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.
- Diabetes Australia and the Royal Australian College of General Practitioners, Diabetes Management in General Practice, 16th Edition 2010/11, Diabetes Australia, 2010.
- Diabetes Australia, March 2011.
- 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.