As yet, there is no cure for diabetes, and no known way to prevent it. Treatments focus on ways to balance glucose levels in the blood. Dietary control and exercise, both important in controlling blood sugar are the cornerstones of diabetes management. Most people with diabetes are able to live nearly normal lives, provided they follow their doctor's advice regarding diet, exercise, insulin treatments and general health care. There are, however, many complications, such as damage to the vascular system, the nervous system and kidneys that may affect some people. In some severe cases, damage to the capillaries in the retina of the eye can lead to blindness.
People with Type 1 diabetes (that is, insulin-dependent) must inject the hormone daily. If taken orally insulin is broken down by digestive enzymes. In addition to insulin, they must also carefully monitor their food intake. The development of new devices with thinner needles has made self-injection much easier.
Type 2 can usually be controlled through dietary measures and regular exercise programs. If blood sugar levels don't respond to changes in lifestyle, then hypoglycaemic agents, taken orally, may be necessary to stimulate insulin production, or to increase the cells' ability to use insulin. In some cases, persons with Type 2 diabetes may need insulin injections.
Type 2 diabetes is more common than Type 1 diabetes and, in many cases, can be treated with diet changes and increased exercise alone. When diet and exercise are not successful in lowering blood sugars to acceptable levels, then medication may be necessary. Medications that can be helpful in type 2 diabetes include glyburide, glucophage and prandase.
There continue to be advances in the treatment and management of diabetes. For instance, an insulin nasal spray is currently at the test stage of development. Researchers are testing a promising new substance that seems to mimic the actions of insulin. But a cure is still years away. For the moment, the best treatment is close cooperation between the person with diabetes and his or her health care providers.
People with diabetes are at risk for a number of other serious conditions. Some of these include:
- Microvascular complications (small blood vessel damage)
- Retinopathy: the sole cause of blindness in 86% of people with Type 1 diabetes, and in 33% of people with Type 2 diabetes. Diabetes is the leading cause of blindness in adults.
- Neuropathy: (nerve damage and foot problems) Neuropathy affects 40 to 50% of people with diabetes. Diabetes is the leading cause of all non-accident-related amputations.
- Nephropathy: (kidney disease due to blood vessel damage) Nephropathy is a major cause of illness and death for people with diabetes.
- Macrovascular complications: (large blood vessel damage) These complications include cardiac problems and hypertension.
Other complications related to diabetes include greater risk of infections, impotence and some pregnancy complications.