Diabetes mellitus affects 350 million people worldwide, resulting in approximately 20 million new cases each year. Diabetes mellitus can be caused by damage to the pancreas and insufficient insulin production in the body, which leads to high blood sugar levels. Type I diabetes is often linked with an autoimmune disease called insulin-dependent diabetes mellitus or Type I diabetes (IDDM). Diabetes mellitus type 1 (DM1) occurs when the pancreas does not produce insulin or is not capable of producing enough of it to keep blood sugar levels under control. There is no cure for diabetes mellitus, but there are treatments that help control blood sugar levels and reduce complications of diabetes. Management of the disease depends on the type of diabetes being treated, as well as the intensity of symptoms, and often include anti-diabetic medications, insulin therapy, changes in diet, and exercise.
According to World Health Organization (WHO), treatment of diabetes mellitus using anti-diabetic medications remain the most effective way to manage blood glucose levels. The first line of treatment is metformin (Glucophage) which is as effective as insulin for treatment of type 2 diabetes mellitus (Cole, 2020). One of the most common side effect is vitamin B12 deficiency anemia. The second line of treatment is oral sulfonylureas which act as insulin secretagogues and stimulate insulin secretion from beta cells in the pancreas. Examples are glipizide (Glucotrol), glyburide (DiaBeta, Glynase PresTab), and glimepiride (Amaryl). Common side effects include hypoglycemia, weight gain and liver problems.
In addition to anti-diabetic medications, WHO recommends insulin therapy as another way of managing diabetes mellitus. This therapy acts by binding to insulin receptors in liver and muscle cells. Type 1 diabetes mellitus (T1DM) patients cannot produce insulin due to autoimmune destruction of pancreatic beta cells. Insulin therapy is often necessary if medications are no longer able to maintain adequate levels of blood glucose (McIntyre et al., 2019). The most commonly prescribed insulins are lispro (Humalog) and aspart (NovoLog-XR), which is a combination of rapid acting insulin and intermediate acting insulin (NPH). Insulin therapy is contraindicated in some patients with a history of problems from using insulin (Cole, 2020). The therapy is frequently recommended for individuals at high risk for developing diabetes, including women with polycystic ovarian syndrome (PCOS), children who are overweight, those who are obese, and older people with symptoms of insulin resistance or when body mass index (BMI) exceeds 25. Type 1 diabetes mellitus (T1DM) patients cannot produce insulin due to autoimmune destruction of pancreatic beta cells.
Moreover, treatment for diabetes also include changes in diet. The most important change in diet is decreased caloric intake, as a result of decreased food intake or excessive exercise. In addition, the patient should consume at least 2000 calories a day to avoid malnutrition and overeating while maintaining the desired weight (Tilg, 2017). Weight loss is considered as one of the essential steps in treating diabetes mellitus because it helps reduce insulin resistance, which also helps control blood sugar levels. Weight loss can also help lower blood pressure and improve cholesterol levels (McIntyre et al., 2019). It is recommended for type 1 diabetes mellitus patient to have a protein restricted diet in order to reduce body weight and avoid complications from ketoacidosis. The recommended daily protein intake for patients with type 1 diabetes is 0.8 – 1. 3 grams per kilogram body weight.
Furthermore, exercise, especially in a supervised setting, can be helpful in managing blood sugar levels and reducing future risk of diabetes mellitus. Exercising for 30 – 60 minutes each day increases insulin sensitivity and reduces insulin resistance. The moderate intensity of physical activity is enough to reduce blood glucose levels by 1 – 2 points on the glycosylated hemoglobin test (McIntyre et al., 2019). Moderate intensity physical activity includes brisk walking, jogging, gymnastics and other types of exercises. However, vigorous exercise, such as sprinting or heavy weight lifting does not benefit patients with type 1 diabetes mellitus. A moderate level of physical activity may be beneficial for individuals who have mild symptoms (Cole, 2020). It is important to consult a healthcare professional before starting a regular exercise routine because there are certain limitations that may be experienced by patients with type 1 diabetes mellitus.
A healthy lifestyle that incorporates changes in diet and anti-diabetic medications are essential to prevent the progression of diabetes mellitus. Regular exercise and lifestyle modification are also helpful in preventing and controlling diabetes mellitus. The most effective way to prevent complications of diabetes is to maintain blood glucose level within normal range.
References
Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature reviews nephrology, 16(7), 377-390. https://www.nature.com/articles/s41581-020-0278-5
McIntyre, H. D., Catalano, P., Zhang, C., Desoye, G., Mathiesen, E. R., & Damm, P. (2019). Gestational diabetes mellitus. Nature reviews Disease primers, 5(1), 1-19. https://www.nature.com/articles/s41572-019-0098-8
Tilg, H., Moschen, A. R., & Roden, M. (2017). NAFLD and diabetes mellitus. Nature reviews Gastroenterology & hepatology, 14(1), 32-42. https://www.nature.com/articles/nrgastro.2016.147%3E
World Health Organization. (2022, September 16). Diabetes. World Health Organization (WHO). https://www.who.int/news-room/fact-sheets/detail/diabetes