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Exercise
Exercise helps tower blood glucose and increases insulin sensitivity, it also helps lower blood pressure, improve cholesterol levels, decrease body fat and reduce the risk of cardiovascular disease. Aerobic exercise is best. Regular exercise even of moderate intensity, improves insulin sensitivity. Patients who are taking medications that lower blood glucose, particularly insulin, should take special precautions before embarking on a workout program. Because diabetics may have silent heart disease, they should always check with their physicians before undertaking vigorous exercise.
Monitoring Blood Glucose
Patients should aim for pre–meal glucose levels of between 80 and 120 and bedtime levels of between 100 and 140. Usually, a drop of blood obtained by pricking the finger is applied to a chemically treated strip. The glucose level is read on a standard meter or a small, portable digital device.
Medication
Insulin lowers blood sugar levels.
People with type 1 diabetes require multiple daily insulin injections for survival.
People with type 2 diabetes may require oral hypoglycaemic drugs to lower their blood sugar and some may need insulin injections at some point.
It is important to achieve the right balance of the above elements. Too much or too little of either can impact upon how you feel. Achieving this balance is a life–long commitment on the part of the person with diabetes.
Studies undertaken in the United Kingdom by the National Institute of Diabetes and Digestive and Kidney Diseases (DCCT) and the Diabetes Trial Unit at Oxford University (UKPDS) have shown conclusively that effective control of blood glucose in an effort to keep blood sugar levels as close to normal as possible is beneficial in preventing and delaying the progression of complications of diabetes. The results showed that good control of blood sugar and blood pressure led to massive reductions in the development of complications:
- Up to a 76% reduction in the risk of developing eye disease.
- Up to a 50% reduction in the risk of developing kidney disease.
- Up to a 60% reduction in the risk of developing nerve disease.
- More than a 33% reduction in strokes.
- Up to a 33% reduction in death from long–term complications.
As the developing world is expected to bear the brunt of the escalating diabetes epidemic in the future, diabetes prevention is proving especially urgent and difficult in developing countries.
In most developing countries, health policies and services need to put more emphasis on non–communicable diseases such as diabetes, but in many of these countries (as well as in developed ones) decision–makers lack awareness of diabetes and the political will to invest in prevention.
The resources required for future research need to be found. Standards in diabetes monitoring and surveillance need to be set in countries where progress has been limited.
