Treatments

The treatment of diabetes consists of keeping a daily check, at all times, on the balance between blood sugar (glucose) and insulin. Only the individual with diabetes and/or those close to him/her can monitor this balance. 

To do this, the diabetic individual with diabetes must change his/her lifestyle completely by: 

• maintaining a stable weight with diet control and the taking of physical exercise
• learning to measure glycaemia (reading of glycaemia levels with a glucometer)
• always having medications and/or insulin at hand 
• rigorously following treatment according to the prescriptions of the doctor
• giving up smoking
• always carrying fast-acting carbohydrate to avoid hypoglycaemia. 

To avoid complications, the individual with diabetes must also undergo medical examinations regularly:

• checking of blood pressure
• inspecting and treating the feet
• screening for retinopathy (which causes a loss of sight)
• checking blood lipids (fats, cholesterol)
• monitoring for the first signs of diabetes-related kidney disease.

The treatment given depends on the type and stage of the diabetes:

The treatment of Type-2 diabetes depends primarily on the management of excess weight: correcting bad eating habits and practising regular physical activity. 

Oral antidiabetic agents (OAD) can complement the treatment. Either they reduce the resistance of the cells to the action of insulin or they stimulate the pancreas to produce more insulin.

At an advanced stage, the doctor is sometimes obliged to prescribe injections of insulin to keep the glycaemia levels as regular as possible.

Persons suffering from Type-1 diabetes need daily injections of insulin or an insulin pump to survive and they will have direct access to a diabetes self-management healthcare agreement.

A healthy lifestyle with a balanced diet and the taking of physical exercise is obviously recommended to complete the treatment.

The diabetic passport gives diabetics access to dietician and podiatry visits, which are to a large extent reimbursed by their health insurance.

The passport is a memory aid documenting all the visits made by the diabetic and includes:

• the details of the healthcare professionals who are treating him/her
• medical information concerning him/her (results of tests, examinations carried out)
• personalised therapeutic objectives
• procedures to be carried out by those close to him/her in the case of hypoglycaemia.

Ask your family doctor or your health insurance company.

The National institute health and disability insurance (Inami-Riziv) Institute has decided to develop a “pre-pathway” for all patients with Type-2 diabetes. This model covers everything from diagnosis to the Type-2 diabetes care pathway or up to the diabetes healthcare agreement.

A care pathway is a contract signed by a patient suffering from a chronic disease, his/her family doctor and a specialist doctor. It makes it possible to set a treatment objective and formalises the commitments of all of the parties. 

The contract binds the three parties for 4 years and provides for close cooperation between the 3 parties in order to coordinate the management, treatment and follow-up of the patient according to his/her specific situation.

At present only patients with chronic kidney failure or Type-2 diabetes have access to these care pathways during certain stages of these diseases.

If you require 2 or more insulin injections per day and are not included in a care pathway, you have the right to education and to multidisciplinary care in an endocrinology hospital department of the “contracted” kind (contracted with the health insurance).