Adherence to Long-Term Therapies - Evidence for Action
(2003; 211 pages) View the PDF document
Table of Contents
View the documentPreface
View the documentAcknowledgements
View the documentScientific writers
View the documentIntroduction
View the documentTake-home messages
Open this folder and view contentsSection I - Setting the scene
Open this folder and view contentsSection II - Improving adherence rates: guidance for countries
Close this folderSection III - Disease-Specific Reviews
Open this folder and view contentsChapter VII - Asthma
Open this folder and view contentsChapter VIII - Cancer (Palliative care)
Open this folder and view contentsChapter IX - Depression
Close this folderChapter X - Diabetes
View the document1. Introduction
View the document2. Treatment of diabetes
View the document3. Definition of adherence
View the document4. Prevalence of adherence to recommendations for diabetes treatment
View the document5. Correlates of adherence
View the document6. Interventions
View the document7. Methodological and conceptual issues in research on adherence to treatment for diabetes
View the document8. Conclusions
View the document9. References
Open this folder and view contentsChapter XI - Epilepsy
Open this folder and view contentsChapter XII - Human immunodeficiency virus and acquired immunodeficiency syndrome
Open this folder and view contentsChapter XIII - Hypertension
Open this folder and view contentsChapter XIV - Tobacco smoking cessation
Open this folder and view contentsChapter XV - Tuberculosis
Open this folder and view contentsAnnexes
Open this folder and view contentsWhere to find a copy of this book
 

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).

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