The best ways to treat diabetes

The Canadian Diabetes Association (CDA) released new clinical practice guidelines in 2003 based on the most recent research from around the world on the prevention, diagnosis and treatment of diabetes and its related complications. The bottom-line message from the CDA is that Type 2 diabetes can be prevented with early screening and, once diagnosed, all types of diabetes can be much better managed with more aggressive treatment. Both prevention and better management can be achieved by lifestyle modifications — moderate weight loss and regular exercise — and, where appropriate, drug therapy.

Here are highlights from the current guidelines

• New risk factor
All Canadians 40 and over (down from 45 and over) are considered at risk for Type 2 diabetes. There are 14 million Canadians over 40.

• Lower blood glucose targets
Most people with diabetes should aim to have the results of their three-month glycated hemoglobin tests below seven per cent. And if it can be achieved safely, a six-per-cent result is even better. By reducing blood glucose levels to these ranges, patients can prevent the onset of complications a/or delay the progression. Complications include kidney disease, heart disease and stroke, eye disease and limb amputation due to nerve damage.

• Recognition of diabetes as a cardiovascular disease
Eighty per cent of people with diabetes will die from heart disease or stroke. Damage to the body’s large blood vessels can be prevented by catching diabetes through earlier screening and by earlier diagnosis and very aggressive treatment to control blood glucose levels, blood pressure and lipid levels.

• Lower blood pressure and cholesterol targets
People with diabetes should aim to keep their blood pressure at 130/80 or below as well as lower cholesterol and lipid levels. Lower levels have been shown to greatly reduce the risk of heart disease and stroke, which are the most common diabetes complications.