Self-Management

Whether you have type 1 or type 2 diabetes, your self-management plan most likely requires you to take some form of medication and to modify your diet, activity level, and lifestyle.   

From 1983 - 1993, the National Institutes of Health conducted a $280 million study called the Diabetes Control and Complications Trial (DCCT).  The main purpose of this study was to compare the effects of intensive insulin therapy against those of conventional insulin therapy.  Some of the findings of this study include:

• the incidence of severe hypoglycemia (dangerously low blood sugars) in the intensive therapy group was three times that of the conventional therapy group

• intensive insulin therapy was able to delay the onset and slow the progression of retinopathy, neuropathy, and nephropathy by 29-74%, but could not stop them from occurring

• intensive therapy is not recommended for children under age 13, people with heart disease or advanced complications, the elderly, and people with a history of frequent or severe hypoglycemia.

• it is extremely difficult, if not impossible, for highly motivated people given adequate resources and education to maintain blood sugar control in the normal range.

There is currently no way of knowing if, or when, you will experience the irreversible complications of diabetes.  Some people need only moderately good blood sugar control to prevent complications; others need perfect control.  For many people, once they start to experience the secondary complications of diabetes, additional complications start to occur.

Although intensive insulin management may delay the onset of diabetic complications, it can not duplicate the function of islet cells.  The only way to achieve normal blood glucose control is through either a pancreas or an islet transplant.  When trying to determine which treatment option is best for you, learn as much as you can about intensive insulin management, as well as pancreas and islet transplantation.  Weigh the comparative risks and rewards of each option before making your choice.  Whether you choose intensive insulin management, pancreas transplantation, or islet transplantation, you will need long-term medical management.  If you stay on insulin, educate yourself about the risks of secondary diabetic complications.  If you are thinking of having a transplant, educate yourself about the side effects of immunosuppressive medications.

In addition to transplant services, the University of Minnesota Medical Center, Fairview, also provides both inpatient and outpatient diabetes education and self-management programs.  For inpatient services, contact the Patient Learning Center at 612-273-4894.  If you are seeking outpatient services for an adult with diabetes, call the University appointment line at 612-626-1123.  If you are seeking outpatient services for a child with diabetes, please call 612-626-6777.  If you want to make an appointment for a person who has diabetes and cystic fibrosis, call 612-624-1135.