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5 Pillar for Diabetes

Diabetes is a chronic disease and so far can not be cured (and still developed stem cell
therapy technology and molecular therapy for future healing). But diabetes can be
controlled, so people with diabetes can have a good quality of life, living like a normal
person. Activity and togetherness is not an obstacle.

To control diabetes, can not rely on only one component, such as drug therapy
alone. Need the concept of integrated diabetes care management, consisting of 5 pillars
of diabetes care, ie 4 healthy 5 regular. Without this integrated management of diabetes
care, the risk of complications is progressively more rapid / progressive and worsening
after 10 years of diabetes. Thus 4 healthy 5 regularly can slow the progression of
complications and minimize the manifestation of complications, even if done early,
people with diabetes can maintain a good quality of life equivalent to normal people.

In large clinics / hospitals there is usually a team of diabetic educators consisting of


doctors, nurse educators, and nutritionists, who will provide integrated therapy
management of the 5 pillars of diabetes care. With the support of IDF, WDF, Dep Kes,
Perkeni, Persadia, the healthcare industry, and various stakeholders of diabetes care,
more and more medical providers including clinics, doctors, and even certain
puskesmas provide this integrated therapy.

1. Lifestyle Education (Life Style )

Lifestyle modification / correction: Reduce sedentary lifestyle, stress, obesity, smoking


Emergency hypoglycemia solution
How to use blood glucose self-monitoring
tool How to wear insulin pens
Foot care

2. Physical activity

Frequency: 30 minutes per day, for 5 days per week


Intensity: Medium, with pulse parameter 70% x (220 - age)
Type: Aerobic

3. Diet / Nutrition

3 J ie;
Amount: Set total calories and calories per meal
Type: Every meal needs combination with high fiber components, and low glycemic
index
Schedule: Shared 3 x main meals and 3 x snacks

4. Drug therapy tablets or insulin

Your doctor will decide what type and dose of therapy is most appropriate for
you. Generally the dose is increased gradually and the adjustment is usually based on
self-monitoring of blood glucose.
Type 1 diabetes: Must be insulin injections
Diabetes type 2: If mild, starting with diet and activity only. If not controlled coupled with
antidiabetic tablets drug therapy. If more severe, need insulin injections

5. Self-monitoring of blood glucose

individually adjusted. It is recommended for self-monitoring on a weekly basis, eg 2-3


times per week. If there is economic consideration, minimum 1 week. On the day of the
test, for SMGD results to be useful for self-care, it is advisable to have a structured /
focused monitoring test regimen of 2-point test, pre-meal glucose and post-meal
glulossa. For therapy adjustment, every 3 months, during doctor's consultation visit
schedule, a structured / focused monitoring test will be done in the form of multi-point
test, for example 4 - 7 test per day, for 3 consecutive days.