Insulin is an anabolic hormone released from the pancreatic islet beta cells in response to a rise in blood glucose levels. By facilitating glucose uptake into cells it keeps blood glucose within tightly controlled limits.
Type 2 diabetes represents a heterogeneous group comprising a milder form of hyper glycaemia that occurs predominantly in adults and occasionally in juveniles. This pathology is a chronic disease with a strong family predisposition. This is frequently associated with a time consuming, painful and very intrusive treatment. Also it comes with a reduced life expectancy often punctuated by metabolic catastrophes and frightful complications.
Nowadays there is unequivocal evidence that optimizing the control of blood sugar reduces the risk of developing diabetic complications. The essence of management is to bring this about with minimal disruption to the diabetics lifestyle. Part of this risk reduction is achieved by addressing the patients blood glucose directly and by educating the patient to adopt a lifestyle that is compatible with this condition.
In addition to controlling the blood glucose, the risks of macro vascular disease is minimized by treating hypertension and hyperlipidaemia aggressively by ensuring that the patients are not passive or active cigarette smokers and in post menopausal women oestrogen should be replaced.
The strategy should consist of a negotiated settlement between the doctor and the patient.
In many cases the clinical diagnosis of diabetes is obvious and can be confirmed readily by a single random test of urine, which is important and by a blood glucose test. However Glycosuria (sugar in the urine) is not a diagnostic of diabetes mellitus as the absence of sugar in the urine does not exclude diabetes.
A check up from the doctor to evaluate the right parameter is essential in order to prevent the risk factors such as:
as well as the most common complications such as:
Diet is another must in order to stabilize the pathology. The emphasis should be on a balanced diet of good whole food with complex carbohydrates such as:
These should make up at least 50% of the calorie intake.
Quick fixes of readily absorbed sugar should be avoided; however, if the odd surreptitious chocolate bar is enough to make the patient stop smoking, make them take his anti-hypertensive medication as prescribed by the doctor, then the pay-off is worthwhile.
It is a priority for the doctor to optimise the metabolic control and minimise the complications, without forcing the patient to sacrifice what they consider to be an acceptable lifestyle.