When you have type 1 or type 2 diabetes, you need to be very aware of not only what you eat, but also when and how much you eat. A Certified Diabetes Educator (CDE) at Joslin can work with you to develop a healthy meal plan that fits your lifestyle. Following a meal plan can also help you lose weight and lower your risk of developing complications.
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If you have type 1 diabetes, your pancreas no longer makes the insulin your body needs to use blood sugar for energy. You will need insulin in the form of injections or through use of a continuous pump. Learning to give injections to yourself or to your infant or child may at first seem the most daunting part of managing diabetes, but it is much easier that you think.
For type 2 diabetics, diabetic management consists of a combination of diet, exercise, and weight loss, in any achievable combination depending on the patient. Obesity is very common in type 2 diabetes and contributes greatly to insulin resistance. Weight reduction and exercise improve tissue sensitivity to insulin and allow its proper use by target tissues. Patients who have poor diabetic control after lifestyle modifications are typically placed on oral hypoglycemics. Some Type 2 diabetics eventually fail to respond to these and must proceed to insulin therapy. A study conducted in 2008 found that increasingly complex and costly diabetes treatments are being applied to an increasing population with type 2 diabetes. Data from 1994 to 2007 was analyzed and it was found that the mean number of diabetes medications per treated patient increased from 1.14 in 1994 to 1.63 in 2007.
According to a review of clinical trials published in December 2014 in JAMA Surgery, people with diabetes who underwent bariatric surgery had greater weight loss than those who received nonsurgical treatment, and the surgery was more effective in helping obese participants get diabetes under control. An article on the notable Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently trial, which was published in February 2017 in the New England Journal of Medicine, suggests that gastric bypass surgery and sleeve gastrectomy helped people with diabetes attain better glycemic control than medication alone. Compared with the medication-only group, people who underwent the surgeries also saw greater reductions in heart disease risk and medication use, as well as an improved quality of life.
Taylor and his colleagues observed that people who were unable to restart normal insulin production had lived with diabetes for a longer time. Individuals who had lived with diabetes for an average of 3.8 years could not correct their condition through weight loss, while those who had it for an average of 2.7 years were able to regain normal blood sugar control.
Drugs of this class decrease the absorption of carbohydrates from the intestine. Before being absorbed into the bloodstream, enzymes in the small intestine must break down carbohydrates into smaller sugar particles, such as glucose. One of the enzymes involved in breaking down carbohydrates is called alpha-glucosidase. By inhibiting this enzyme, carbohydrates are not broken down as efficiently, and glucose absorption is delayed.