DIABETES THE BASICS An Introduction

How is Diabetes Managed?

The primary goal of therapy for diabetes is to maintain the patient's quality of life and overall sense of well-being as well as to avoid acute and chronic complications. Since virtually every aspect of daily life may be affected by treatment, the person with diabetes is the key member of the diabetes health care team. For most people with diabetes, maintaining blood glucose near normal levels at all times will achieve the primary goal of preventing long-term complications. This objective may be more or less difficult to achieve without causing acute side effects depending on the type of diabetes and the therapy required to achieve near normal blood glucose levels. 10

Targets for Glycemic Control

A1C Type 1 and Type 2 Diabetes Fasting Plasma Glucose (FPG) 2-hour Post-Meal Plasma Glucose 510 mmol/L OR 58 mmol/L if A1C targets are not being met

7%

47 mmol/L

Please remember that treatment must be tailored to the individual with diabetes, with consideration given to individual risk factors. Glycemic targets for children < 12 years of age and pregnant women are different. What is A1C? A1C stands for glycated hemoglobin. Measuring the A1C gives an average of a persons blood glucose levels over the previous 120 days. It is a good indication of the overall management of a persons diabetes but does not show the day-to-day variations in blood glucose levels the way that blood glucose monitoring does. Generally speaking, people with diabetes should have their A1C measured approximately every three months but may be extended to 6-month intervals in adults during periods of treatment and lifestyle stability when other glycemic targets have been consistently achieved.11 The specifics of managing diabetes vary and are often dependent on the type of diabetes. Future courses in this program will go into more detail on many of these areas. However, people with diabetes can expect to live active, independent and vital lives if they make a lifelong commitment to careful diabetes management, which usually includes most of the following:4

Education

Diabetes education is an important first step. All people with diabetes as well as their family members need to be informed about their condition.

Physical Activity

Regular physical activity helps the body lower blood glucose levels, promotes weight loss, reduces stress and enhances overall fitness.

Nutrition

What, when and how much a person eats all play an important role in regulating blood glucose levels.

Weight Management

Maintaining a healthy weight is especially important in the management of type 2 diabetes.

Medication

Type 1 diabetes is always treated with insulin. Type 2 diabetes is managed through physical activity and meal planning and may require medications and/or insulin to assist the body in controlling blood glucose more effectively.

Lifestyle Management

Learning to reduce stress levels in day-to-day life can help people with diabetes better manage their disease.

Blood Pressure

High blood pressure can lead to eye disease, heart disease, stroke and kidney disease, so people with diabetes should try to maintain a blood pressure level at or below 130/80.

KEY POINT: IN ORDER TO SUCCESSFULLY MANAGE THEIR DIABETES,

PEOPLE SHOULD KNOW: What type of diabetes they have What their blood glucose level is What their target levels for blood glucose should be

PRACTICE TIP-HOW YOU CAN HELP Getting to know your patients will help them become more comfortable with you. This will make them more likely to ask questions and share their concerns with you in the future. This can make you a valuable asset to the pharmacy team.