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Controlling diabetes

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How is diabetes controlled?
Type 1 diabetes is controlled through doses of insulin and a diet and exercise program. Since the body cannot make its own insulin, it must be introduced through an insulin pump or an injection. The dose, frequency and type of insulin you need depend on your blood glucose levels.

Insulin is most effective when combined with a healthy, balanced diet. Food and insulin directly affect your blood glucose levels. If your diet or insulin doses are out of balance, your blood sugar level can become too high or too low. Your doctor may recommend working with a dietitian or nutritionist to plan healthy meals that are diabetic-friendly. Exercise also plays a role in controlling blood glucose levels. Physical activity helps burn excess calories and fat, and keeps your weight down. If you have Type 1 diabetes, your doctor may caution you about strenuous or vigorous exercise. Your doctor can let you know what exercises are best for your condition.

Type 2 diabetes is generally controlled through diet and exercise. If you are overweight, weight reduction is also recommended. You may be prescribed certain medications to control your cholesterol and blood pressure levels.

For patients with either Type 1 or Type 2 diabetes, your doctor may have you monitor your blood sugar levels through a self-testing meter and record your levels throughout the day. A member of your health care team can instruct you on how to use the meter and give you guidelines as to what your target glucose levels should be. Recording your levels is an important activity in managing your diabetes. You and your doctor will be able to see how your body is reacting to food, exercise or medication. This record can give your doctor an idea of how well your treatment plan is working and whether or not there needs to be adjustments made.

What are the treatments for diabetes?
The primary treatment for Type 1 diabetes is insulin. Because the body cannot produce insulin, it must be introduced manually–either through an insulin pump or an injection. Your doctor will also recommend a diet and exercise program for you to follow.

Type 2 diabetes is treated through diet and exercise. Insulin is rarely needed, but certain medications that can affect your body’s response to insulin or glucose can be prescribed. These medications are used when controlling your blood sugar through diet and exercise has failed.

Both types of diabetes require a healthy, balanced diet and moderate exercise. Each patient has unique needs; your health care team can design the most effective and appropriate treatment plan for you.

How can I tell if my treatment is effective?
In addition to monitoring your own glucose levels with a self-testing meter, your doctor can perform what is called a hemoglobin A1C test (also known as a glycated hemoglobin or hbA1c test).

This test gives you an average of your blood glucose levels over a period of 2-3 months. This can give you a good idea of how well your diabetes treatment is working. You should have an A1C test at least twice a year (minimum). Your doctor will determine how often you should have an A1C test.

How many people in the U.S. have diabetes?
In the U.S., approximately 18 million people have diabetes. Of this number, 10.3 million people have been diagnosed with this disease and an estimated 5.4 million are undiagnosed. 90% of these people have Type 2 diabetes, and the remaining 10% have Type 1 diabetes.

Where can I learn more about diabetes?
Your doctor and health care team can answer any questions you may have about diabetes. There are also several organizations online that provide information and support to diabetics.

The American Diabetes Association (http://www.diabetes.org) has in-depth articles about research, prevention and treatment of this disease.

The National Institute of Diabetes & Digestive & Kidney Diseases (http://www.niddk.nih.gov) has an educational program called the National Diabetes Education Program (http://www.ndep.nih.gov). This program has several publications about controlling, managing and caring for your diabetes. These publications are available for download or mail order.