http://stopdiabeteslie.blogspot.com/ MANAGING DIABETES MELLITUS

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MANAGING DIABETES MELLITUS
Controlling your diabetes mellitus begins by learning how to manage your
blood sugar levels. In conjunction with a healthy lifestyle and regular exercise,
there are many other steps you can take to regulate your blood sugar levels
and reduce the risk of complications.
Learning how to manage diabetes may seem like a challenge to you at the outset. You
may feel insecure about how best to control your blood sugar, or you may have trouble
identifying when it is high because you do not necessarily have to feel different.
There are three important steps that can help control your glucose levels:
1. Monitor closely your blood glucose levels so that you can respond to any
changes;
2. Take the medication you have been prescribed;
3. Opt for healthier eating and increase your physical activity.
This section is intended to help you keep your blood glucose within the range of normal
reference values, which may prevent long-term complications. If you understand what
causes your blood sugar levels to change and if you learn how to respond to those
variations, you will feel confident in controlling your diabetes.

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MANAGING DIABETES MELLITUS BEGINS HERE:
 Preparation of Consuta
 Control glycemic changes
 Collaborate with your doctor
 Treating Type 2 Diabetes
 Medication for Type 2 Diabetes
PREPARING THE CONSULTATION
An important step for anyone with Diabetes is the preparation of the consultation. It is
essential that you feel an active part in the management of Diabetes and learn more
about it so you know better how to control it. Discuss with your healthcare team what
you can do at the level of self-monitoring and surveillance and clarify all your questions.
POINTS YOU MAY WANT TO DISCUSS WITH YOUR
PHYSICIAN
 The results of your blood and urine tests.
 Problems resulting from very high or very low glycemic levels, including the symptoms
you may have and what to do about them.
 Your medication - when to take it and how to adjust it if necessary.

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 Your food plan and what kind of food you eat, as well as the difficulties you feel about
certain foods.
 All situations that may interfere with your day-to-day management of Diabetes, such
as school, work, travel, etc.
 Questions you want to go deeper into or any point you need help with.
WHAT TO DO TO PREPARE FOR CONSULTATION
 If you want to address specific issues, you should do so early in the
consultation. Already during the consultation, whenever you have any questions do
not hesitate to ask - this is the ideal time to clarify it!
 If there is any aspect of your treatment plan that is not working well, try to find out the
reasons for it.
 Take with you all records regarding diet, exercise and glycemic levels, as well as your
Diabetes Diary.
 Always keep track of the medication you are currently taking, even if the doctor in
question has prescribed all medication. It is important to record the name, dosage and
number of tablets you take, and at what times. If you are afraid of forgetting
something, take the entire boxes of the medications you are currently taking (do not
just take the "caps", as you often cut the "wrong" cap, that is, the one that does not
have the name of the Drug or dosage).
 Take with you all the exams you have done between appointments - these may or
may not be important to your doctor, but it is preferable to have more than less. If you
have been hospitalized, it is very important to take the discharge you were given
when you left the hospital.
CONTROLLING BLOOD SUGAR CHANGES
UNDERSTAND THE REFERENCE RANGES OF
BLOOD GLUCOSE (BLOOD SUGAR)
According to the International Diabetes Federation, for most people with diabetes,
normal blood glucose values are as follows:

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Fasting (plasma fasting glucose): less than 110 mg / dL
After meals (plasma glucose postprandial): less than 145 mg / dL
It should not be below 80 mg / dL at any time of the day. When the values are below 70
mg / dL, we speak of hypoglycemia or "low sugar", a situation that can be dangerous
and is to be avoided.
Talk to your doctor about the range of blood glucose reference values that is most
suitable for you.
HIGH BLOOD GLUCOSE LEVELS
When your blood glucose is high (hyperglycemia) may experience any of these
symptoms: dry mouth, thirst, frequent urination, fatigue and blurred vision . If you
experience any of these symptoms, immediately confirm your blood glucose values.
Uncontrolled increases in blood glucose levels may be due to overeating, being less
active than usual, not feeling well, being stressed, or needing an adjustment in diabetes
medication.
LOW BLOOD GLUCOSE LEVELS
Low blood glucose values are usually caused by eating less or later than usual, being
more active than usual or being on medication that does not match your needs. Consult
your doctor whenever you experience episodes of low blood glucose. It is also very
important to recognize the symptoms of hypoglycemia and to know how to effectively
control it.
When your blood sugar is low, you may experience nervousness, tremors, sweating
more than usual or fatigue . Symptoms may be mild at first, but may worsen rapidly if
left untreated. If you have hypoglycaemia, confirm your values immediately. If the level
of blood glucose is below 70 mg / dL , or immediately ingest a carbohydrate drink such
as a fruit juice cup 3 glucose tablets or lozenges 5 or 6. You may need to repeat the
treatment in the next 15 to 20 minutes if the values have not increased. Waiting for
values to increase spontaneously or waiting to act is not safe.
Your family and friends and colleagues should be aware that as a patient with diabetes,
you are at risk for episodes of hypoglycaemia.
See the truth about diabetes that doctor never tell you.

