How do medications treat diabetes?
Most medications used to treat diabetes act by lowering blood sugar levels through different mechanisms. There is broad consensus that when people with diabetes maintain tight glucose control – keeping the glucose levels in their blood within normal ranges – they experience fewer complications, such as kidney problems or eye problems.
How is diabetic diabetes diagnosed?
Diabetes is typically diagnosed by a blood test showing unusually high blood sugar. The World Health Organization defines diabetes as blood sugar levels at or above 7.0 mmol/L (126 mg/dL) after fasting for at least eight hours, or a glucose level at or above 11.1 mmol/L (200 mg/dL) two hours after an oral glucose tolerance test.
What is the goal of treatment for Type 1 diabetes?
Learning about the disease and actively participating in the treatment is important, since complications are far less common and less severe in people who have well-managed blood sugar levels. Per the American College of Physicians, the goal of treatment is an HbA 1C level of 7-8%.
Why is it important to manage diabetes effectively?
Doing so is important not only in terms of quality of life and life expectancy but also economically – expenses due to diabetes have been shown to be a major drain on health – and productivity-related resources for healthcare systems and governments.
What is the treatment method of diabetes?
Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting. Treatment of type 2 diabetes primarily involves lifestyle changes, monitoring of your blood sugar, along with diabetes medications, insulin or both.
What are the 4 essential components in treatment of diabetes?
ManagementMeals. Contrary to popular belief there is no specific diabetes diet. ... Movement. Movement or exercise helps the body utilize insulin more efficiently to keep blood sugar under control and it aids in weight management. ... Medication. ... Monitoring.
How is the type of diabetes determined?
The primary test used to diagnose both type 1 and type 2 diabetes is known as the A1C, or glycated hemoglobin, test. This blood test determines your average blood sugar level for the past 2 to 3 months. Your doctor may draw your blood or give you a small finger prick.
What is the cornerstone of treatment for the person who has type 2 diabetes?
Exercise: the brittle cornerstone of type 2 diabetes treatment.
What are the three main factor to success with diabetes?
When you have diabetes, you should closely monitor three key areas: blood glucose and hemoglobin A1C, blood pressure and cholesterol. These are sometimes referred to as the ABCs of diabetes management. Monitoring these will also help you make lifestyle changes to improve your diabetes control.
How is Lantus insulin different from other insulins?
Glargine (Lantus) is an insulin analog recently available in the U.S. It is a long-acting insulin but differs from other long-acting insulins (such as NPH, Lente, and ultralente) because it is clear as opposed to cloudy. It also has an acidic pH and should not be mixed with other insulins.
What test determines type 1 or type 2 diabetes?
Health care professionals most often use the fasting plasma glucose (FPG) test or the A1C test to diagnose diabetes. In some cases, they may use a random plasma glucose (RPG) test.
What is the difference in treatment for type 1 and 2 diabetes?
Treatment for Type 1 and Type 2 Diabetes Type 1 diabetes has only one treatment: insulin replacement. There is no other treatment for Type 1 diabetes and without insulin, death is very likely. Whereas Type 2 diabetes can be managed with diet, weight loss, medications, and/or insulin.
How can you differentiate between type 1 and type 2 diabetes?
The main difference between the type 1 and type 2 diabetes is that type 1 diabetes is a genetic condition that often shows up early in life, and type 2 is mainly lifestyle-related and develops over time. With type 1 diabetes, your immune system is attacking and destroying the insulin-producing cells in your pancreas.
How can type 2 diabetes be controlled without insulin?
To help manage your blood sugar levels, try to:eat a well-balanced diet.get at least 30 minutes of aerobic exercise per day, five days per week.complete at least two sessions of muscle-strengthening activities per week.get enough sleep.
Can type 2 diabetes be reversed permanently?
According to recent research, type 2 diabetes cannot be cured, but individuals can have glucose levels that return to non-diabetes range, (complete remission) or pre-diabetes glucose level (partial remission) The primary means by which people with type 2 diabetes achieve remission is by losing significant amounts of ...
What is type 2 diabetes remission?
Diabetes remission in people with type 2 diabetes means that your blood sugar levels are healthy without needing to take any diabetes medication.
What are the treatment goals for diabetes?
