Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
The major goal in treating diabetes is to minimize any elevation of blood
sugar (glucose) without causing abnormally low levels of blood sugar. Type 1
diabetes is treated with insulin, exercise, and a
diabetic diet. Type 2 diabetes
is treated first with weight reduction, a diabetic diet, and exercise. When
these measures fail to control the elevated blood sugars, oral medications are
used. If oral medications are still insufficient, treatment with insulin is
Adherence to a diabetic diet is an important aspect of controlling elevated
blood sugar in patients with diabetes. The American Diabetes Association (ADA)
has provided guidelines for a diabetic diet. The ADA diet is a balanced,
nutritious diet that is low in fat, cholesterol, and simple sugars. The total
daily calories are evenly divided into three meals. In the past two years, the
ADA has lifted the absolute ban on simple sugars. Small amounts of simple sugars
are allowed when consumed with a complex meal.
Weight reduction and exercise are important treatments for diabetes. Weight
reduction and exercise increase the body's sensitivity to insulin, thus helping
to control blood sugar elevations.
WARNING: All the information below applies to patients who are not pregnant or breastfeeding. At present the only recommended way of controlling diabetes in women who are pregnant or breastfeeding is by diet, exercise and insulin therapy. You should speak with your doctor if you are taking these medications and are considering becoming pregnant or if you have become pregnant while taking these medications.
Based on what is known, medications for type 2 diabetes are designed to:
increase the insulin output by the pancreas,
decrease the amount of glucose released from the liver,
increase the sensitivity (response) of cells to insulin,
decrease the absorption of carbohydrates from the intestine, and
slow emptying of the stomach to delay the presentation of carbohydrates for digestion and absorption in the small intestine.
When selecting therapy for type 2 diabetes, consideration should be given to:
the magnitude of change in blood sugar control that each medication will provide;
issues that may affect compliance (timing of medication, frequency of dosing); and
cost to the patient and the health care system.
It's important to remember that if a drug can provide more than one benefit (lower blood sugar and have a beneficial effect on cholesterol, for example), it should be preferred. It's also important to bear in mind that the cost of drug therapy is relatively small compared to the cost of managing the long-term complications associated with poorly controlled diabetes.
Varying combinations of medications also are used to correct abnormally elevated levels of blood glucose in diabetes. As the list of medications continues to expand, treatment options for type 2 diabetes can be better tailored to meet an individual's needs. Not every patient with type 2 diabetes will benefit from every drug, and not every drug is suitable for each patient. Patients with type 2 diabetes should work closely with their physicians to achieve an approach that provides the greatest benefits while minimizing risks.
Patients with diabetes should never forget the importance of diet and exercise. The control of diabetes starts with a healthy lifestyle regardless of what medications are being used.
Proper nutrition is essential for anyone living with diabetes. Control of blood glucose levels is only one goal of a healthy eating plan for people with diabetes. A diet for those with diabetes should also help achieve and maintain a normal body weight as well as prevent heart and vascular disease, which are frequent complications of diabetes.
There is no prescribed diet plan for those with diabetes. Rather, eating plans are tailored to fit an individual's needs, schedules, and eating habits. A diabetes diet plan must also be balanced with the intake of insulin and oral diabetes medications. In general, the principles of a healthy diabetes diet are the same for everyone. Consumption of a variety of foods including whole grains, fruits, non-fat dairy products, beans, and lean meats or vegetarian substitutes, poultry and fish is recommended to achieve a healthy diet.
Some people with diabetes will benefit from using specific methods to help follow a diabetes meal plan. None of these diet plans is required for people with diabetes, but many people will find one them useful. Some of these ways include:...