Diabetes Treatment (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is the treatment for diabetes?
- Medications for type 2 diabetes
- Meglitinides - (Prandin and Starlix)
- Medications that decrease the amount of glucose produced by the liver
- Medications that increase glucose excretion by the kidney
- Medications that increase the sensitivity of cells to insulin (Actos and Avandia)
- Medications that decrease the absorption of carbohydrates from the intestine (Precose)
- Medications that affect glycemic control (Symlin, Byetta, Victoza, Bydureon)
- DPP-IV inhibitors
- Combination medications
- Treatment of diabetes with insulin
- Different methods of delivering insulin
- Pre-filled insulin pens
- Insulin pump
- Inhaled Insulin
- Intranasal, Transderm
- Diabetes diet
- The future of pancreas transplantation
- Find a local Endocrinologist in your town
Inhaled insulin, marketed by Pfizer in 2006, was approved by the FDA. This inhaled form of insulin was called Exubera. Acceptance of Exubera was poor over the after it was introduced, and it was subsequently discontinued in October 2007.
Other routes for the delivery of insulin have also been tried. Intranasal insulin delivery was thought to be promising. However, this method was associated with poor absorption and nasal irritation. Transdermal insulin (skin patch delivery) has also yielded disappointing results to date. Insulin in pill form is also not yet effective since the digestive enzymes in the gut break it down.
Proper nutrition is essential for anyone living with diabetes. Control of blood glucose levels is only one goal of a healthy eating plan for people with diabetes. A diet for those with diabetes should also help achieve and maintain a normal body weight as well as prevent heart and vascular disease, which are frequent complications of diabetes.
There is no prescribed diet plan for those with diabetes. Rather, eating plans are tailored to fit an individual's needs, schedules, and eating habits. A diabetes diet plan must also be balanced with the intake of insulin and oral diabetes medications. In general, the principles of a healthy diabetes diet are the same for everyone. Consumption of a variety of foods including whole grains, fruits, non-fat dairy products, beans, and lean meats or vegetarian substitutes, poultry and fish is recommended to achieve a healthy diet.
Many experts, including the American Diabetes Association, recommend that 50% to 60% of daily calories come from carbohydrates, 12% to 20% from protein, and no more than 30% from fat. People with diabetes may also benefit from eating small meals throughout the day instead of eating one or two heavy meals. No foods are absolutely forbidden for people with diabetes, and attention to portion control and advance meal planning can help people with diabetes enjoy the same meals as others in the family.
Some people with diabetes will benefit from using specific methods to help follow a diabetes meal plan. None of these diet plans is required for people with diabetes, but many people will find one them useful. Some of these ways include:
- Rating your plate is a meal planning system based upon portion size. Imaginary lines are used to divide a meal plate into two halves, and one half is further divided into fourths. One-fourth of the plate should contain grains/starches, one-fourth should contain protein, and the remaining half should contain non-starchy vegetables.
- Exchange lists help in the planning of balanced meals by grouping together foods that have similar carbohydrate, protein, fat, and calorie content. Meal planning exchange lists have been published by The American Dietetic Association and the American Diabetes Association.
- Carbohydrate counting is based upon the total carbohydrate intake (measured in grams) of foods.
- Glycemic Index ranks carbohydrates according to the effects they have on blood sugar levels.
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