Diabetes Mellitus Management
Introduction to Diabetes
- Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both, leading to long-term damage and dysfunction of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels 1, 2, 3
Diagnostic Criteria
- The American Diabetes Association recommends diagnostic criteria for diabetes, including a fasting plasma glucose ≥126 mg/dL (7.0 mmol/L) on two occasions, 2-hour plasma glucose ≥200 mg/dL (11.1 mmol/L) during OGTT, HbA1c ≥6.5%, or random plasma glucose ≥200 mg/dL (11.1 mmol/L) with classic symptoms 7, 8
Type 1 Diabetes
- The American College of Endocrinology states that type 1 diabetes is characterized by autoimmune destruction of pancreatic β-cells leading to absolute insulin deficiency, and is often associated with rapid onset, especially in children and adolescents 4, 5
- The European Association for the Study of Diabetes recommends that type 1 diabetes always requires insulin treatment for survival 6
Type 2 Diabetes
- The American Heart Association notes that type 2 diabetes is the most common form, characterized by insulin resistance and progressive insulin secretory defect, and is often asymptomatic at early stages and discovered during screening 1, 8
- The European Society of Cardiology states that type 2 diabetes is frequently associated with obesity and physical inactivity, and may initially be managed with lifestyle modifications and oral medications, but may eventually require insulin 6, 8
Dietary Management
- The Academy of Nutrition and Dietetics recommends an individualized approach to dietary management, focusing on overall healthy eating patterns rather than single nutrients, and regular monitoring of blood glucose to assess dietary impact 9
- The American Diabetes Association suggests that carbohydrate intake should be distributed throughout the day, and refined carbohydrates and added sugars should be limited 9