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Diabetes Demands a Triad of Treatments

Oral Drugs continued...

Product labeling recommends that doctors start patients on lower doses to combat the flatulence problem.

"Although the lowest effective dose is 25 milligrams three times a day with meals, some physicians are starting patients on just 25 mg daily to minimize this side effect," Misbin says.

The newest drug, Rezulin, was well-tolerated in clinical studies. The most commonly reported side effects were infection, pain and headache, but these occurred at rates comparable to those in the placebo-treated patients. The drug should be prescribed with caution in patients with advanced heart failure or liver disease.

Some diabetes experts report that when it comes to prescribing initial therapy for Type II diabetics, some doctors tend to follow a "treatment of laziness" -- for example, prescribing SFUs if they perceive difficulties in the patient's ability to change dietary habits or lifestyle.

"Sometimes, patients with diabetes are treated with drugs when it's not really necessary," Misbin says. "Oral pills should be used in Type II diabetes only when diet and exercise are not effective. It's very common for overweight patients who lose weight to lower their own blood sugar levels and come off the medicines. The problem is that it's very difficult to get patients to lose weight."

So, the bottom line in diabetes control still hinges on patients' ability to manage the disease themselves. "I don't know of a chronic disease in which the person who suffers from it is so responsible for its management," says ADA president Cryer. "The patient has to become an expert regarding their own diabetes."

Although drug treatment makes a difference to many diabetics and their quality of life, Cryer adds that current diabetes treatments are still "not ideal." He hopes that continuing research will someday find the answer to the diabetes dilemma.

Blood Glucose Monitoring Devices

For millions of Americans with diabetes, regular home testing of blood glucose levels is critical in controlling their disease.

"The most near-normal glucose patterns you can get will have a terrific long-term impact on how well people with diabetes do," says Steven Gutman, M.D., director of the division of clinical laboratory devices in FDA's Office of Device Evaluation. But he adds, "Tight control isn't easy because it requires multiple glucose measurements."

For many years, diabetics relied on home urine glucose testing to monitor blood sugar levels. But the method was not without drawbacks. Monitoring glucose levels via the urine is problematic for several reasons: First, blood glucose concentrations above which glucose appears in the urine vary widely among individuals, so the tests are not very reliable. Second, factors such as fluid or vitamin C intakes can influence test results. And third, negative tests can't distinguish between normal, low, and moderately high blood sugar levels.

WebMD Public Information from the FDA

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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