Diabetes Management Goals

Last week I started to write about diabetes, it's prevalence, symptoms, and complications. My last word on diabetes is on the American Diabetes Association's new recommendations for adults with diabetes.

There are several classes of agents which can be used to treat diabetes. These medications are complex and need to be discussed with your doctor. The two newest treatments that are available are an inhaled form of insulin known as Exubera and a new injectable class of diabetes medication called exenatide (Byetta).

Regardless of the types of medications that may be used the goals of treatment are the same for most patients. Here is a summary of the 2006 recommendations for goals for diabetic patients:

Hemoglobin A1C(a marker of blood sugar level for the last 2-3 months): less than 7 percent. This should be monitored every 6 months if the goal is met and every 3-4 months if it is not in ideal range.
Blood Pressure: should be less than 130/80 mm Hg. It should be checked at each doctor visit.
Finger stick testing glucose level (2 hours after meals): less than 180 mg per dL (10 mmol per L).
Fingerstick tsting before meals: 90-130 mg per dL (5.0-7.2 mmol oer L).
HDL cholesterol (the good cholesterol that protects against heart disease): greater than 40 mg per dL (1.05 mmol per L).
LDL cholesterol (the bad cholesterol that contributes to heart disease and stroke) : less than 100 mg per dL (2.60 mmol per L).
Triglycerides (another kind of fat that is measured in the blood): less than 150 mg per dl (1.70 mmol per L).

Other recommendations include increased physical activity, weight control, diabetes self management education and monitoring and preventing any of the complications of the diabetes.

Diabetes is a complicated disease which has reached epidemic proprotions. The extent and impact of this disease which can be devastating in terms of health and economic cost may be reduced significantly with the education of the public, the health workers, and policy makers. Wehther we live in the high technology area of Silicon Valley or in the remote corners of India or Africa, in one way or another we will be affected by this disease. I hope that campaigns such as Unite for diabetes, and World Diabetes Day on November 14 will succeed in increasing global awareness of diabetes.