Diabetes includes many different metabolic disorders and problems, which can cause serious damage to health if there is an unusually high concentration of glucose in the blood. Diabetes mellitus type 1 results when the pancreas does not produce a significant amount of hormone insulin, usually due to the autoimmune destruction of beta cells of the insulin-producing pancreas. Diabetes mellitus type 2, on the contrary, is now considered as a result of autoimmune attacks on the pancreas and/or insulin resistance. The person with type 2 diabetes can produce large amounts of insulin in normal or unusually large quantities. Other forms of diabetes mellitus, such as the beginning of the maturation of the young, can represent some variation of diabetes, inadequate insulin production and some combination of insulin resistance. Some degree of insulin resistance can also exist in type 1 diabetes.
The main goal of diabetes management is to restore carbohydrate metabolism in a normal condition, as far as possible. In order to achieve this goal, people with complete depletion of insulin need insulin replacement therapy, which is given through injection or insulin pumps. On the contrary, insulin resistance can be cured by dietary modifications and exercise. Other goals of diabetes management are to prevent or cure many complications, which can be caused by illness and its treatment.
The goals of treatment are related to the effective control of blood sugar, blood pressure and lipid in reducing the risk of long-term consequences associated with diabetes. They have been suggested in the clinical practice guidelines issued by various National and International Diabetes Agencies.
The goals are:
• HbA1c of less than 6% or 7.0%
• Preprandial blood glucose: 3.9 to 7.2 mmol/L (70 to 130 mg/dl)
• two-hour postprandial blood glucose: <10 mmol/L (<180 mg/dl)
Among the older patients, the Clinical Practice Guideline by the American Geriatrics Society states "For older adults, people with an estimated age of 5 years, and others who take advantage of intensive glycemic control risks, a lower goal The target is 8% HbA1c is appropriate ".
The primary requirement for management is the glucose cycle. In this, the glucose cells in the bloodstream are made available in the body; A process enters the bloodstream on the twin chakras of glucose, and insulin allows proper uplift in body cells. Management may be required for both aspects. Another issue that is associated with the glucose cycle, the balanced amount of glucose is being given to the main organs so that they are not negatively affected.
Daily glucose and insulin cycle The main complications are derived from the nature of the feedback loop of the glucose cycle, which is tried to regulate:
• Glucose cycle is a system that is affected by two factors: the entry of glucose in the bloodstream and the level of blood insulin to control the flow of blood
• As a system, it is sensitive to diet and exercise
• It is influenced by the need for the anticipation of the user due to the complex effects of the time delay between related activity and any effect on the glucose system.
• Management is highly intrusive, and compliance is an issue, because it depends on the change in the user's lifestyle, and often in regular cases to take sampling and measure blood sugar level, in many cases many times a day.
• As people grow and grow, it varies.
• It is highly personal
Since diabetes is a major risk factor for cardiovascular disease, therefore controlling other risk factors which can lead to secondary conditions, as well as diabetes is also one of the aspects of diabetes management. Checking levels of cholesterol, LDL, HDL, and triglyceride can be a sign of hyperlipoproteinemia, which can treat with hypolipidemic drugs. To check blood pressure and keep it within strict limits (using diet and antihypertensive treatment) protects against diabetes retina, kidney, and cardiac complications. Podiatrists or other foot health experts are encouraged to stop developing regular follow-up diabetic foot. The annual eye examination is recommended for monitoring for the progress of diabetic retinopathy