In the treatment of diabetes, there are five basic principles:
- balanced diet
- physical activity
- education of patients
- self-monitoring of glucose in blood and urine
- medicines for the treatment of diabetes
Diabetic diet has an important role in the treatment of all types of diabetes. The diet should be distributed in 3 main meals and 2-3 snacks a day, which should be taken regularly, as recommended. When selecting foods, it should be achieved that in the daily food intake there are 50-60% of carbohydrates (and foods that do not cause a sudden and prolonged increase in blood glucose - legumes, some types of pasta, rice, while the concentrated sugars are not recommended) , about 30% of fats, (up to 10% of food rich in saturated fats - animal fats: butter, grease, dairy products, eggs, meat - that cause atherosclerosis, and about 20% of food rich in unsaturated fatty acids - fats of plant origin - olive, soybean, pumpkin, corn oil, margarine, almonds, hazelnuts, peanuts - which contain essential fatty acids, which are necessary for metabolism), and 15-20% of proteins (animal products - meat, fish, milk, eggs, or proteins of plant origin - beans, green peas, broad beans, soy beans, mushrooms). Calculation of daily calorie intake is determined individually according to body mass index (BMI) (weight in kilograms divided by height in meters squared). Alcohol has a high calorific value, and has the adverse effect on fat metabolism, can cause side effects when taken simultaneously with drugs, and should not be consumed by people with diabetes.
Physical activity is very important in the treatment of diabetes because it improves blood circulation, increases the consumption of glucose in the muscles up to 20 times compared to muscles at rest, and increases the number of receptors for the use of glucose in cells. It also increases the use of fat, reduces the level of fat in the blood, thus reducing the development of atherosclerosis.
Education of patients
Through education on diabetes, people with diabetes more easily and more completely accept the disease; the education on diet, physical activity, self-control and treatment certainly provides better control of blood sugar levels.
Self-monitoring of blood glucose
Self- monitoring of blood glucose, and glucose and ketones in urine, using a sensitive test strips and devices enables the frequent checks of blood glucose values at all times, several times a day, in order to produce the necessary correction of treatment, in order to better control blood sugar. Without regular self-monitoring of blood glucose there is no quality control of blood glucose, or the satisfactory treatment. Today it is considered necessary to determine the blood sugar levels at least twice a day, and in certain periods of time (before breakfast, two hours after breakfast, before lunch, two hours after lunch, before dinner, two hours after dinner, before bed, and at 3 am ), so that during several days the blood glucose profile is formed.
Treatment of type 2 diabetes
Treatment of type 2 diabetes is achieved by oral antidiabetic agents (tablets), insulin, or a combination of tablets and insulin.
When diet and exercise do not achieve satisfactory control of blood glucose, then the treatment with oral antidiabetic agents (tablets) is included. Oral antidiabetics act in different ways, and it is therefore possible to combine them in order to better control diabetes. Some act in the intestine, slowing down and reducing food absorption from the intestines, others increase the secretion of insulin from beta cells of the pancreatic islets, the third decrease the production and release of glucose from the liver, and reduce insulin resistance. Inclusion of one or more drugs at the same time, and the drug dosage is determined by the physician - a diabetes specialist.
Insulin is used to treat patients suffering from type 1 diabetes, but also from type 2, when the maximum dose of oral antidiabetics cannot achieve satisfactory control of blood sugar. Insulin is used to treat patients who have acute complications caused by diabetes, and coma, patients who have some other illnesses (infection, surgery), and patients in whom beta cells in the pancreas are destroyed (due to surgery, chronic inflammation, tumors). Pregnant women with diabetes should be treated with insulin. Types of insulin are divided into short-acting insulin (rapid onset and short period of action), long-acting insulin (delayed onset and long period of action - from 16 to 24 hours) and premixed insulin - insulin combination of the two in various proportions. Insulin in the treatment of diabetes type 2 is administered in single or multiple doses, alone or in combination with oral antidiabetic agents (tablets). All methods of treating diabetes have one goal- good control of diabetes and prevention of diabetic complications. Living with diabetes is not easy; patients are forced to sacrifice a lot, and to change their lifestyle. Complications lead to permanent disabilities and increased mortality, and with the increase in the number of patients, diabetes is becoming a global health problem.