussing this with their veterinarian. Insulin therapy is the mainstay of treating Type 1 diabetes mel Continue reading >>

Diabetes And Erectile Dysfunction

Diabetes And Erectile Dysfunction

Diabetes, high blood pressure (hypertension), elevations in blood lipids or cholesterol are considered blood vessel problems and have all been associated with Erectile Dysfunction. The blood vessel abnormalities caused by these diseases affect vessels throughout the body and often produce other symptoms of vascular diseases. Diabetics and patients with hypertension frequently have heart disease. These conditions typically interfere with the ability of the penile vessels to work properly and ultimately cause ED. ED & Diabetes Dr. J. Francois Eid discusses the relationship between ED and Diabetes. Diabetes is one of the most common causes of ED. Men who have Diabetes are three times more likely to have Erectile Dysfunction than men who do not have Diabetes. Among men with ED, those with Diabetes are likely to have experienced the problem as much as 10 to 15 years earlier than men without Diabetes. A recent study of a clinic population revealed that 5% of the men with ED also had undiagnosed Diabetes. The risk of ED increases with the number of years you have Diabetes and the severity of your Diabetes. Even though 20% to 75% of men with Diabetes have ED, it can be successfully managed in almost all men. In regards to high blood pressure, this makes the heart work harder to pump blood which can prevent blood flow from reaching the penis and in turn prevent an erection. Recent reports say that close to 2 out of 3 men report a change in the quality of their erections if they have high blood pressure. It is established that Diabetes affects not only peripheral nerve function but peripheral blood flow as well. The association between Diabetes and ED was first documented in 1978. Men with Diabetes have four main risk factors for ED. First, diabetes can cause damage to nerves (ne Continue reading >>

Treatment Options For Type 2 Diabetes—what's Available?

Treatment Options For Type 2 Diabetes—what's Available?

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website. What is diabetes? Your body uses sugar (glucose) from food for fuel and energy. Insulin is a hormone made by your pancreas, one of the organs in your body. Insulin helps maintain your blood sugar level in the normal range (not too high or too low). Diabetes is a disease in which your body does not properly use sugar, causing your blood sugar level to become too high. High levels of sugar in the blood for long periods of time can harm your body including your eyes, heart, kidneys and feet. What is type 2 diabetes? Type 2 diabetes can result when: Your body does not make enough insulin (insulin deficiency). Your body makes insulin, but does not use it properly (insulin resistance). Your body makes too much sugar. Quite often, it is a combination of these effects that causes type 2 diabetes. There is no cure for diabetes, but treatment can improve your blood sugar levels. What are the different steps in managing my diabetes? The first step in controlling your blood sugar is to eat healthy foods and exercise. By doing so, your body will try to fix itself. If you are overweight, losing weight will lower your blood sugar level and make you feel better. If diet and exercise do not help, there are some medicines (pills and insulin shots) that your doctor can prescribe. Remember that treatment for type 2 diabetes is not the same for every person, and it is common for your therapy to change over time. The kind of therapy your doctor chooses will depend on how long you have had diabetes, Continue reading >>

There Are Treatment Options For Diabetic Neuropathy

There Are Treatment Options For Diabetic Neuropathy

Dear Dr. Roach • What are the treatment options for diabetic neuropathy? What is likely to happen over time to someone with this condition? — M.P. Answer • Diabetic neuropathy is a condition of nerve damage associated with diabetes, both Type 1 and Type 2. It affects the long nerves of the body earliest, especially those to the feet, causing numbness and sometimes pain. The hands also may be affected. Usually, both sides are affected the same way. Numbness usually is the first sign, followed by pain, often described as burning or tingling. The nerves to the gut can be affected, leading to constipation and bloating. The best way of dealing with diabetic neuropathy is to not get it in the first place. Excellent control of diabetes, with near-normal sugar levels, was shown to reduce the incidence of people with diabetes developing the condition. In people who already have diabetic neuropathy, good control of blood sugar can improve symptoms and slow progression, but the condition usually is not reversible in people who have established symptoms. However, the pain sometimes can go away mysteriously. Numbness to the feet puts individuals at risk for injury, as the affected person does not realize he or she is beginning to develop a problem, such as a sore or abrasion. People with diabetic neuropathy need to inspect their feet daily for warning signs, such as dry, cracking skin, redness or drainage. This should be combined with regular professional foot care by a diabetes doctor or foot specialist. For people with pain due to diabetic neuropathy, there are several treatment options. Medication treatments include anti-epilepsy drugs, like gabapentin (Neurontin) and pregabalin (Lyrica); antidepressant drugs, like amitriptyline or venlafaxine (Effexor); anesthetic agents, Continue reading >>

