¿Qué tratamientos y medicamentos se usan para controlar la diabetes?
Según el tipo de diabetes que tenga, el control del azúcar en sangre, la insulina y los medicamentos por vía oral pueden afectar su tratamiento. But no matter what type of diabetes you have, eating a healthy diet, exercising on a regular basis, maintaining a healthy weight and watching your blood sugar levels are very important to managing your diabetes.
Treatments for All Types of Diabetes
Maintain a Healthy Weight Through a Healthy Diet and Exercise Plan
Healthy eating: There is no specific diet for diabetes. To manage your diabetes, your diet will need to include more fruits, vegetables, whole grains and proteins – foods that are high in nutrition and fiber and low in fat and calories — and cut down on high fat animal products, refined carbohydrates (examples are chips, crackers and white bread) and sweets. In fact, this eating plan is great for the entire family. Sugary foods are OK once in a while, as long as they’re included in a balanced meal plan.
Understanding what to eat, how much to eat and the healthiest ways to prepare your meals can be a challenge. A registered dietitian can help you create a meal plan that fits your health goals, food likes and dislikes and lifestyle. As part of your plan, you may have to count the amount of carbohydrates that you eat, especially if you have type 1 diabetes.
Physical activity: Everyone, including people with diabetes, needs regular aerobic exercise (examples are stair climbing, walking and swimming). Exercise helps to lower your blood sugar level by carrying sugar to your cells, where it’s used for energy. It also increases your body’s sensitivity to insulin, which means you need less insulin to carry sugar to your cells.
Always check with your doctor to make sure you are healthy enough to exercise before you start a regular exercise program. Then choose activities you enjoy such as walking, swimming or biking. It's important to make physical activity part of your daily routine. Aim for at least 30 minutes or more of aerobic exercise most days of the week. If you haven't been active for a while, start slowly and build up gradually.
Treatments for Type 1 and Type 2 Diabetes
The treatment for type 1 diabetes can include insulin injections or the use of an insulin pump, frequent blood sugar checks and carbohydrate counting. Treatment of type 2 diabetes primarily includes blood sugar monitoring, along with daily medicines and/or insulin.
Monitoring your blood sugar: Depending on your treatment plan, you may need to check and record your blood sugar level several times a week, or you might need to check it three or more times a day. Careful monitoring is the only way to make sure that your blood sugar levels remain stable. People who receive insulin may also choose to monitor their blood sugar level with a continuous glucose monitor device. Although this technology doesn’t replace the glucose meter, it can provide important information about your blood sugar levels that your doctor can use.
Even if you eat on a strict schedule, the amount of sugar in your blood can change unpredictably. With help from your diabetes treatment team, you'll learn how your blood sugar level changes due to food, physical activity, medicines, illness, alcohol, stress and, for women, changes in hormone levels.
Your doctor may also recommend regular A1C testing, a blood test that measures your average blood sugar level for the past two to three months. Compared with daily blood sugar tests, A1C testing helps your doctor know how well your diabetes treatment plan is working. An elevated A1C level may mean you need a change in your insulin dosage or meal plan. Your A1C test results may vary depending on your age and other factors. However, for most people with diabetes, the American Diabetes Association recommends an A1C of below 7 percent. Ask your doctor what your A1C should be.
Insulin: Most people with type 1 diabetes need to take insulin (known as insulin therapy) to survive. Some people with type 2 diabetes also need insulin therapy. Often, insulin is taken as a shot using a very thin needle and syringe or an insulin pen (a device that looks like an ink pen, except the cartridge is filled with insulin).
An insulin pump may also be an option. The pump is a device about the size of a cellphone worn on the outside of your body. The pump is connected to a tube that's inserted under the skin of your abdomen. A tubeless pump that works wirelessly is also now available. The insulin pump is programmed by your doctor to give out specific amounts of insulin. It can be adjusted to deliver more or less insulin depending on meals, your activity level and blood sugar level.
A new treatment is called the closed loop insulin delivery, also known as the artificial pancreas. It links a continuous glucose monitor to an insulin pump. The device automatically delivers the correct amount of insulin when the monitor indicates that your body needs it. Testing has shown positive results, but more research is still needed.
Many types of insulin are available, including rapid-acting insulin, long-acting insulin and intermediate options. Depending on your needs, your doctor may prescribe a mix of insulin types throughout the day and night.
Oral or other medicines: Sometimes other oral or injected medicines are prescribed as well. Some diabetes medicines get your pancreas to produce and release more insulin. Others stop or slow down the production and release of glucose from your liver, which means you need less insulin to bring sugar into your cells. Still others block the action of stomach or intestinal enzymes that break down carbohydrates or make your tissues more sensitive to insulin.
- Transplants: In some people who have type 1 diabetes, a pancreas transplant may be an option. Islet (cells in the pancreas that produce insulin) transplants are being studied as well. With a successful pancreas transplant, you would no longer need insulin therapy. But transplants aren’t always successful and these procedures pose serious risks; immune-suppressing drugs are needed on a daily basis to prevent organ rejection. These drugs can have serious side effects, including a high risk of infection, organ injury and cancer. Because the side effects can be more dangerous than the diabetes, transplants are usually reserved for people whose diabetes can’t be controlled or those who have other serious health problems due to their diabetes.
Bariatric surgery (weight loss surgery): Although it is not considered a treatment for type 2 diabetes, people with type 2 diabetes who also have a body mass index (BMI) higher than 35 may benefit from this type of surgery. People who’ve undergone gastric bypass have seen significant improvements in their blood sugar levels. However, this procedure’s long-term risks and benefits for type 2 diabetes aren’t yet known.
Treatments for Gestational Diabetes
Controlling your blood sugar level is very important as it will help keep your baby healthy and avoid problems during delivery. In addition to eating a healthy diet and exercising, your treatment plan may include monitoring your blood sugar and, in some cases, using insulin or other medicines.
Your health care provider will also monitor your blood sugar level during labor. If your blood sugar rises, your baby may release high levels of insulin, which can lead to low blood sugar right after birth.
Treatments for Prediabetes
If you have prediabetes, healthy lifestyle choices can help bring your blood sugar level back to normal or at least keep it from rising too high. Maintaining a healthy weight through regular exercise and healthy eating habits can help. Exercising at least 2 1/2 hours a week and losing 5 to 10 percent of your body weight may prevent or delay type 2 diabetes.
Sometimes medicines such as metformin (e.g., Glucophage, Glumetza and others) may be an option if you're at high risk of diabetes. Your doctor may prescribe medicine when your prediabetes is getting worse or if you have cardiovascular disease, fatty liver disease or polycystic ovary syndrome.
Your doctor may also prescribe medicines to control cholesterol, such as statins, and high blood pressure medicines if they are needed. Your doctor might prescribe low-dose aspirin therapy to help prevent heart disease if you're at high risk. However, healthy lifestyle choices remain the best treatment for prediabetes.