(2003; 211 pages)
2. Treatment of diabetes
The goals of diabetes treatment are to keep blood glucose levels as near normal as possible while avoiding acute and chronic complications (7,18). Because the normal homeostatic control mechanisms are disrupted in patients with diabetes, food intake, emotional stress and changes in physical activity can cause blood glucose to become too low or too high leading to the acute complications of hypoglycaemia or hyperglycaemia. In addition, inappropriate nutrition and insufficient physical activity increase the risk of developing the long-term complications of diabetes, especially heart disease. Keeping blood glucose within a target range requires feedback in the form of self-monitoring of blood glucose. Patients with type 1 diabetes must carefully balance food intake, insulin and physical activity. Patients with type 2 diabetes are often prescribed oral medications that increase insulin production, decrease insulin resistance, or block carbohydrate absorption and may have to take exogenous insulin to achieve adequate metabolic control. Because improved metabolic control ends the spilling of glucose in the urine, patients who do not reduce their food intake will gain weight thus increasing insulin resistance, risk for heart disease and other obesity-related complications (19,20).