Non insulin dependent diabetes mellitus. Rational approach to management

This article emphasises the importance of the underlying insulin resistance in NIDDM and its relationship to other associated disorders. The need for screening individuals at risk, with the aim of preventing micro and macrovascular complications, is discussed. Major lifestyle changes are advocated: weight loss, exercise, cessation of smoking and reduction of alcohol intake, dietary changes and self foot care. Patient education and self monitoring of blood glucose play a part in involving the patient in his or her own management. There is much benefit to the patient from the monitoring and early treatment of blood pressure, lipid levels and any diabetic complications that develop.