Diagnostic Studies and Medical Treatments For Diabetes

Diagnosis is based on a blood test that measures blood glucose levels. Elevated blood glucose doesn't necessarily indicate diabetes, but it does call for more extensive testing. In general, a diagnosis is established if two separate blood tests, done after fasting for eight hours, show glucose levels of 140 milligrams of glucose per deciliter of blood (mg/dI). In borderline cases, a glucose challenge test may be ordered. This involves measuring glucose after fasting, and again after drinking sugar water.

Medical Treatments

There is no cure for either type of diabetes, but the disease can be controlled with a combination of therapies. People with Type I need regular insulin injections and a special diet and exercise regimen. They must also measure their own blood sugar . Most people with Type II diabetes can control it with just diet and exercise, especially if they lose weight. In fact, studies show that weight loss alone can produce normal blood glucose levels in more than 80 percent of overweight Type II patients. Others may need oral hypoglycemics to increase insulin production and its effectiveness. These drugs include chlorpropamide (Diabinese), glipizide (GlucotroI), glyburide (Diageta and Micronase), tolbutamide (Orinase), and tolazamide (Tolinase). Patients with both types of diabetes require extra medical care and should establish a close working relationship with a specialist, usually an internist or endocrinologist. Because diabetes affects especial

y the heart, blood vessels, kidneys, nerves, and eyes, other specialists may be needed.

For example, an ophthalmologist should be seen at least every 6 to 12 months to check for diabetic retinopathy, a disorder in which blood vessels in the retina overgrow and rupture. If unchecked, this bleeding can lead to blindness. Cardiovascular complications, such as high blood pressure and coronary artery disease, are particularly common in diabetes. A significant number of patients develop kidney failure, and require dialysis or a kidney transplant. Reduced circulation to the legs and feet may lead to the need for vascular surgery or even amputation. There is, however, good news for the 13 million Americans who have diabetes. A layear study showed that maintaining normal blood sugar levels dramatically slows the progression of complications. More doctors are now encouraging diabetic patients to follow a regimen that maintains blood glucose levels as near to normal as possible. This involves frequent glucose monitoring (at least four times a day), adjustment of insulin or other medication dosages, changes in exercise patterns,and alteration of the timing, frequency, md content of meals and snacks. To make insulin injections easier, :here is now an insulin pump, which is carried in a pocket or worn on a belt. It can be programmed to administer small amounts of insulin at specific times through a syringe left in place in the abdomen or other convenient site.

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