Diabetes Treatment (cont.)
Robert Ferry Jr., MD
Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.
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.
In this Article
- Diabetes treatment facts
- What is the treatment for diabetes?
- Medications for type 2 diabetes
- Meglitinides (Prandin and Starlix)
- Metformin (Glucophage)
- Canagliflozin (Invokana) and dapagliflozin (Farxiga)
- Thiazolidinediones: pioglitazone (Actos) and rosiglitazone (Avandia)
- Acarbose (Precose)
- Pramlintide (Symlin)
- Exenatide (Byetta)
- Liraglutide (Victoza)
- Long-acting exenatide (Bydureon)
- Albiglutide (Tanzeum)
- Dulaglutide (Trulicity)
- DPP-IV inhibitors (sitagliptin, saxagliptin, linagliptin)
- Combination medications
- Treatment of diabetes with insulin
- Different methods of delivering insulin
- Diabetes diet
- The future of pancreas transplantation
- Find a local Endocrinologist in your town
Proper nutrition is essential for all diabetic individuals. Control of blood glucose levels is only one goal of a healthy eating plan for diabetic people. A diabetic diet helps achieve and maintain a normal body weight, while preventing the common cardiac and vascular complications of diabetes.
There is no prescribed diet plan for diabetes. Eating plans are tailored to fit each individual's needs, schedules, and eating habits. Each diabetes diet plan must 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 various foods in a healthy diet includes whole grains, fruits, non-fat dairy products, beans, lean meats, vegetarian substitutes, poultry or fish.
The American Diabetes Association and many experts 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 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. Attention to portion control and advance meal planning can help people with diabetes enjoy the same meals as everyone else.
Many people with diabetes benefit from using specific methods to help follow a diabetes meal plan. Some of these approaches 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. The American Dietetic Association and the American Diabetes Association have published exchange lists to plan meals.
- 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, based on their rate of absorption.
The future of pancreas transplantation
Ultimately, the goal for managing type 1 diabetes is to provide insulin therapy in a manner that mimics the natural pancreas. Perhaps the closest therapy available at this time is a pancreas transplant. Several approaches to pancreatic transplantation are currently being studied, including the whole pancreas and isolated islet cells. Islets are clusters of cells that contain the beta-cells responsible for insulin production. Almost 8,000 patients underwent pancreatic transplantation by 1995 Most patients who undergo pancreatic transplantation do so at the time of kidney transplantation for diabetic kidney disease.
Transplantation carries significant risk. Both the surgery itself and the ongoing immunosuppression that must follow pose significant risks. For these reasons, the kidney and pancreas are usually transplanted at the same time. At present, controversy exists about whole pancreas transplantation for patients' not currently requiring kidney transplantation. The issue under debate is whether the benefits outweigh the risks. Diabetes usually relapses after pancreas transplant. Selectively transplanting islet cells has been an emerging alternative to whole pancreas transplantation, but concern over rejection remains. Attempts are underway to disguise islets in tissues that the body won't reject, for example, by surrounding the islet cells with the patient's own cells before implanting them. Researchers are exploring artificial barriers to surround the islets and protect against rejection, yet still allow insulin to enter the bloodstream.
These last few years have been exciting times in diabetes care. Many agents for treating type 2 diabetes are under development. Options for insulin therapy and methods for insulin delivery continue to expand and refine. While research continues across multiple areas, one thing remains constant. Achieving the best blood sugar control possible remains the ultimate goal in all people with diabetes. Without doubt, good blood sugar control minimizes the serious long-term complications of diabetes, including blindness, nerve damage, and kidney damage. Finally, a healthy lifestyle always helps and must remain the cornerstone of diabetes management.
American Diabetes Association.
FDA prescribing information.
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