CURRENT TRENDS IN MANAGEMENT OF DIABETES MELLITUS

Medical nutrition therapy –total diabetes care and management.Dietary control plays a important role.Diet and drug(oral hypoglycemic drugs)Diet and insulin

INTRODUCTION

Improve the overall health by achieving and maintaining nutritional status. Achieve and maintain ideal level of body fat or ideal body weight. Maintain blood glucose level as near normal level. Minimize the glucosuria. Prevent, delay and treat the acute complication –renal diseases, retinol, hypertension and cardiovascular diseases.

AIM OF THE DIETARY TREATMENT

•Recent studies have shown that high carbohydrate/high fiber diets are effective in lowering blood glucose and beneficial for management of diabetes.•The same foods that have low glycemic index also help to reduce blood cholesterol and triglycerides level.

HIGH CALORIE / HIGH FIBER / LOW FAT DIET

Classification

GI range Examples

Low GI 55 or less

Beans (white, black, pink, kidney, lentil, soy, almond, peanut, walnut, chickpea); small Seeds(sunflower, flax, pumpkin, poppy, sesame); most wholeintact Grains (durum/spelt/kamut wheat,millet, oat, rye, rice, barley); most Vegetables, most sweet Fruits (peaches, strawberries, mangos); tagatose; fructose

Medium GI 56–69

not intact whole wheat or enriched wheat, pita bread, basmati rice, potato, grape juice, raisins,prunes, pumpernickel bread, cranberry juice[citation needed], regular ice cream, sucrose, banana

High GI 70 and above

white bread (only wheat endosperm), most white rice (only rice endosperm), corn flakes,extruded breakfast cereals, glucose, maltose, maltodextrins, potato, pretzels, parsnip

Monounsaturated fat (such as canola, olive and peanut oils) may have beneficial effects on triglyceride and glycemic control in some individuals with diabetes but care must be taken to avoid weight gain.

LOW FAT DIET

Nutrition management is a key component of long term health and quality of life for people with diabetes.

Choosing a healthy diet with the right mixture of low and high glycemic index foods and exercising regularly is a good way to maintain glucose control.

Medical nutrition therapy for people with should be individualized with consideration given to usual eating habits and other lifestyle factors.

Monitoring metabolic parameter including blood pressure, blood glucose, lipids and body weight as well as quality of life is crucial to ensure successful outcomes.

It is important that the health care team work with people affected by diabetes to set realistic goals that meet the individuals micro and macro nutrients, physical activity, life style and medical needs.

One of the principal disadvantages with insulin therapy, from the patient’s point of view is the need of painful injection.

Oralin- Generex has been developing an aerosol containing insulin for buccal absorption, using an applicator similar to those used for asthma medication.

Studies havee shown benefit from Oralin comparable to insulin injections in reducing blood sugar level, alone or in combination with oral hypoglycemic agents.

New methods of insulin delivery

Condi.,Inhaled insulin- Inhale therapeutic systems have developed insulin in the form of powder for inhalation.

The inhalator consists of a plastic cylinder and air compression system. Insulin containing blisters are punctured with a needle and insulin s aerosolized into particles of less than 5 microns.

Transdermal insulin – The electronic adhesive patch is first applied to the skin, vaporizing superficial dermal cells and forming micropores for insulin to pass through and than the insulin patch is applied. It provides basal insulin delivery over 12 hours.

TREATMENTS