A multidisciplinary approach is usually used in the management of the patient with diabetes. Diabetic patients are likely to have vascular complications of diabetes such as coronary heart disease, stroke, renal disease and peripheral vascular complications. Therefore, the goal of treatment is to reduce the risks of complications in order to minimize symptoms, allowing a normal life.
This can be done through 2 main modes: pharmological interventions and lifestyle changes.
1) Lifestyle Changes:
-Diet:
Calorie control can be done by changing the diet that is 30 calories per kg of ideal body weight can be increased to 40 calories per kg for an active person and 50 calories per kg, if the patient is heavy physical work. Therefore, ideal calorie intake Tan should be 30 x 69 = 2070 calories per day. Calories should be distributed as 55-60% carbohydrate, 25% to 35% fat and protein 15% to 20%.
Emphasis should be placed on complex carbohydrates as opposed to simple and refined starch and polyunsaturated fats instead of saturated fats, in a ratio of 2: 1. Therefore, Tan should be advised to eat whole wheat bread, brown rice, margarine, vegetable oil instead of rice, fried foods and fatty meats.
Also need to be educated on the glycemic index of various foods. A lower increase of blood sugar occurs after ingestion of simple sugars, complex carbohydrates compared to that seen after the absorption of glucose.
Intake of fiber (soluble and insoluble) also should be encouraged because it slows the absorption of glucose and have also shown high triglycerides lower level.
– Exercise:
Should be advised to exercise at least 3 times a day for at least 30 minutes each time.
And, if possible, you should take the stairs instead of the elevator. It works as a taxi driver takes the stand for long hours, increases the risk of deep-vein thrombosis. Therefore, it should be recommended to do some light exercises every few hours to improve blood circulation.
2) Pharmological Intervention: oral hypoglycemic
-Biguanides (insulin sensitizers)
Metformin is the commonly used drug in this group.
They work by increasing the density of insulin receptors; directly stimulate Glycolysis in peripheral tissues; reduce hepatic gluconeogenesis; decrease the absorption of glucose from the gastrointestinal tract and reduce the level of plasma glucagon.
-Sulphonylureas (insulin secretagogues)
Glibenclamide daonil is used in this patient, as produces a synergistic effect with metformin diabetes control.
Working with the closure of sensitive potassium channels by ATP, causing the islet cell depolarization and calcium influx, which stimulates the release of insulin.
Other classes of medications like, thiazolinediones meglitinide, Alpha-glucosidase inhibitors have also been prove their worth in the diabetic control. Therefore, it can be used as additions or subsitiutions to the current regime of Travaglini if insufficient glycemic control, given the subsequent follow-up.
Throughout, Mr diabetic patients should be educated about the importance of good glycemic control and blood pressure (preferably less than 130/80 mmHg) to prevent complications of diabetes mellitus. Good compliance with diet and medication, as well as family support and health workers will help reduce the morbidity and mortality of the disease.
http://www.Diabetes-Symptom.blogspot.com
This can be done through 2 main modes: pharmological interventions and lifestyle changes.
1) Lifestyle Changes:
-Diet:
Calorie control can be done by changing the diet that is 30 calories per kg of ideal body weight can be increased to 40 calories per kg for an active person and 50 calories per kg, if the patient is heavy physical work. Therefore, ideal calorie intake Tan should be 30 x 69 = 2070 calories per day. Calories should be distributed as 55-60% carbohydrate, 25% to 35% fat and protein 15% to 20%.
Emphasis should be placed on complex carbohydrates as opposed to simple and refined starch and polyunsaturated fats instead of saturated fats, in a ratio of 2: 1. Therefore, Tan should be advised to eat whole wheat bread, brown rice, margarine, vegetable oil instead of rice, fried foods and fatty meats.
Also need to be educated on the glycemic index of various foods. A lower increase of blood sugar occurs after ingestion of simple sugars, complex carbohydrates compared to that seen after the absorption of glucose.
Intake of fiber (soluble and insoluble) also should be encouraged because it slows the absorption of glucose and have also shown high triglycerides lower level.
– Exercise:
Should be advised to exercise at least 3 times a day for at least 30 minutes each time.
And, if possible, you should take the stairs instead of the elevator. It works as a taxi driver takes the stand for long hours, increases the risk of deep-vein thrombosis. Therefore, it should be recommended to do some light exercises every few hours to improve blood circulation.
2) Pharmological Intervention: oral hypoglycemic
-Biguanides (insulin sensitizers)
Metformin is the commonly used drug in this group.
They work by increasing the density of insulin receptors; directly stimulate Glycolysis in peripheral tissues; reduce hepatic gluconeogenesis; decrease the absorption of glucose from the gastrointestinal tract and reduce the level of plasma glucagon.
-Sulphonylureas (insulin secretagogues)
Glibenclamide daonil is used in this patient, as produces a synergistic effect with metformin diabetes control.
Working with the closure of sensitive potassium channels by ATP, causing the islet cell depolarization and calcium influx, which stimulates the release of insulin.
Other classes of medications like, thiazolinediones meglitinide, Alpha-glucosidase inhibitors have also been prove their worth in the diabetic control. Therefore, it can be used as additions or subsitiutions to the current regime of Travaglini if insufficient glycemic control, given the subsequent follow-up.
Throughout, Mr diabetic patients should be educated about the importance of good glycemic control and blood pressure (preferably less than 130/80 mmHg) to prevent complications of diabetes mellitus. Good compliance with diet and medication, as well as family support and health workers will help reduce the morbidity and mortality of the disease.
http://www.Diabetes-Symptom.blogspot.com
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