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HOW IT CAN HELP PREVENT SUDDEN CHANGES IN
BLOOD SUGAR:
 Keep your routine and daily meal and exercise times as much as possible, and be
sure to take your medication.
 Check your blood glucose levels as you have been taught and share the records with
your doctor.
 Set goals for weight, physical activity, blood glucose and HbA1C with your doctor.
 Use an object that tells other people who are suffering from diabetes, in case of an
emergency, such as a wire or a bracelet.
 Always have carbohydrates (such as sweets or sugar packets) to treat hypoglycaemia
at any time ("low sugar").
Consult your doctor if you frequently experience high or low blood glucose levels. You
may need to review and make some changes to your diet, physical activity, or diabetes
medication.
COLLABORATE WITH YOUR DOCTOR
It is important to establish a good relationship with your doctor and other healthcare
team as this will be a crucial source of support and guidance in managing your
diabetes. Working with your doctor can help you determine if your blood sugar levels
are under control and together can identify areas for better diabetes management.

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At each visit, your doctor will do routine blood tests or evaluate your blood glucose
measurements ("finger prick") between appointments to help monitor your blood
glucose levels.
 Plasma fasting glucose (also called FPG) is the level of blood glucose after at least
8 hours without eating. This test is usually done early in the morning upon waking.
 Postprandial plasma glucose (also called postprandial glucose) is the level of blood
glucose after a meal. You can tell this value by doing the capillary glycemia ("finger
prick") an hour and a half to two hours after the start of the meal.
 Hemoglobin A1c (HbA1c) is a measurement that indicates your average blood
glucose level over the previous 2 to 3 months.
To help reduce the risk of complications, your doctor will also monitor your blood
pressure, your cholesterol level, and your weight.
GET THE MOST OUT OF EVERY MEDICAL
APPOINTMENT
It is important to be prepared with your daily blood glucose records so that you can
review the values with your doctor. Each consultation should be an opportunity to:
 Review how often your blood glucose was higher or lower than the reference value
 Discuss whether you have taken your medication correctly and whether it is producing
the intended effects
 Get advice on healthy eating
 Get advice on the proper ways to exercise
 Talk about how you feel and the challenges you face
 Ask questions about immunizations (for example, about the flu vaccine)
Additionally, write down any questions you may have in advance and make sure you
have obtained the necessary clarification for each of the following areas:
 HbA1c analyzes and blood glucose monitoring
 Blood pressure
 Cholesterol
 Complications (eg, kidney damage, heart disease)
 Nutrition
 Physical activity
 Family, friends and feelings
 Where can you find more information about your diabetes

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TREATING TYPE 2 DIABETES
Many people need treatment to help manage their diabetes, and with so many
options available, it's important that you feel comfortable and confident about
the medications that are prescribed for you.
Along with a healthy lifestyle, diabetes treatment can be an important component in
controlling your diabetes.
A wide variety of treatment options are available to help control type 2 diabetes. It is
important to know how these different medications help regulate blood sugar levels so
that you can discuss with your doctor what the Most appropriate for you.
FINDING THE RIGHT TREATMENT STARTS HERE:
MEDICATION FOR TYPE 2 DIABETES
Some people can keep their blood sugar controlled by simply adopting a
healthier lifestyle. However, if you need the additional help of diabetes
medications, this section will help you understand what treatment options are
right for you.

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DIABETES MANAGEMENT OPTIONS
The first step in the treatment of type 2 diabetes is often a calorically restricted diet,
abstaining from simple sugars, weight loss and increased physical activity. However,
these measures are not always sufficient to lower your blood sugar levels to the
reference values.
ADVANTAGES OF TREATMENT
There are several treatment options available for people with type 2 diabetes. These
medicines work differently to lower blood glucose levels. Your doctor will tell you what
type of medicine is right for you.
Several treatment options available for the treatment of type 2 diabetes:
 Biguanides: Essentially, reduce the amount of glucose produced by the liver
 Inhibitors of DPP-4 and GLP 1: Induce glucose lowering, increasing the amount
of insulin produced by the pancreas and reducing the amount of sugar produced in the
liver
 Insulin: An injectable hormone that replaces the insulin normally produced by
the body to help control blood glucose levels
 Alpha glucosidase inhibitors: After meals, slow down decomposition and
absorption of carbohydrates
 Sulfonylureas and meglitinides: directly stimulate the pancreas to release
insulin
 Glitazones (also known as TZDs or Thiazolidinediones): Essentially help the
body to use the insulin and glucose transport to the interior of cells
This diagram shows where each of the mentioned medicines acts in the body:

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Adjuvant oral therapy
as treatment options mentioned above act differently to lower blood glucose levels, are
often prescribed together. If a single medication does not produce the desired effects,
your doctor may combine two or more medications to help improve glycemic control.
Weight Gain
The weight increase may be a side effect of taking some of the drugs mentioned
above. If this is of concern to you, you should discuss the matter with your doctor so
that he or she can adjust your medication accordingly. And remember that you do not
have to settle for weight gain as part of your diabetes treatment. There are measures
that can help to counteract the weight gain

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