Treatment and Management. Part 2

The medical management of Type 2 diabetes has changed dramatically over the recent years. Several new oral medications have been released on the market, providing more treatment options. Sulfonylureas are a group of drugs that stimulate the release of insulin from the pancreas. Medications in this category include Glucotrol, Microase and Amaryl.

Thiazolidenediones are another group of drugs that increase insulin sensitivity and effectiveness. Alpha-glucosidase inhibitors include a variety of medications that have an effect on the glucose in the body.

Precose (also called Acarbose) delays the absorption of glucose by the intestine. A beta cell sensitizer, called Prandin, causes insulin release upon exposure to elevations in blood sugar. Phenformin (or Metformin) reduces production of glucose by the liver.

The choice of medication depends upon each individual’s needs. It is important to know that all diabetic medications are not interchangeable.

In addition, it is very important to know the name, dose, frequency and side effects of the medication being prescribed. When some of these drugs are used, it is necessary to monitor liver and kidney functions periodically.

The diabetic diet is designed to meet nutritional needs, to maintain normal blood glucose and weight, and to promote growth and development in children.

Its principles are based upon the food pyramid. The composition of the diabetic diet is 55 to 60 percent complex carbohydrates, 20 percent protein, and 20 percent or less fat.
The cholesterol level also must be controlled and a decrease in salt may be necessary for patients with high blood pressure.

It also is important to eat meals at regular times, especially if insulin is used. A nutritional assessment and diet education by a registered dietician are ideal; individualized meal plans are best.

Exercise also is an important component of diabetes therapy. Exercise utilizes blood glucose and makes the body more sensitive to insulin, making it more effective.

People with diabetes should discuss exercise options with their physician. An exercise physiologist may be consulted to determine which exercise is best for the individual. In some patients, a stress test may be warranted before beginning an exercise program.

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