Crisis In Care: Limited Treatment Options For Type 2 Diabetes In Adolescents And Youth

Crisis In Care: Limited Treatment Options For Type 2 Diabetes In Adolescents And Youth

Until two decades ago, children and adolescents were automatically assumed to have insulin-dependent type 1 diabetes. However, type 2 diabetes emerged as a “new type” of childhood diabetes in the 1990s in association with the epidemic of childhood obesity. It quickly became apparent that this new pediatric disease disproportionally affected disadvantaged minority children and was associated with comorbidities that increased the risk of future cardiovascular disease. After more than 20 years, the optimal approach to the treatment of childhood type 2 diabetes remains largely unknown. Besides insulin, metformin remains the only other antidiabetic medication that is approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for use in youth with type 2 diabetes. Glimepiride and rosiglitazone failed noninferiority tests versus metformin as initial monotherapy in company-sponsored clinical trials. While the primary study results of the randomized phase of the TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) study showed that combination therapy with metformin plus rosiglitazone was more effective than metformin plus intensive lifestyle intervention and metformin alone (1), rosiglitazone will not be used with any frequency in young patients with type 2 diabetes because of concerns about the cardiovascular and other adverse effects of this class of medications. Once again, pediatric diabetes practitioners are left with just metformin and insulin for adolescents with type 2 diabetes. Why haven’t glucagon-like peptide 1 (GLP-1) agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors that have been approved for use in adults with type 2 diabetes been approved for the treatment of adolescents with the same condition? W Continue reading >>

Type 2 Diabetes Mellitus In Adults

Type 2 Diabetes Mellitus In Adults

show all detail Treatment Options Presumptive Patient Group Tx Line Treatment nonpregnant: at diagnosis 1st BP control Adults with type 2 diabetes are twice as likely to die of stroke or myocardial infarction (MI) compared with those without diabetes, and they are more than 40 times more likely to die of macrovascular than microvascular complications of diabetes. [26] [27] A primary goal of care is treatment of blood pressure. Joint National Commission (JNC 8) and American Diabetes Association (ADA) guidelines recommend a treatment goal of <140/90 mmHg. [2] [25] Combination therapy is often required to reach BP goals. Antihypertensive therapy may be initiated with a thiazide diuretic, a calcium-channel blocker, an ACE inhibitor, or an angiotensin-II receptor antagonist. Antihypertensive drugs for black people may be initiated with a thiazide diuretic or a calcium-channel blocker. [25] ACE inhibitors may reduce mortality and cardiovascular events more than angiotensin-II receptor antagonists. [29] Combining an ACE inhibitor with an angiotensin-II receptor antagonist is not recommended due to increased risk of adverse events. [41] However, all people with chronic kidney disease (CKD) should receive an ACE inhibitor or an angiotensin-II receptor antagonist as part of their regimen. [25] 2[A] Evidence Evidence Reducing cardiovascular risk: there is good-quality evidence that intensive BP lowering (targeting a systolic pressure <120 mmHg over 4.7 years, as compared with targeting <140 mmHg) does not lessen risk (composite outcome: nonfatal MI, nonfatal stroke, or death from cardiovascular cause) in people with type 2 diabetes. Intensive BP lowering increased the risk of adverse events. [42] CKD is defined as (a) age <70 years with GFR <60 mL/minute/1.73 m^2, or (b) people of Continue reading >>

What Are Treatment Options For Diabetes?

What Are Treatment Options For Diabetes?

Unfortunately, there is no cure for diabetes. If you have type one diabetes, your body will require daily insulin injections to regulate your blood sugar. Additionally, you may test your blood sugar several times daily to ensure that your blood sugar levels are healthy. Thanks to technology, there are plenty of smartphone apps and wearable devices to help you manage. If your kidneys are unable to filter your blood effectively, you could be required to undergo dialysis on a regular basis, a process that filters and cleans your blood. Depending on your unique physiology, a medication could be prescribed to manage the symptoms of your diabetes. As with many medical conditions, lifestyle and diet are a huge factor in preventing further complications. Staying active, and eating nutritious foods can prevent and even reverse certain symptoms. Continue reading >>

