Treatment Goals in Type 2 Diabetes

Type 2 Diabetes Mellitus
Introduction:
Type 2 diabetes is primarily the result of two interrelated problems: Cells in muscle, fat and the
liver become resistant to insulin. Because these cells don't interact in a normal way with insulin,
they don't take in enough sugar. The pancreas is unable to produce enough insulin to manage
blood sugar levels.
The goals in caring for patients with diabetes mellitus are to eliminate symptoms and to prevent,
or at least slow, the development of complications. Microvascular (i.e., eye and kidney disease)
risk reduction is accomplished through control of glycemia and blood pressure; macro vascular
(i.e., coronary, cerebrovascular, peripheral vascular) risk reduction, through control of lipids and
hypertension, smoking cessation, and aspirin therapy; and metabolic and neurologic risk
reduction, through control of glycemia.
Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and
resulting from the combination of resistance to insulin action, inadequate insulin secretion, and
excessive or inappropriate glucagon secretion.
Treatment goals in type 2 diabetes
The goal of treatment in type 2 diabetes is to achieve and maintain optimal BG, lipid, and blood
pressure (BP) levels to prevent or delay chronic complications of diabetes. Many people with type 2
diabetes can achieve BG control by following a nutritious meal plan and exercise program, losing
excess weight, implementing necessary self-care behaviors, and taking oral medications, although
others may need supplemental insulin. Diet and PA are central to the management and prevention of
type 2 diabetes because they help treat the associated glucose, lipid, BP control abnormalities, as
well as aid in weight loss and maintenance. When medications are used to control type 2 diabetes,
they should augment lifestyle improvements, not replace them.
Programme: Week 5:
Aerobic Exercises
Aim to get at least 30 minutes of cardio (aerobic) exercise most days of the week. If the thought of
finding 30 minutes too difficult, you can break up the exercise into shorter periods, say 10 minutes
here and there, aiming for a minimum of 30 minutes at the end of the day.
Aerobic exercises include:
 Tennis
 Dancing and Zumba
 Jogging/Running
 Walking
 Basketball
 Swimming
 Biking
Try to build up to 30 minutes gradually by adding a few minutes to each walk or exercise every
other week until you can manage 20-30 minutes at a time. But don't stop there—try to keep adding
a few minutes over time to reach 60, even 90 minutes, a day to keep building your duration and
fitness.

Also, stretch your creativity when it comes to fitting in exercise. Take a walk at lunch, or get the
whole family out after dinner for a game of basketball. Remember that walking your dog is a form
of exercise. Taking the stairs is exercise. Walking from your car and into the store is exercise—so
park farther away.
You need to find a way to exercise that you actually enjoy—because if it’s not fun, you won’t do
it. It’ll be harder to stay motivated, even if you know all the benefits of exercise. Consider taking
group classes at the gym, or find a friend to walk or run with. Having someone else exercising with
you does make it more fun and motivating.
Week 6:Strength Training
Once you have been able to include aerobic activity into your days, then you can start to add in
some resistance training.
Strength training helps you to achieve lean, efficient muscles. These resistance-type exercises,
adding to walking or jogging, also support strong, healthy bones. Building more muscle in place of
fat, is particularly beneficial when you have type 2 diabetes because muscles use the most glucose,
so the more you use your muscles, the more effective you can be at controlling your blood glucose
level.
Weight training is one of the most used strength building techniques, although you can also use
your own body weight to build up strength—think of pull-ups and planks.
When you’re starting a weight training program, make sure you know how to use all the
equipment. Ask the staff at your gym how you should properly use the weights, or consider getting
a personal trainer to learn the best exercises for you.
Lifting weights for 20-30 minutes two or three times a week is sufficient to get the full benefits of
strength training.
Week 7:
Flexibility Training
With flexibility training, you’ll improve how well your muscles and joints work. Stretching before
and after exercise (especially after exercise) reduces muscle soreness and actually relaxes your
muscles.
Week 8:
Create a Routine and Stick with It
Make a commitment to exercise; make it a priority. Your long-term health depends on it, so as
tough as it may be to find time or to motivate yourself to exercise, keep at it. It will help you lose
weight (if you need to do that), and it will make your body more efficient at using its insulin and
glucose.
Another 8-week training plan:
Rationale:
When you have type 2 diabetes, physical activity is an important component of your treatment plan.
It’s also important to have a healthy meal plan and maintain your blood glucose level through
medications or insulin, if necessary.
If you stay fit and active throughout your life, you’ll be able to better control your diabetes and keep
your blood glucose level in the correct range. Controlling your blood glucose level is essential to
preventing long-term complications, such as nerve pain and kidney disease.
Explanation of Reasoning: