Treatment for diabetes mellitus type 1:
Type 1 Diabetes mellitus could be controlled at three stages :The early prevention is to control in the childhood before the activation of immune system against islets cells. The second prevention is to non-diabetic individuals with humoral or metabolic markers of high risk of progression to diabetes the third and most obvious type of prevention is to destroy, limit or reverse the damaged or harmful immune cells and to improve or increase the strength of the beta cells. 1 Skyler JS, Ricordi C. 2011
Traditional system of cure Diabetes today
Pathophysiology :central and peripheral tolerance mechanism is a method to control the transformation of the lymph CD cells. Thymocytes derived from the more bone marrow originators which enter into the immature cells as T cells which do not have the surface markers like CD4 and CD8 are absent here. In the thymus a number of cells which recognize the conversion of these cells into CD4+ and CD8+ as lymphocytes. T cells that have a great affinity for self-antigens and positively antigens have weak affinity for antigens. CD4 and CD8 cells and constimulatory molecules are CD80/86 and CD40L are used to control the T cells regulation and deletion. 2 David Levy – 2011
Some of the methods are also available in which the glucose and insuln reserverd patients who has the relevant antibodies and susceptible HLA genotype. Which predict the patients that have the high and low risk for T1DM. 3 Ragnar Hanas – Diabetes – 2007
Once patients are susceptible with this genotype HLA cannot titers the antibodies automatically to any three of the major islets cells auto antigens and clear evidence of diminution in insulin reserve.
Figure : central mechanism for the induction of tolerance 4Bingley Pj, Mahon Jl,
Units and insulin concentrations:
Today the most common concentration around the world is 100units/per ml (U-100). In some countries mostly 40U/ml (U-40).
Figure : Injection concentration of insulin
A larger insulin dose gives the long lasting effects. For the children’s insulin can be diluted like 10U/ml (U-10). T1DM has advantageous when the patient has low daily dose requirement, this is called the twice daily treatment. Treatments doses are changed time to time and according to the environment of the patient like during tea or dinner time it will be used as thrice time per day. And with the increase the patient illness it will also the multiple injections. 5 Frederick W. Alt 2009 (28-29)
Treatment for diabetes mellitus type 2:
Diet and physical activity:
There is some evidence that intensive programs of lifestyle interventions targeting patients with impaired fasting blood glucose reduce the incidence of type 2 diabetes. All patients should strive to:
Make smart choices from every food group to meet their caloric needs.
Get the most and best nutrition from the calories consumed.
Find a balance between food intake and physical activity.
Get at least 30 minutes of moderate-intensity physical activity on most days.6 Serge Jabbour Elizabeth A. Stephens 2007
The serious patients have increase the risk of foot ulcers. The cure and preventions are required to get rid of this ulcers.
Patients at very high risk are those with a previous foot ulcer, amputation, or major foot deformity (claw/hammer toes, bony prominence, or Charcot deformity).
Patients at increased risk are those who are insensate to 5.07 monofilament at any site on either foot or who have bunions, excessive corns, or callus.
Patients at average risk are those with none of the aforementioned complications.
Surgically induced weight can improve the blood glucose level better blood glucose control and less need for diabetic medications than conventional diabetes therapy focused on weight loss through lifestyle changes.7 Abbatini F, Capoccia D, 2013
References :1 Skyler JS, Ricordi C. Stopping type 1 diabetes – attempts to prevent or cure type 1 diabetes in man. Diabetes 2011 Pg 8-9
2 David L. 2011 Pg(55-56)Type 1 Diabetes
3 Ranger H. Type 1 diabetes in children, at adolescence 2007 Pg 195
4 Bingley Pj, Mahon Jl, Diabetes intervention 2010 Pg(25-33)
5 Frederick W. Alt Imunopathogenesis of Type 1DM 2009 (28-29)
6 Serge Jabbour, Elizabeth A. Stephens Type 1 Diabetes in Adults: Principles and Practice
7 Abbatini F, Capoccia D, Casella G Long-term remission of type 2, 2013 Pg(10-11)