Type 2 Diabetes Mellitus Treatment & Management

Type 2 Diabetes Mellitus Treatment & Management

Approach Considerations The goals in caring for patients with diabetes mellitus are to eliminate symptoms and to prevent, or at least slow, the development of complications. Microvascular (ie, eye and kidney disease) risk reduction is accomplished through control of glycemia and blood pressure; macrovascular (ie, coronary, cerebrovascular, peripheral vascular) risk reduction, through control of lipids and hypertension, smoking cessation, and aspirin therapy; and metabolic and neurologic risk reduction, through control of glycemia. New abridged recommendations for primary care providers The American Diabetes Association has released condensed recommendations for Standards of Medical Care in Diabetes: Abridged for Primary Care Providers, highlighting recommendations most relevant to primary care. The abridged version focusses particularly on the following aspects: The recommendations can be accessed at American Diabetes Association DiabetesPro Professional Resources Online, Clinical Practice Recommendations – 2015. [117] Type 2 diabetes care is best provided by a multidisciplinary team of health professionals with expertise in diabetes, working in collaboration with the patient and family. [2] Management includes the following: Ideally, blood glucose should be maintained at near-normal levels (preprandial levels of 90-130 mg/dL and hemoglobin A1C [HbA1c] levels < 7%). However, focus on glucose alone does not provide adequate treatment for patients with diabetes mellitus. Treatment involves multiple goals (ie, glycemia, lipids, blood pressure). Aggressive glucose lowering may not be the best strategy in all patients. Individual risk stratification is highly recommended. In patients with advanced type 2 diabetes who are at high risk for cardiovascular disease, lowering Hb Continue reading >>

A Third Treatment Option In Uncontrolled Type 2 Diabetes

A Third Treatment Option In Uncontrolled Type 2 Diabetes

Addition of dapagliflozin may benefit patients whose blood glucose is uncontrolled with both metformin and sulfonylurea… Dapagliflozin is a selective and reversible sodium-glucose co-transporter 2 (SGLT2) inhibitor, which lowers plasma glucose level by increasing urinary excretion of glucose. Addition of dapagliflozin may benefit patients whose blood glucose is uncontrolled with both metformin and sulfonylurea; however, the effectiveness and safety of this combination is unknown. This study was a 24-week, international, multicenter, randomized, double-blind, parallel-group, placebo-controlled, phase IIIb study, designed to evaluate the efficacy and safety of dapagliflozin compared to placebo in uncontrolled type 2 diabetic patients with metformin and sulfonylurea combination therapy. The study population included 219 patients more than 18 years of age and inadequate glycemic control (HbA1C ≥ 7.0% and ≤ 10.5%). They were randomly assigned to either dapagliflozin 10 mg group or a placebo group, along with metformin and a sulfonylurea. HbA1C levels were measured at baseline and after 24 weeks of treatment. The primary end point was change of HbA1C levels from baseline to week 24. Key secondary end points included change from baseline to week 24 in FPG, total body weight, proportion of patients having HbA1C < 7%, and change from baseline to week 8 in SBP. Statistical tests included ANCOVA and last observation carried forward (LOCF) approach. At the end of the study, patients treated with dapagliflozin demonstrated significant improvements in glycemic control compared to patients with placebo. HbA1c levels were significantly lower in dapagliflozin group compared to placebo group, with a decrease of 0.86% and 0.17% from baseline levels, respectively (p-value < 0.0001). Continue reading >>

Diabetes (mellitus, Type 1 And Type 2) (cont.)

Diabetes (mellitus, Type 1 And Type 2) (cont.)

A A A Various treatments exist for diabetes. Type 1 diabetes is treated with insulin (by multiple daily injections or pump), diabetic diet, and other lifestyle modifications. Type 2 diabetes is generally treated with diabetic diet, lifestyle changes such as moderate to vigorous exercise, and medication(s). If a person has diabetes, healthful lifestyle choices in diet, exercise, sleep, and other habits will help improve glycemic (blood sugar) control and prevent or minimize complications from diabetes. Diabetes diet: A healthy diet is key to controlling blood sugar levels and preventing diabetes complications. If the patient is obese and has had difficulty losing weight on their own, talk to a health-care professional. He or she can recommend a dietitian or a weight-modification program to help the patient reach a goal. Eat a consistent, well-balanced diet that is high in fiber, low in saturated fat, and low in concentrated sweets. A consistent diet that includes roughly the same number of calories at about the same times of day helps the health-care professional prescribe the correct dose of medication or insulin. A healthy diet also helps to keep blood sugar at a relatively even level and avoids excessively low or high blood sugar levels, which can be dangerous and even life-threatening. Exercise: Regular exercise, in any form, can help reduce the risk of developing diabetes. Activity can also reduce the risk of developing complications of diabetes such as heart disease, stroke, kidney failure, blindness, and leg ulcers. As little as 20 minutes of walking three times a week has a proven beneficial effect. Any exercise is beneficial. No matter how easy or how long, some exercise is better than no exercise. If the patient has complications of diabetes (such as eye, kidne Continue reading >>

