♦ heart ♦ peripheral vascular disease ♦ hypertension ♦ cerebrovascular disease Cardiovascular disease is about two to three times as common in people with diabetes as in the general population. Premenopausal diabetic women are about as likely to have a myocardial infarct as diabetic men. Diabetic men are over two times, diabetic women over three times, as likely to die from cardiovascular causes as the general population. About 70 per cent of people with diabetes die from cardiovascular disease (mostly coronary artery disease). Prevention and reduction of cardiovascular risk People with diabetes should pay attention to the same risk factors as those without diabetes. It seems … Continue reading →

Exercise is good for people with diabetes. Regular exercise may, indeed, prevent or delay the onset of non-insulin-dependent diabetes. Regular exercise improves blood glucose balance in non-insulin-dependent diabetes and can do so in insulin-dependent diabetes if appropriate insulin dosage adjustments are made. Exercise increases insulin sensitivity, improves glucose tolerance, and in conjunction with a diet, helps weight reduction. Regular exercise also reduces the risk of coronary heart disease. It makes many people feel good. In order to derive full benefit from exercise it should be regular—at least 20-30 minutes most days. The aim should be to keep … Continue reading →

Controlling the blood glucose Diet-treated diabetes No special measures need to be taken regarding blood glucose balance if the glucose is well-controlled on diet alone. Oral hypoglycaemic treatment Metformin alone usually presents no problem, although if insulin sensitivity increases and weight is lost, a smaller dose of metformin maybe needed. Unexpected or vigorous exercise in patients taking sulphonylureas occasionally causes hypoglycaemia which may be prolonged. In this case, the person should check his blood glucose during or after exertion and eat some carbohydrate if necessary. If hypoglycaemia ensues the person should eat a series of small snacks until … Continue reading →

Intensive blood glucose control reduces the development and progression of the complications of diabetes (DCCT, UKPDS). In DCCT, the intensively-treated group of Type 1 diabetic patients had a mean blood glucose concentration of 8.6 mmol/1 compared with 12.8 mmol/1 in the conventionally treated group. Intensive therapy reduced the risk of developing new retinopathy by 76 per cent, and, in those with preexisting retinopathy, slowed its progression by 54 per cent. Overall, intensive therapy reduced occurrence of microalbuminuria by 39 per cent, overt proteinuria by 54 per cent, and clinical neuropathy by 54 per cent. In UKPDS (34), intensive treatment with metformin in overweight Type 2 patients produced a median … Continue reading →