November 22, 2014
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Diabetes

 Health Home >> Diabetes >> Diagnosis and treatment of diabetes 


Your Care Plan: Diabetes

Condition description

Diabetes is a condition of elevated blood glucose (sugars) where the body does not produce enough insulin to meet the body's needs or the body does not respond properly to the insulin being made. The food you eat provides the body with glucose, which is used by the cells as a source of energy. Insulin is an important hormone that enables glucose to move into cells. If insulin isn't available or doesn't work correctly to move glucose from the blood into cells, glucose will stay in the blood. High blood glucose levels are toxic and cells that don't get glucose are lacking the fuel they need.

First visit to your health care provider

To determine whether you have diabetes, your physician or primary health care provider will ask you about your symptoms (such as weight loss, thirst, and frequent urination) and perform some simple blood tests to diagnose diabetes. Your health care provider will also ask about your medical and family history. Your health care provider may order or perform the tests described below. Most people with diabetes can be cared for by their family physician, but in some cases you may be referred to another primary health care provider, such as a dietitian, diabetes educator, or endocrinologist.

Tests

There are a number of tests that your health care provider may perform or order, such as:

  • blood sugar tests:
    • fasting plasma glucose (FPG): measures blood sugar when you have not had anything to eat for at least 8 to 10 hours
    • random plasma glucose: measures blood sugar at a random time
    • oral glucose tolerance test (OGTT) : measures your blood sugar at fasting and 2 hours after you drink a 75 g carbohydrate drink
    • A1C: a measurement that reflects the average blood sugar level in your blood over the last 2 to 3 months
  • physical exam
  • cholesterol test
  • blood pressure test
  • kidney function tests

Treatment goals

The main goals of treatment are to:

  • control diabetes symptoms
  • maintain a high quality of life
  • keep blood sugars as close to a normal range as possible
  • prevent hypoglycemia
  • prevent or lower the risk of diabetes-related complications (such as eye, kidney, or heart damage or foot problems)
  • to control other health-related conditions such as high blood pressure and high cholesterol

Treatment

There are two main types of diabetes, and treatment depends on the type of diabetes you have:

In Type 1 diabetes, which is more common in children and where the body does not make any insulin, the usual treatment is insulin injections. There are different types of insulin that differ in how fast they act and how long they last. Your physician or primary health care provider will recommend an insulin regimen that fits your needs. For young children, the family will need to learn how to give the insulin injections, and will need to communicate with the child's school about their treatment plan.

In Type 2 diabetes, which is more common in adults and where the body does not make enough insulin or does not respond properly to the insulin that is being made, the usual treatment is healthy lifestyle changes (such as healthy eating and exercise ), medications taken by mouth or by injection (if lifestyle changes are not enough to control blood sugar), or insulin therapy (if lifestyle changes and other medications are not enough to control blood sugar).

Follow-up and monitoring

Your health care provider will recommend that you:

  • monitor your blood sugar levels using a blood glucose meter:
    • at least 3 times a day if you have type 1 or type 2 diabetes and are using insulin more than once a day
    • at least once a day if you have type 2 diabetes and are using insulin once a day
    • as directed by your doctor if you have type 2 diabetes and are not using insulin
  • have your A1C levels tested every 3 months (or every 6 months if your blood sugar is consistently controlled)
  • watch for symptoms of low blood sugar (fatigue, hunger, confusion, shakiness, irritability) or high blood sugar (thirst, blurred vision, frequent urination), and note when and how often they occur
  • check your feet every day for cuts, bruises, sores, swelling, or redness

Your health care provider may also regularly test your weight, blood pressure, kidney function, eyes, and cholesterol levels to watch for signs that you may be at risk of heart, eye, or kidney disease caused by diabetes.

Your health care provider will schedule regular follow-up appointments to see how your treatment plan is working. You should also see your physician or primary health care provider if:

  • you're having trouble keeping your blood sugar under control (your blood sugar tends to spike and drop very frequently)
  • you think you may be having side effects from your medication
  • you're not sure how to use your medication
  • you think you may have a complication from diabetes, such as a foot sore, eye problems, or heart problems

What's next?

You will need to keep monitoring your blood sugars and sharing your results with your health care team on a regular basis. Lifestyle changes such as diet and exercise are very important. You may need adjustments to your medications in order to keep your blood sugars in a healthy range. Your physician or primary health care provider may also recommend regular testing and follow-up to monitor your risk of diabetes-related problems such as heart, eye, and kidney disease, or foot problems.


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