Diabetes Treatment & Cure
Can diabetes be cured?
This question is uppermost in the minds of all diabetics. The claims of 'cure for diabetes' are completely unfounded. Once diabetes develops, it persists and cure is not possible, at least at present. At times, the disease may be so mild that the person may not need either insulin or tablets or even marked dietetic restrictions. This is called a remission and not a cure. Although diabetes cannot be cured, it can be controlled and a well controlled diabetic can look forward to a normal or a near normal life for many years.
Aims of Treatment of Diabetes
- To eliminate complaints like thirst, weakness, excess of urine, weight loss, itching of the vulva. This is not difficult and can be achieved in a few days.
- To prevent the short-term and long-term complications of diabetes.
The altered blood chemistry of uncontrolled diabetes damages the blood vessels and the nerves in the long run giving rise to the long-term complications of diabetes and hence, has to be corrected. A child with diabetes should have normal physical and psychological development. As the blood glucose level is brought and maintained within a normal range, episodes of mild or an occasional hypoglycaemia {low blood glucose) reaction are inevitable. But severe and frequent hypoglycaemia should be avoided especially in a person living alone. Above all, a person with diabetes should have a sense of well-being and should be able to lead a full life.
Why is control of diabetes important?
A person with poorly controlled diabetes is prone to develop infection besides developing other complications. A child or an adolescent with uncontrolled diabetes does not have a normal growth. Tight control of diabetes is absolutely essential for the successful outcome of pregnancy. Surgery is hazardous when diabetes is out of control. A poorly controlled diabetic especially type 1 is likely to slip into diabetic coma. The chances of developing long-term complications are more when diabetes is uncontrolled.
How is diabetes controlled?
All persons with diabetes need a suitable diet. In the case of many, especially those with an excess weight, diabetes can be controlled by diet alone. In addition to diet, some need insulin and others can be treated with oral drugs. A combination of insulin and oral drugs may be useful at times. Exercise is an important part of the treatment of diabetes. All diabetics, their parents or spouses should understand the nature of this ailment and its implications and cooperate intelligently with their doctor. The details of treatment vary from person to person and in the same person from time to time.
Psychological adjustment to diabetes
Anxiety, anger, a sense of panic or frustration arc common when diabetes is detected for the first time. "Why me?", "Will my lifestyle change?", "Will I be able to continue with my job?" are some questions that haunt newly diagnosed diabetics. Some just ignore the disease. Others try their own ideas of effecting a cure. It is very essential that a person with diabetes, comes to terms with this condition and approaches the disease objectively. The earlier it is done the better. A sense of purpose and motivation are essential for the successful treatment of diabetes.
How to assess control of diabetes?
A person with well controlled diabetes does not have complaints like thirst, excess of urine or weakness. A person with diabetes, should weigh himself/herself at regular intervals, at the same time in the same type of clothes on a reliable scale. An estimate of blood glucose level at least once in two or three months is essential. The HbAl test gives a retrospective idea of control of diabetes. Blood glucose monitoring at home has helped many people considerably in controlling diabetes. A well controlled diabetic does not experience severe hypoglycaemia very frequently, has a sense of well-being and is able to lead a full and an active life, consistent with his/her age and physical state.
The targets of management vary from person to person and even in the same person from time to time, according to his/her age, associated conditions, life expectancy and social circumstances. While a pregnant diabetic should aim at a strict control of diabetes, one should be satisfied if symptoms of diabetes are relieved, hypoglycaemia is avoided and blood glucose levels are within reasonable limits in an elderly person, especially one who is living alone,
Criteria of optimal management of diabetes.
| Blood glucose | Fasting below 100 mg per cent 2 hrs after meats below 140 mg per cent |
| Glycated hemoglobin | Within normal range |
| Total Scrum Cholesterol | than 200 mg/dl |
| Serum LDL Cholesterol | less than 100 mg/dl |
| Serum triglycerides | less than 150 mg/dl |
| Body weight | normal |
| Blood pressure mm of Hg | 130/85 or below |
| Tobacco | nil |
| Exercise | at least 5 days in a week |
Regular Check-ups
Regular check-ups are necessary to ensure control of diabetes, to detect its complications and to adjust the dose of anti-diabetic drugs and diet.
At every visit to the clinic, a diabetic should carry the following: a file of test reports, a record of blood glucose tests, usual syringe and insulin vials if he/she is on insulin and the latest prescription of medicines.
Possibilities when the control of diabetes deteriorates
| Neglect of diet- festivals, weddings, travel |
| Omission of exercise-rainy season, laziness |
| Obesity |
| Errors hi medication, technique of insulin injection, dosage, timings. |
| Infection |
| Other drugs which increase blood glucose level |
| Failure of drugs, effective initially. |
| Pregnancy |
| Development of other diseases which increase blood glucose level |
Diabetic Clinics
The value of diabetic clinics in the management of diabetes is well-established. Here, a diabetic can have the services of a physician, eye specialist, nurse educator, a dietician, podiatrist, laboratory and other specialists, all at one place. Diabetic clinics have contributed a great deal to the education of diabetics and research in diabetes. Unfortunately, diabetic clinics arc functioning only in a few cities in India.