The Complexities of Diabetes
The main complexities stem from the nature of the feedback loop itself, which is sought to be regulated.
- The glucose cycle is a system which is affected by two factors: entry of glucose into the bloodstream and also blood levels of insulin to control its transport out of the bloodstream
- As a system, it is sensitive to diet and exercise
- It is affected by the need for user anticipation due to the complicating effects of time delays between any activity and the respective impact on the glucose system
- Management is highly intrusive and compliance is an issue, since it relies upon user lifestyle change and (often) upon regular sampling and measuring of blood glucose levels, multiple times a day in many cases
- It changes as people grow and develop
- It is highly individual
As diabetes is a prime risk factor for cardiovascular disease, controlling other risk factors which may give rise to secondary conditions, as well as the diabetes itself, is one of the facets of diabetes management. Checking cholesterol, LDL, HDL and triglyceride levels may indicate hyperlipoproteinmia, which may warrant treatment with a hypolipidemic drugs. Checking the blood pressure and keeping it within strict limits (using diet and antihypertensive treatment) protects you against the retinal, renal and cardiovascular complications of diabetes. Regular follow-up by a podiatrist or other foot health specialists is encouraged to prevent the development of diabetic foot. Annual eye exams are recommended to monitor for progression of diabetic retinopathy.
The expense, inconvenience and discomfort of frequent blood glucose measurements have been a significant challenge until recently. Recently newer devices which monitor glucose levels on an ongoing basis have been developed.