The Management Of Insulin-Dependent Diabetes Mellitus.

Diabetes Mellitus is a metabolic disorder associated with great morbidity and mortality. According to the American Diabetes Association, about 16 million Americans
have diabetes, with up to 675,000 being insulin-dependent (also known as Type 1 or
Juvenile-Onset Diabetes) . Short-term complications of diabetes include coma and
possible death from hypoglycemia (low blood sugar), and ketoacidosis, which can lead to coma and death from hyperglycemia (high blood sugar). Long-term complications are a result of microvascular and macro vascular manifestations. These changes can cause devastating complications to the eyes (retinopathy), nerves (neuropathy), kidneys
(nephropathy), and to the large blood vessels that supply the body, especially the head and heart.
The optometrist's role in providing eye care to diabetics is essential, but their
knowledge needs to go beyond the proper diagnosis and treatment of ocular
complications. Diabetes is not a disease that is simply treated. It is a lifelong process that must be managed every day. Optometrists need to be knowledgeable about the
management of diabetes so they can better understand, communicate with, and educate their patients. Optometrists also need to be able to communicate with other doctors and become part of their patient's management team. The Diabetes Complication and Control Trial (DCCT) showed that keeping blood glucose close to normal can prevent complications in patients without any, and discontinue or even reverse the process in those patients with complications. The DCCT concluded that a team including endocrinologists, nurses, dietitians, social workers and other specialists needs to work together to manage diabetes. If optometrists are to be part of this team, then they must understand the management of diabetes. The primary treatment of retinopathy, and other long-term complications, needs to be prevention first, then proper treatment later if they occur. This paper will discuss specifically the management of insulin-dependent diabetes mellitus.