Diabetes Treatment

Type 1 Diabetes

Type 1 diabetes is managed with insulin replacement through lifelong insulin injections (up to 6 every day), by following a healthy diet and eating plan, taking regular exercise and monitoring of blood glucose levels regularly (up to 6 times every day or as directed by a doctor or Credentialled Diabetes Educator).

Type 2 Diabetes

The aim of treatment of type 2 diabetes is normal blood glucose levels (normoglycaemia). Healthy eating is a critical component in the management of type 1 and type 2 diabetes. In over 50% of people presenting with type 2 diabetes restriction of energy intake, increased activity and weight reduction will initially normalise blood glucose levels. Unless the patient is very symptomatic (blood glucose level >20 mmol/L), a trial of at least 6 to 8 weeks of lifestyle modification is wise before oral hypoglycaemic agents are considered.

Insulin may be needed early in the condition when treatment is being started (the so-called ‘primary’ failure of oral hypoglycaemic agents that suggests the patient actually has type 1 diabetes) or when the patient has later become refractory to oral hypoglycaemic agents (so-called ‘secondary’ failure consistent with the usual progression of type 2 diabetes). However, ensure that exercise and dietary management are satisfactory and exacerbating factors eg: intercurrent infection, problems with medication (e.g. non-adherence & drug interactions) have been excluded.

References:

1. Diabetes Australia and the Royal Australian College of General Practitioners, Diabetes Management in General Practice, 16th Edition 2010/11, Diabetes Australia, 2010.
2. Diabetes Australia, March 2011.
3. Caring for Diabetes in Children and Adolescents, Third Edition, 2010. Online Version, The Children's Hospital at Westmead and the Royal Children's Hospital, Melbourne.