The Top Diabetes Treatment Options For Better Blood Sugar Control

The Top Diabetes Treatment Options For Better Blood Sugar Control

There are some health conditions that can be managed by simply taking a pill — but type 2 diabetes isn’t one of them. Diabetes is a complex condition that often requires lifestyle changes and sometimes additional treatment that can help keep your blood sugar level under control. For some people, making healthful lifestyle changes can be enough to gain control over their blood sugar level. For others, taking medication may also be necessary. There are many drug options available, and the initial approach might need to be tweaked as treatment progresses. How Type 2 Diabetes Can Be Treated Through Diet and Lifestyle Changes The first approach to managing diabetes usually means practicing healthier lifestyle habits. This is often centered on eating a better diet, getting exercise, and losing weight if necessary. If your doctor says that you need to make these changes, it’s smart to tailor them to your personal preferences so that you'll be more likely to stick with them. “First, I ask people about their exercise patterns and about what they like to eat, and try to get an idea about what might be improved,” says endocrinologist William Sivitz, MD, a professor of internal medicine at the University of Iowa Carver College of Medicine in Iowa City. Dr. Sivitz emphasizes the importance of being active, eating a healthy diet, and having a good understanding of the role that carbohydrates play. He recommends eating healthy carbs, such as nonstarchy vegetables, fruits, legumes, whole grains, and nonfat dairy products. A certified diabetes educator or a registered dietitian can help personalize your diet and teach you strategies to control your blood sugar. Depending on your desired blood sugar range and weight loss goals, recommendations for foods, carbohydrate intake, an Continue reading >>

Treatment Options For Type 2 Diabetes

Treatment Options For Type 2 Diabetes

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Treatments For Diabetes

Treatments For Diabetes

Type 2 diabetes has a number of drug treatment options to be taken by mouth known as oral antihyperglycemic drugs or oral hypoglycemic drugs. Oral diabetes drugs are usually reserved for use only after lifestyle measures have been unsuccessful in lowering glucose levels to the target of an HbA1c below 7.0%, achieved through an average glucose reading of around 8.3-8.9 mmol/L (around 150-160 mg/dL).1-3 The lifestyle measures that are critical to type 2 diabetes management are diet and exercise, and these remain an important part of treatment when pills are added.2,3 People with type 1 diabetes cannot use oral pills for treatment, and must instead take insulin. How do oral drugs lower glucose levels? Oral antihyperglycemic drugs have three modes of action to reduce blood glucose levels:3 Secretagogues enhance insulin secretion by the pancreas Sensitizers increase the sensitivity of the peripheral tissues to insulin Inhibitors impair gastrointestinal absorption of glucose. Each class of antihyperglycemic drug has a different adverse event or safety profile, and side effects are the main consideration when it comes to choosing a medication. Possible side effects range from weight gain, through gastrointestinal ones such as diarrhea, to pancreatitis and more serious problems. Hypoglycemia is also a possible adverse event.2 What oral drugs are available for type 2 diabetes? No one particular choice of oral hypoglycemic is considered the most effective form of treatment - the decision over which drug to use is instead based on:1-3 Consideration of the adverse side effects Convenience and overall tolerability Personal preference. In reality, weighing up each drug is something to do in partnership with a prescriber - guidelines partly drawn up by the American Diabetes Associatio Continue reading >>

Type 2 Diabetes Treatment

Type 2 Diabetes Treatment

Although diabetes cannot be cured, it can be treated successfully. If a high blood sugar level is brought down to a normal level, your symptoms will ease. You still have some risk of complications in the long term if your blood glucose level remains even mildly high - even if you have no symptoms in the short term. However, studies have shown that people who have better glucose control have fewer complications (such as heart disease or eye problems) compared with those people who have poorer control of their glucose level. Therefore, the main aims of treatment are: To keep your blood glucose level as near normal as possible. To reduce any other risk factors that may increase your risk of developing complications. In particular, to lower your blood pressure if it is high and to keep your blood lipids (cholesterol) low. To detect any complications as early as possible. Treatment can prevent or delay some complications from becoming worse. Type 2 diabetes is usually initially treated by following a healthy diet, losing weight if you are overweight, and having regular physical activity. If lifestyle advice does not control your blood sugar (glucose) levels then medicines are used to help lower your blood glucose levels. One medicine (usually metformin) is used first but two or even three medicines may be needed. Most of the medicines for type 2 diabetes are given in tablet form. However, some people with type 2 diabetes need insulin injections to help control blood glucose levels. Some people gain a great deal of benefit from insulin injections and these are sometimes used fairly soon after the diagnosis of type 2 diabetes has been made. Insulin injections can be used in combination with other medicines to further improve glucose control. Lifestyle - diet, weight control an Continue reading >>

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