54 sec
Service
Diabetes treatment and follow-up
Short answer
In modern diabetes treatment, the goal is not to lower blood sugar sharply. The right medication has to be chosen with coexisting conditions (heart, kidney, liver) in mind, and blood sugar has to be kept under long-term control. Dr. Shirvan Zekeriyeyev does the following:
- chooses the treatment individually for each patient;
- lowers very high blood sugar in stages, under control;
- when needed, starts with insulin and then switches to tablet treatment;
- tracks the result with HbA1c.
In the doctor's practice
- Medication choice by coexisting condition. “In recent years, there have been many drugs for treating diabetes that have protective effects on the heart, the liver and the kidneys alike. That is why, in diabetes, lowering blood sugar sharply should be avoided, and if there are coexisting conditions, the right medication should be prescribed with them in mind” (video).
- Lowering in stages. In patients who come in with very high blood sugar, it is lowered not all at once but, in the doctor's words, “under full control and step by step.”
- From insulin to tablets. In a patient with a diabetic foot wound, blood sugar was first brought under control with insulin, and then, as promised, treatment was switched to tablets. The surgeon carried out the surgical treatment of the wound.
- Do not stop medication on your own. In patients who stop treatment because the medication has run out, or for reasons such as a holiday or a trip, results get worse instead of better. “When your treating doctor says to come back after a certain period, you must come back within that period without fail.”
- Monitoring frequency. HbA1c is checked every 3 months until it normalizes, and after that every 6 or 12 months as the doctor decides.
- Measuring at home. Blood sugar should be measured from time to time on an empty stomach and 2 hours after a meal. If, during treatment, blood sugar is above 180 mg/dL (10 mmol/L) most of the time, you need to consider changing the treatment or the diet.
- Type 1 diabetes. “No medication replaces the insulins you are using… In the treatment of type 1 diabetes, the core therapy is insulin therapy” (video).
- Complications. The key condition for effective treatment of diabetic neuropathy is fully stable blood sugar. When needed, treatment is carried out together with a neurologist. In people who have taken metformin for a long time, vitamin B12 should be checked from time to time.
General information
4 principles of nutrition in diabetes
From the doctor's post
- Carbohydrates. Prefer complex carbohydrates — whole grains and legumes. Cut down on simple carbohydrates (flour products, white rice, sweets) as much as possible, because they raise blood sugar suddenly.
- Protein and fiber. High-fiber foods help keep blood sugar steady. At every meal, protein foods such as chicken, eggs, hazelnuts and walnuts are useful.
- Fats. Saturated and trans fats increase insulin resistance. Prefer plant-based fats (avocado, olive oil, walnuts).
- Intervals between meals. When the intervals are set correctly, the risk of both a drop in blood sugar (hypoglycemia) and a rise (hyperglycemia) goes down.
Q&A
Video: Misconceptions about diabetes
Is fruit forbidden in diabetes?
There is no such ban. The amount of fruit, that is, the portion size, is what matters.
If I start insulin, is there no going back?
That is not so. Sometimes, in the early stages of diabetes, insulin is started so that the pancreas and the body can recover, and after that going back is possible.
Do herbal teas cure diabetes?
No. “We are not against herbal teas. It is just that, in diabetes, herbal teas do not cure it. You can use them as an addition.”
Do complications depend only on the blood sugar level?
No. Complications can also depend on the medications used, so the medication prescribed must suit the patient.
My medications have run out. Can I wait without seeing a doctor?
No. Medication must not be stopped without the doctor's permission. You need to come in before the treatment runs out.
The doctor’s videos
The videos are in Azerbaijani.
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