Treatment of diabetes can be challenging. But believe it or not, there is some good news!

Think about diabetes, and you might think about the risk of complications-the heart disease; kidney failure, vision loss and foot problems that could result from damaged blood vessels and nerves. This risk increases if high blood pressure or high cholesterol levels are also present.

But instead; think about this: The treatment of diabetes has greatly progressed over the last decade. Now, many people can prevent and even reverse diabetic complications. How? By pairing lifestyle changes with the right kinds of medication.

Type matters  in Diabetes Disease

In type 1 diabetes the pancreas fails to produce insulin, a hormone that helps remove glucose from the blood so that cells can use it for energy. In type 2 diabetes, the body becomes resistant to the insulin the pancreas produces. This is called insulin resistance. Later in type 2 diabetes, the pancreas may stop making insulin altogether.

Type 2 of diabetes is more common than type 1.

The right treatment for diabetes depends on the type you have and the stage. With type 1, you will need to take insulin to supply your body with what it cannot produce itself. With type 2, treatment starts with helping your body more effectively use the insulin it does make. Later, insulin also may be needed to replace what your body can no longer make.

People who suffer from diabetes should wear some form of identification, such as a diabetes alert -necklace, to ensure proper treatment in case of a medical emergency.

Getting at the source

The first stage of treating type 2 diabetes includes changes that help you get at the source of your condition: insulin resistance. To start, proper diet and exercise are a must! For many people, this alone will get blood sugar back within a safe range. For people who need extra help numerous types of oral medicine are avail­able. Medications that work differently are often combined to have a stronger effect on blood sugar levels:

Biguanides (Glucophage) decrease the amount of glucose your liver makes and help your body respond better to insulin.

Sulfonylureas (Amaryl, DiaBeta, Diabinese, Dymelor, Gluco­troll, Glynase, Micronase, Orinase, Tolinase) stimulate your pancreas to increase insulin production and help your body use insulin more efficiently.

• Alpha -glucosidase inhibitors (Glyset, Precose) delay how fast your body absorbs carbohydrates.

• Thiazolidinediones (Actos, Avandia) make your body more sensitive to the insulin it is producing.

D-phenylalanine derivatives (Starlix) and meglitinides (Prandin) help your pancreas make more insulin following meals.

Testing, testing . . .

To keep close tabs on your blood sugar, use your blood glucose meter regularly. Over time, this will give you a good sense of how your body responds to food, beverages and the medicines you’re taking, as well as other things that can affect blood sugar, such as exercise, stress and illness.

When and how often you should test your blood sugar will depend on your situation and what your doctor recommends. You may need to test your blood sugar when you have fasted, such as in the morning before breakfast and one to two hours after eating (this is called post-prandial glucose), as well as at other times.

Be sure to ask your doctor about a Hemoglobin A1C test. This test evaluates how well your blood glucose levels have been controlled over a period of several months. It reflects your fasting, post-prandial and other glucose levels over time- giving a good measurement of overall control.

Regular testing can help you maintain good control of blood sugar levels, and good control may help you avoid complications.

Insulin to the rescue

Insulin is part of the first tier of treatment for people with type 1 diabetes, along with a healthy diet and exercise. But if you have type 2 diabetes and you aren’t able to control your blood sugar with diet, exercise and oral medications, you also may need insulin.

Different types of insulin are available and have various rates of action. Some work very fast (within 15 mlnutes) but last only three to four hours. At the other end of the spectrum, some types of insulin don’t kick in for four to six hours after taking them, but they keep working for 24 hours or more. All types of insulin require injection by syringe, or the use of an insulin pen or pump.

Often, people with diabetes use more than one type of insulin and also take oral diabetes medications. With all of the treat­ment options available, you and your doctor can find the right mix for you.

Other treatments  options of Diabetes

Recently, doctors have discovered that many other medicines used in combination with oral diabetes drugs and insulin can boost protection against complications, regardless of the type of diabetes you have.

Aspirin can greatly reduce the risk of cardiovascular disease.

ACE inhibitors and angiotensin receptor blockers (ARBs) reduce blood pressure. High blood pressure is especially dangerous for people with diabetes because it puts added stress on your heart and blood vessels. But these drugs can help protect your heart and kidneys if you have diabetes –even if you don’t have high blood pressure.

Statins reduce cholesterol –particularly important because high cholesterol damages and narrows blood vessels. The recommended level of low-density lipoprotein (LDL) cholesterol for people with diabetes is less than 100 mg/dL, the same as for people who have had heart attacks. But even if you don’t have high cholesterol, statins may still help: They appear to change an inflammatory reaction in blood vessels, which may lower the risk of vessel damage associated with diabetes.

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