Prevention and Management of Diabetes
A number of studies have shown that regular physical activity can significantly reduce the risk of developing type 2 diabetes. It also appears to be associated with obesity. Researchers are making progress in identifying the exact genetics and "triggers" that predispose some individuals to develop type 1 diabetes, but prevention, as well as a cure, remains elusive.
In response to the growing health burden of diabetes mellitus (diabetes), the diabetes community has three choices: prevent diabetes; cure diabetes; and take better care of people with diabetes to prevent devastating complications. The US Department of Health and Human Services is actively pursuing all three approaches.
Both the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) are involved in prevention activities. The NIH is involved in research to cure both type 1 and type 2 diabetes, especially type 1. CDC focuses most of its programs on being sure that the proven science is put into daily practice for people with diabetes. The basic idea is that if all the important research and science are not made meaningful in the daily lives of people with diabetes, then the research is, in essence, wasted.
Pancreas transplantation
Islet cell transplantation (islet cells produce insulin)
Artificial pancreas development Genetic manipulation (fat or muscle cells that don't normally make insulin have a human insulin gene inserted - then these "pseudo" islet cells are transplanted into people with type 1 diabetes).
Each of these approaches still has a lot of challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas.
Today, injections or inhalations of insulin are the basic therapy for type 1 diabetes. Insulin injections involve the patient or a caregiver injecting insulin one or more times a day just below the skin or involve the administration of insulin by an automated pump. Insulin is also available in an inhaled form that is preferred by most diabetics. Insulin therapy must be balanced with meals and daily activities, and glucose levels must be closely monitored through frequent blood sugar testing.
Diet, exercise, and blood testing for glucose are also the basis for management of type 2 diabetes. In addition, some people with type 2 diabetes take oral drugs or insulin to lower their blood glucose levels. People with diabetes must take responsibility for their day-to-day care. Much of the daily care involves trying to keep blood sugar levels from going too low or too high. When blood sugar levels drop too low--a condition known as hypoglycemia--a person can become nervous, shaky, and confused. Judgment can be impaired. Eventually, the person could pass out. The treatment for low blood sugar is to eat or drink something with sugar in it.
On the other hand, a person can become very ill if blood sugar levels rise too high, a condition known as hyperglycemia. Hypoglycemia and hyperglycemia, which can occur in people with type 1 diabetes or type 2 diabetes, are both potentially life-threatening emergencies. People with diabetes should have a healthcare professional who provides primary care for them and who monitors their diabetes control and checks for complications. Doctors who specialize in diabetes are called endocrinologists or diabetologists. In addition, people with diabetes often see ophthalmologists for eye examinations, podiatrists for routine foot care, dietitians for help in planning meals, and diabetes educators for instruction in day-to-day care.
The goal of diabetes management is to keep blood glucose levels as close to the normal (nondiabetic) range as safely possible. The recent 10-year study, the Diabetes Control and Complications Trial (DCCT) sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), proved that keeping blood sugar levels as close to normal as safely possible reduces the risk of developing major complications of diabetes. Researchers believe that DCCT findings have important implications for the treatment of type 2 diabetes, as well as type 1 diabetes.
