Hffi
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Liu
Chang-Shan
THETHREE LEVELS
OF
MANAGEMENT
FOR
DIABETES
ln
the atfluent 21st
Century,
dia-
betes
is
on the
increase.
The first
de-
gree prevention is directed
to
reduce
the
tendency for diabetes,
e.9., health
education
on
weight watching, regular
exercises,
balance of
fiber
and sugars
in the
diet,
etc; subject targeted are:
over 40 years of age or any age with
family history of diabetes, changing life
style to
a
more
affluent
one, obese,
hypertensives, high cholesterol, early
onset
of
coronaries,
diabetic trend de-
tected during previous pregnancy,
etc.
Second degree prevention
is
the detec-
tion of subjects with impaired glucose
tolerance (lGT)
by
screening
selected
normal population who are without
symptoms
to
detect
IGT or
those
who
already have diabetes but still do
not
have symptoms: with early discovery
and
effective
treatment, complications
of
diabetes reduces
drastically.
However, as the cost of such exercises
is enormous, the
cost-effectiveness
must be reckoned
carefully.
Third
de-
gree prevention is directed
towards
strict control
of
diabetes clinically
and
to prevent
or
tackle all complications
of
diabetes
as
these are much more com-
mon on
those
patients who seek
treat-
ment only when they have symptoms
of diabetes and/or complications.
ln
diabetics,
prolound
metabolic changes
in
the
body occur and
the
high sugar
level in
the
blood must be controlled
persistently to prevent complications
of
diabetes
in the coming years.
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