Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco. Control of blood pressure and maintaining proper foot care are important for people with the disease. Type 1 DM must be managed with insulin injections. Type 2 DM may be treated with medications with or without insulin. Insulin and some oral medications can cause low blood sugar. Weight loss surgery in those with obesity is sometimes an effective measure in those with type 2 DM. Gestational diabetes usually resolves after the birth of the baby.
In 2003, ephedrine -- also known as ma huang -- became the first herbal stimulant ever banned by the FDA. It was a popular component of over-the-counter weight loss drugs. Ephedrine had some benefits, but it could cause far more harm, especially in high doses: insomnia (difficulty falling and staying asleep), high blood pressure, glaucoma, and urinary retention. This herbal supplement has also been associated with numerous cases of stroke.
But as I write in my forthcoming book, The Good Neighbor: The Life and Work of Fred Rogers, Rogers’s placidity belied the intense care he took in shaping each episode of his program. He insisted that every word, whether spoken by a person or a puppet, be scrutinized closely, because he knew that children—the preschool-age boys and girls who made up the core of his audience—tend to hear things literally.
Insulin serves as a “key” to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy. Without insulin, there is no “key.” So, the sugar stays -- and builds up-- in the blood. The result: the body’s cells starve from the lack of glucose. And, if left untreated, the high level of “blood sugar” can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death.
Acetaminophen, aspirin, ibuprofen, or naproxen can ease mild to moderate pain caused by diabetic nerve damage, says Kimberly Sackheim, DO, a clinical assistant professor of rehabilitation medicine at NYU Langone Medical Center's Rusk Rehabilitation. "But speak with your physician if you take them regularly," she says. Some of these drugs may raise your risk of heart attack, stroke, or kidney damage.
To explain what hemoglobin A1c is, think in simple terms. Sugar sticks, and when it's around for a long time, it's harder to get it off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die off. When sugar sticks to these hemoglobin proteins in these cells, it is known as glycosylated hemoglobin or hemoglobin A1c (HBA1c). Measurement of HBA1c gives us an idea of how much sugar is present in the bloodstream for the preceding three months. In most labs, the normal range is 4%-5.9 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it's less than 7.0% (optimal is <6.5%). The benefits of measuring A1c is that is gives a more reasonable and stable view of what's happening over the course of time (three months), and the value does not vary as much as finger stick blood sugar measurements. There is a direct correlation between A1c levels and average blood sugar levels as follows.
McInnes, N., Smith, A., Otto, R., Vandermey, J., Punthakee, Z., Sherifali, D., … Gerstein, H. C. (2017, March 15). Piloting a remission strategy in type 2 diabetes: Results of a randomized controlled trial. The Journal of Clinical Endocrinology and Metabolism, 2016-3373. Retrieved from https://academic.oup.com/jcem/article-abstract/doi/10.1210/jc.2016-3373/3070517/Piloting-a-Remission-Strategy-in-Type-2-Diabetes?redirectedFrom=fulltext
While there is currently no cure for diabetes, researchers are hopeful for advancements. A 2017 pilot study may provide hope for a diabetes cure in the future. Researchers found that an intensive metabolic intervention, combining personalized exercise routines, strict diet, and glucose-controlling drugs could achieve partial or complete remission in 40 percent of patients, who were then able to stop their medication. More comprehensive studies are in the pipeline.
Powerful drugs like oxycodone (Oxycontin) and the opioid-like medicine tramadol (Conzip, Ultram) can treat much stronger pain. But these tend to be a last resort for pain relief. You might use these medications if other treatments aren’t working. However, these drugs aren’t meant for long-term relief because of side effects and the potential for addiction. Work closely with your doctor and use caution when taking opioid medicines.
In 1991, the National Institutes of Health issued a consensus statement, cautiously recommending surgery as a treatment for people living with morbid obesity, meaning they have a body mass index, or BMI, over 40. For people who have health complications connected to obesity, such as type 2 diabetes, the limit goes down to a BMI of 35. Relying on these guidelines, insurance companies and public payers like Medicaid and Medicare typically only cover surgery for people living with diabetes who fall into that category.
Strengthening muscles eases pressure on the joints and tendons. It also gives you a greater sense of control, which really helps people deal with pain. Stretching to increase your flexibility can also be helpful for pain relief, when done as part of a regular exercise routine. Walking, sitting, and moving with good posture and balance can take pressure off tender muscles and nerves. You may want to consult a physical therapist to find exercises that are right for you.
Abnormal cholesterol and triglyceride levels. If you have low levels of high-density lipoprotein (HDL), or "good," cholesterol, your risk of type 2 diabetes is higher. Triglycerides are another type of fat carried in the blood. People with high levels of triglycerides have an increased risk of type 2 diabetes. Your doctor can let you know what your cholesterol and triglyceride levels are.