Abstract
Historically, patient treatment has been reactive, guided by the assessment of patients’ symptoms. However, elevated blood glucose, elevated blood pressure and elevated cholesterol often have no symptoms. Yet, research has demonstrated that early and successful treatment of these problems can prevent or delay complications of diabetes [1].
In the long-term, treatment goals of diabetes are intended to prevent microvascular complications, including blindness, kidney failure and amputations, and, to whatever extent possible, prevent macrovascular complications as well. The healthcare provider’s goal for the diabetes patient must be proactive, working to extend life while maximizing wellness for the individual patient, based on the patient’s informed choice of treatment goals. In the short term, the healthcare provider can be guided by treatment goals established by a variety of experts. Experts recommend that the primary focus of the providers’ attention be on controlling the ABCs of diabetes: A1C, blood pressure and cholesterol [2] (see Figure 2.1).
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Phillips LS, Branch WT, Cook CB, et al. Clinical inertia. Ann Intern Med 2001; 135(9):825–834.
The National Diabetes Education Program. Working together to manage diabetes: a guide for pharmacy, podiatry, optometry, and dental professionals. Available at: http://ndep.nih.gov/diabetes/pubs/PPODprimer_color.pdf Last accessed September 2007.
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2007; 30(Suppl 1):S4–S41.
Delamater AM. Clinical use of hemoglobin A1c to improve diabetes management. Clin Diabetes 2006; 24:6–8.
Heisler M, Vijan S, Anderson RM, et al. When do patients and their physicians agree on diabetes treatment goals and strategies, and what difference does it make? J Gen Intern Med 2003; 18(11):893–902.
Bergenstal, RM. Overcoming clinical inertia in diabetes care. Physician's Weekly 2007; 24:1–2.
Wagner EH. Chronic disease management: what will it take to improve care for chronic illness? Eff Clin Pract 1998; 1(1):2–4.
Landers, SJ. Team effort best way to control diabetes. Available at: www.ama-assn.org/amednews/site/free/hlsb0703.htm Last accessed September 2007.
American Association of Clinical Endocrinologists. State of diabetes in America: a new report reveals America's diabetes health is in jeopardy. Available at: www.aace.com/newsroom/press/2005/index.php/r=20050518_2 Last accessed September 2007.
The National Diabetes Education Program. Team care: comprehensive lifetime management for diabetes. Available at: http://ndep.nih.gov/diabetes/pubs/TeamCare.pdf Last accessed September 2007.
Miller CD, Phillips LS, Tate MK, et al. Meeting American Diabetes Association guidelines in endocrinologist practice. Diabetes Care 2000; 23(4):444–448.
Piette JD, Weinberger M, McPhee SJ, et al. Do automated calls with nurse follow-up improve elf-care and glycemic control among vulnerable patients with diabetes? Am J Med 2000; 108(1):20–27.
American Diabetes Association. Position Statement: Nutrition Principles and Recommendations in Diabetes. Diabetes Care 2004; 27(Suppl 1):S36.
Hensrud DD. Dietary Treatment and Long-Term Weight Loss and maintenance in Type 2 Diabetes. Obes Res 2001; 9(Suppl 4):348S–353S
Anderson JW, Randles KM, Kendall CWC, Jenkins DJA. Carbohydrate and fiber recommendations for individuals with diabetes: a quantitative assessment and meta-analysis of the evidence. J Am Coll Nutr 2004; 23(1):5–17
Ferrannini E, Camastra S, Gastaldelli A, Sironi AM, et al. Beta cell function in obesity: effects of weight loss. Diabetes 2004; 53:S26–33.
Franz MJ, Bantle JP, Beebe CA, et al. Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2002; 25(1):148–98.
Kelley DE, Kuller LH, McKolanis TM, et al. Effects of moderate weight loss and orlistat on insulin resistance, regional adiposity, and fatty acids in type 2 diabetes. Diabetes Care 2004; 27(1):33–40
Henry RR, Scheaffer L, Olefsky JM. Glycemic effects of intensive caloric restriction and isocaloric refeeding in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1985; 61:917–925.
Kelley DE, Wing R, Buonocore C, et al. Relative effects of calorie restriction and weight loss in noninsulin-dependent diabetes mellitus. J Clin Endocrinol Metab 1993; 77(5):1287–1293.
American Diabetes Association. Using the Diabetes Food Pyramid. Available at: http://diabetes.org/nutrition-and-recipes/nutrition/foodpyramid.jsp Last accessed September 2007.
Morrato EH, Hill JO, Wyatt HR, Ghushchyan V, Sullivan PW. Physical activity in U.S. adults with diabetes and at risk for developing diabetes, 2003. Diabetes Care 2007; 30(2):203–9.
Snowling NJ, Hopkins WG. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis. Diabetes Care 2006; 29(11):2518–27.
Exercise: Calories burned in 1 hour of exercise. Available at: www.mayoclinic.com/health/exercise/SM00109 Last accessed September 2007.
Hu G, Jousilahti P, Barengo NC, Qiao Q, Lakka TA, Tuomilehto J. Physical activity, cardiovascular risk factors, and mortality among Finnish adults with diabetes. Diabetes Care 2005; 28(4):799–805.
American Diabetes Association. Diabetes mellitus and exercise: position statement. Diabetes Care 2002; 25:S64.
American Diabetes Association. Physical activity/exercise and diabetes mellitus. Diabetes Care 2003; 26:S73–S77.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2009 Springer-Verlag London
About this chapter
Cite this chapter
Fonseca, V.A., Pendergrass, M., McDuffie, R.H. (2009). Management of diabetes. In: Diabetes in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-84882-103-3_2
Download citation
DOI: https://doi.org/10.1007/978-1-84882-103-3_2
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-84882-102-6
Online ISBN: 978-1-84882-103-3
eBook Packages: MedicineMedicine (R0)