The treatment goals are related to effective control of blood glucose, blood pressure and lipids, to minimize the risk of long-term consequences associated with diabetes. They are suggested in clinical practice guidelines released by various national and international diabetes agencies.
How to manage diabetes?
Optimal management of diabetes involves patients measuring and recording their own blood glucose levels. By keeping a diary of their own blood glucose measurements and noting the effect of food and exercise, patients can modify their lifestyle to better control their diabetes.
What are the complications of diabetes?
Adequate control of diabetes leads to lower risk of complications associated with unmonitored diabetes including kidney failure (requiring dialysis or transplant), blindness, heart disease and limb amputation. The most prevalent form of medication is hypoglycemic treatment through either oral hypoglycemics and/or insulin therapy. There is emerging evidence that full-blown diabetes mellitus type 2 can be evaded in those with only mildly impaired glucose tolerance.
Why is nonadherence important in diabetes?
Because many patients with diabetes have two or more comorbidities, they often require multiple medications. The prevalence of medication nonadherence is high among patients with chronic conditions, such as diabetes, and nonadherence is associated with public health issues and higher health care costs. One reason for nonadherence is the cost of medications. Being able to detect cost-related nonadherence is important for health care professionals, because this can lead to strategies to assist patients with problems paying for their medications. Some of these strategies are use of generic drugs or therapeutic alternatives, substituting a prescription drug with an over-the-counter medication, and pill-splitting. Interventions to improve adherence can achieve reductions in diabetes morbidity and mortality, as well as significant cost savings to the health care system. Smartphone apps have been found to improve self-management and health outcomes in people with diabetes through functions such as specific reminder alarms, while working with mental health professionals has also been found to help people with diabetes develop the skills to manage their medications and challenges of self-management effectively.
What is the difference between diabetes mellitus type 1 and type 2?
Diabetes mellitus type 2, in contrast, is now thought to result from autoimmune attacks on the pancreas and/or insulin resistance.
What is glycemic control?
Glycemic control is a medical term referring to the typical levels of blood sugar ( glucose) in a person with diabetes mellitus. Much evidence suggests that many of the long-term complications of diabetes, especially the microvascular complications, result from many years of hyperglycemia (elevated levels of glucose in the blood). Good glycemic control, in the sense of a "target" for treatment, has become an important goal of diabetes care, although recent research suggests that the complications of diabetes may be caused by genetic factors or, in type 1 diabetics, by the continuing effects of the autoimmune disease which first caused the pancreas to lose its insulin-producing ability.
What is the term for the abnormally high concentration of sugar in the blood?
Diabetes management. The term diabetes includes several different metabolic disorders that all, if left untreated, result in abnormally high concentration of a sugar called glucose in the blood.
What is the drug used to treat diabetes mellitus?
Substances which lower blood glucose levels. Drugs used in diabetes treat diabetes mellitus by altering the glucose level in the blood. With the exceptions of insulin, most GLP receptor agonists ( liraglutide, exenatide, and others), and pramlintide, all are administered orally and are thus also called oral hypoglycemic agents or oral ...
What is the therapeutic combination for type 2 diabetes?
Several groups of drugs, mostly given by mouth, are effective in type 2, often in combination. The therapeutic combination in type 2 may include insulin, not necessarily because oral agents have failed completely, but in search of a desired combination of effects.
What is the advantage of insulin in type 2?
The great advantage of injected insulin in type 2 is that a well-educated patient can adjust the dose, or even take additional doses, when blood glucose levels measured by the patient, usually with a simple meter, as needed by the measured amount of sugar in the blood.
What type of diabetes is insulin?
Insulin must be used in type 1, which must be injected. Diabetes mellitus type 2 is a disease of insulin resistance by cells. Type 2 diabetes mellitus is the most common type of diabetes. Treatments include agents that (1) increase the amount of insulin secreted by the pancreas, (2) increase the sensitivity of target organs to insulin, ...
What is the difference between insulin and diabetes mellitus?
There are different classes of anti-diabetic drugs, and their selection depends on the nature of the diabetes, age and situation of the person, as well as other factors. Diabetes mellitus type 1 is a disease caused by the lack of insulin. Insulin must be used in type 1, which must be injected. Diabetes mellitus type 2 is a disease ...
How is insulin given?
