Treatment and Management of Diabetes

Treatment for diabetes:

Specific treatment for diabetes will be determined by your physician based on:

• your age, overall health, and medical history
• type of diabetes
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Treatment may include:

• type 1 diabetes
  Persons with type 1 diabetes no longer produce insulin, and they must have insulin injections to use the glucose they obtain from eating.
  
  Persons with type 1 diabetes must give themselves insulin every day. Insulin can either be injected, which involves the use of a needle and syringe, or it can be given by an external or internal insulin pump, insulin pen, jet injector, or insulin patch. Extra amounts of insulin may be taken before meals, depending on the blood glucose level and food to be eaten.
  
  Insulin currently cannot be taken as a pill. Because it is a protein, it would be broken down during digestion just like the protein in food. It must be injected into the fat under the skin for insulin to get into the blood.

  However, new pharmaceutical materials and techniques have been developed that can protect insulin from being broken down in the digestive tract. The first human trials of oral insulin were reported in 2006. Phase I clinical trials have shown insulin given in a gel capsule to be safe and effective. Clinical trials will continue as the medication moves through the federal approval process.

  In addition, an inhaled form of insulin has recently become available. Exubera®, which is insulin delivered through an inhaler, was approved by the US Food and Drug Administration (FDA) in early 2006. Studies found that portable inhalers, similar to what persons with asthma use for their condition, were both an effective and convenient way to administer insulin. The ease of using insulin through an inhaler has the potential to make a dramatic impact on the health of millions with the disease.

  The amount of insulin needed depends on height, weight, age, food intake, and activity level. Insulin doses must be balanced with meal times and activities, and dosage levels can be affected by illness, stress, or unexpected events.

• type 2 diabetes
  Although persons with type 2 diabetes may continue to produce adequate insulin for some time, their bodies can become incapable of using it. This syndrome is know as insulin resistance, and may indicate the need for oral medications that can help stimulate the pancreas to release insulin or optimize the body's ability to use the insulin secreted.

• Diet and exercise can often bring blood glucose levels down to normal. When these measures are no longer enough, the next step is the addition of medications that lower blood glucose levels.

There are many considerations a person with diabetes must take in order to properly manage his/her condition. Listed in the directory below are some, for which we have provided a brief overview.

If you cannot find the information in which you are interested, please visit the Diabetes Online Resources page in this Web site for an Internet/World Wide Web address that may contain additional information on that topic.

© 2007 Montefiore Medical Center