A NIDDK Overview of Diabetes
How Is Diabetes Managed?
Before the discovery of insulin in 1921, all
people with type 1 diabetes died within a few years after the appearance of the
disease. Although insulin is not considered a cure for diabetes, its discovery
was the first major breakthrough in diabetes treatment.
Today, daily injections of insulin are the
basic therapy for type 1 diabetes. Insulin injections must be balanced with
meals and daily activities, and glucose levels must be closely monitored
through frequent blood sugar testing.
Diet, exercise, and blood testing for glucose
are also the basis for management of type 2 diabetes. In addition, some people
with type 2 diabetes take oral drugs or insulin to lower their blood glucose
People with diabetes must take responsibility
for their day-to-day care. Much of the daily care involves trying to keep blood
sugar levels from going too low or too high. When blood sugar levels drop too
low -- a condition known as hypoglycemia -- a person can become nervous, shaky,
and confused. Judgment can be impaired. Eventually, the person could pass out.
The treatment for low blood sugar is to eat or drink something with sugar in
On the other hand, a person can become very
ill if blood sugar levels rise too high, a condition known as hyperglycemia.
Hypoglycemia and hyperglycemia, which can occur in people with type 1 diabetes
or type 2 diabetes, are both potentially life-threatening
People with diabetes should be treated by a
doctor who monitors their diabetes control and checks for complications.
Doctors who specialize in diabetes are called endocrinologists or
diabetologists. In addition, people with diabetes often see ophthalmologists
for eye examinations, podiatrists for routine foot care, dietitians for help in
planning meals, and diabetes educators for instruction in day-to-day
The goal of diabetes management is to keep
blood glucose levels as close to the normal (nondiabetic) range as safely
possible. A recent Government study, sponsored by the National Institute of
Diabetes and Digestive and Kidney Diseases (NIDDK), proved that keeping blood
sugar levels as close to normal as safely possible reduces the risk of
developing major complications of diabetes.
The 10-year study, called the Diabetes
Control and Complications Trial (DCCT), was completed in 1993 and included
1,441 people with type 1 diabetes. The study compared the effect of two
treatment approaches -- intensive management and standard management -- on the
development and progression of eye, kidney, and nerve complications of
diabetes. Researchers found that study participants who maintained lower levels
of blood glucose through intensive management had significantly lower rates of
Researchers believe that DCCT findings have
important implications for the treatment of type 2 diabetes, as well as type 1
What Is the Status of Diabetes Research?
NIDDK supports basic and clinical research in
its own laboratories and in research centers and hospitals throughout the
United States. It also gathers and analyzes statistics about diabetes. Other
institutes at the National Institutes of Health also carry out research on
diabetes-related eye diseases, heart and vascular complications, pregnancy, and