How is diabetes treated? There are certain things that everyone who has diabetes, whether type 1 or type 2, needs to do to be healthy. They need to have a meal (eating) plan. They need to pay attention to how much physical activity they engage in, because physical activity can help the body use insulin better so it can convert glucose into energy for cells. Everyone with type 1 diabetes, and some people with type 2 diabetes, also need to take insulin injections. Some people with type 2 diabetes take pills called "oral agents" which help their bodies produce more insulin and/or use the insulin it is producing better. Some people with type 2 diabetes can manage their disease without medication by appropriate meal planning and adequate physical activity. Everyone who has diabetes should be seen at least once every six months by a diabetes specialist (an endocrinologist or a diabetologist). He or she should also be seen periodically by other members of a diabetes treatment team, including a diabetes nurse educator, and a dietitian who will help develop a meal plan for the individual. Ideally, one should also see an exercise physiologist for help in developing a physical activity plan, and, perhaps, a social worker, psychologist or other mental health professional for help with the stresses and challenges of living with a chronic disease. Everyone who has diabetes should have regular eye exams (once a year) by an ophthalmologist to make sure that any eye problems associated with diabetes are caught early and treated before they become serious. Also, people with diabetes need to learn how to monitor their blood glucose. Daily testing will help determine how well their meal plan, activity plan, and medication are working to keep blood glucose levels in a normal range. What other problems can diabetes cause? Your healthcare team will encourage you to follow your meal plan and exercise program, use your medications and monitor your blood glucose regularly to keep your blood glucose in as normal a range as possible as much of the time as possible. Why is this so important? Because poorly managed diabetes can lead to a host of long-term complications — among these are heart attacks, strokes, blindness, kidney failure, and blood vessel disease that may require an amputation, nerve damage, and impotence in men. Avoiding the Long-Term Complications of Diabetes How can one avoid the serious complications that diabetes can cause? The message from several very large studies is clear. Whether you have type 1 or type 2 diabetes, you should work with your healthcare providers to achieve blood glucose levels as close to normal as possible to reduce the risks of long-term complications. Some people discover that, despite their best efforts, their diabetes is so difficult to manage that they can’t achieve the type of control they want. And despite their hard work, other people still develop complications. This can be very discouraging. But remember, by doing the best job you can with your diabetes day-to-day, you are lowering your risks of developing further complications later on, and you are slowing the progress of complications that may be just beginning. Controlling blood glucose is the first step, but diabetes affects the whole body including blood vessels and nerves. Therefore, controlling cholesterol and blood pressure can decrease risks for complications even more! Your healthcare provider will perform the following tests, but then you need to learn the results of the tests and what they mean. A1C – A blood test that measures average blood glucose over the past 2 to 3 months and is the best way to measure overall glucose control. It should be measured 2 to 4 times a year with a goal of less than 7%. Blood pressure – Measures the pressure against the walls of your blood vessels. High blood pressure is more common in persons with diabetes and increases risk of stroke, heart attack, kidney and eye diseases. It should be measured at every visit, or at least once a year, with a goal of 130/80 mm Hg or lower. Cholesterol – A blood test that measures the amount of fat (lipid) circulating in your blood stream. LDL cholesterol can clog the walls of the arteries but if caught early, can be treated. Blood fats (lipids) should be tested once a year with an LDL cholesterol goal of at least less than 100 mg/dl, and in people who are at high risk, such as those with diabetes and coronary heart disease, the LDL goal is now recommended to be 70 mg/dl. Further, the HDL cholesterol goal should be greater than 40 mg/dl for men and 50 mg/dl for women; the total cholesterol goal should be less than 200 mg/dl; and the triglyceride goal should be less than 150 mg/dl. Medications can be used to lower your cholesterol if needed, along with a meal plan low in saturated and trans fat. Microalbumin – A urine test that measures how well your kidneys are working. If you catch problems early, they can be treated. Microalbumin measures small amounts of protein in the urine and should be measured at least once a year with a goal of less than 30 micrograms per milligram creatinine. Medications called ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers) can help control microalbumin and blood pressure. Eye exam –To protect your eyes you should have a dilated eye exam every year. Drops will be put in your eyes to dilate your pupils. This makes it easier to see inside your whole eye. Medications or laser surgery can stop problems from getting worse, reduce the risk of vision loss, and in some cases restore useful vision. Foot exam – Remove your shoes and socks for a foot check at each appointment with your healthcare provider. Check your feet daily to prevent problems. Content provided by Joslin Diabetes Center. To learn more about diabetes, or to find a Joslin Diabetes Center Affiliated Center near you, please visit www.joslin.org Copyright © 2007 by Joslin Diabetes Center. All rights reserved. All materials contained on these pages are protected by United States copyright law and may be used for personal, noncommercial use only. Materials from these pages may not be reproduced, distributed, transmitted, displayed or published without the prior written permission of Joslin Diabetes Center (617-226-5815). You may not alter or remove any trademark, copyright or other notice from copies of the content.     *NO PURCHASE NECESSARY. Sweepstakes ends 4/1/07. 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