HOW IS DIABETES MELLITUS TREATED?
Relatively few older people are required to begin insulin treatment to control their diabetes. If you have had diabetes for many years, you may already be taking insulin.
Many older people can have their blood glucose levels lowered by medications that stimulate the pancreas to produce more insulin or facilitate the metabolism of glucose.
The main thrust of diabetic control is to lose weight by controlled diets. These diets must be balanced, and have a limited amount of calories. In the vast majority of older individuals, adequate weight loss eliminates the need for pills to control blood glucose levels. In those who find weight loss difficult, it may be necessary to take one or more types of medications. In many cases diet alone is sufficient to control the symptoms of diabetes mellitus and bring your blood glucose back to normal. For those people receiving insulin, diet is even more important in order to control the balance between insulin and glucose levels. Some physicians recommend a very strict diet, whereas others do not. It is sometimes difficult for the older person to achieve strict control of diabetes when insulin is required. Moderate control is probably the best approach in older persons. It is safer than very strict control which demands that sugar levels stay on the low side, because an excessively low blood glucose level can be dangerous.
For those who do not require insulin, the goal should be to reduce food intake and reduce and maintain your “ideal weight.” Avoiding sugar is not sufficient for a diabetic diet. A balanced, limited-calorie diet is essential. Your physician, a dietitian, or special books can help you learn the principles of a diabetic diet. With good dietary management your symptoms can be controlled, your glucose levels brought back to normal, and in many instances the use of pills avoided. Dietary control takes willpower and knowledge, but it is worth the effort.
In most instances the diabetes cannot be cured, but it can be well controlled. If you have latent diabetes mellitus, which becomes evident when taking medications such as diuretics or cortisone, stopping the drugs may result in your blood glucose returning to normal. This is not a cure, but a return to the latent state. If this is the case, the diabetes may recur in the future. It is therefore important to watch your diet and your weight and have periodic medical supervision.
If you are receiving insulin or pills, it is important to learn how to examine your urine periodically to see if glucose is “spilling” into it. Home testing kits are available for this purpose. Your physician will usually arrange for periodic (every two or three months) blood glucose tests. Home testing of blood glucose may be useful in those people who require insulin therapy. An extensive physical examination every six months should be done to maintain careful glucose control and to check your eyes, feet, urine, blood pressure, and heart. Seeing an eye specialist once a year is helpful in recognizing and treating diabetic eye disease.
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