Insulin is usually given subcutaneously, either by injections or by an insulin pump. In acute care settings, insulin may also be given intravenously. Insulins are typically characterized by the rate at which they are metabolized by the body, yielding different peak times and durations of action.
Can sulfonylurea be used for diabetes?
They work best with patients over 40 years old who have had diabetes mellitus for under ten years. They cannot be used with type 1 diabetes, or diabetes of pregnancy.
What is the blood test for type 1 diabetes?
Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1C).
How to prevent Type 2 diabetes?
Type 2 diabetes is largely preventable by staying a normal weight, exercising regularly, and eating a healthy diet (high in fruits and vegetables and low in sugar and saturated fats). Treatment involves exercise and dietary changes.
Why is Type 2 diabetes so common?
Type 2 diabetes primarily occurs as a result of obesity and lack of exercise. Some people are more genetically at risk than others. Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to type 1 diabetes and gestational diabetes. In type 1 diabetes there is a lower total level of insulin to control blood ...
What causes diabetes type 2?
The development of type 2 diabetes is caused by a combination of lifestyle and genetic factors. While some of these factors are under personal control, such as diet and obesity, other factors are not, such as increasing age, female gender, and genetics. Obesity is more common in women than men in many parts of Africa. The nutritional status of a mother during fetal development may also play a role, with one proposed mechanism being that of DNA methylation. The intestinal bacteria Prevotella copri and Bacteroides vulgatus have been connected with type 2 diabetes.
How much beta cells do you lose in type 2 diabetes?
But when type 2 diabetes has become manifest, a type 2 diabetic will have lost about half of their beta cells.
How many genes are involved in diabetes?
The proportion of diabetes that is inherited is estimated at 72%. More than 36 genes and 80 single nucleotide polymorphisms (SNPs) had been found that contribute to the risk of type 2 diabetes. All of these genes together still only account for 10% of the total heritable component of the disease. The TCF7L2 allele, for example, increases the risk of developing diabetes by 1.5 times and is the greatest risk of the common genetic variants. Most of the genes linked to diabetes are involved in pancreatic beta cell functions.
What is a type 2 diabetic?
A small number of people with type 2 diabetes can develop a hyperosmolar hyperglycemic state (a condition of very high blood sugar associated with a decreased level of consciousness and low blood pressure ).
What is diabetes mellitus?
The following outline is provided as an overview of and topical guide to diabetes mellitus (diabetes insipidus not included below) : Diabetes mellitus – group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because cells do not respond properly to the insulin ...
What are the different types of diabetes?
Main types of diabetes: Type 1 diabetes – disease that results in autoimmune destruction of insulin-producing beta cells of the pancreas. Type 2 diabetes – metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.
What is gestational diabetes?
Gestational diabetes – Gestational diabetes, is a temporary condition that is first diagnosed during pregnancy. Like type 1 and type 2 diabetes, gestational diabetes causes blood sugar levels to become too high. It involves an increased risk of developing diabetes for both mother and child. Other types of diabetes:
How to prevent insulin resistance?
Maintaining a healthy weight –. Proper nutrition –. Regular physical exercise – in addition to helping to maintain a healthy weight, sufficient vigorous physical exercise increases cells' sensitivity to insulin, and can thus prevent and possibly revert insulin resistance.
Is prediabetes a sign of diabetes?
Signs and symptoms of diabetes. Symptoms of prediabetes – prediabetes typically has no distinct signs or symptoms. Patients should monitor for signs and symptoms of type 2 diabetes mellitus (see below).
Where does research for diabetes come from?
Funding for research into type 1 diabetes originates from government, industry (e.g., pharmaceutical companies), and charitable organizations. Government funding in the United States is distributed via the National Institutes of Health, and in the UK via the National Institute for Health Research or the Medical Research Council. The Juvenile Diabetes Research Foundation (JDRF), founded by parents of children with type 1 diabetes, is the world's largest provider of charity-based funding for type 1 diabetes research. Other charities include the American Diabetes Association, Diabetes UK, Diabetes Research and Wellness Foundation, Diabetes Australia, the Canadian Diabetes Association .
How to distinguish type 1 diabetes from type 2 diabetes?
Type 1 diabetes can be distinguished from type 2 by testing for the presence of autoantibodies. There is no known way to prevent type 1 diabetes. Treatment with insulin is required for survival. Insulin therapy is usually given by injection just under the skin but can also be delivered by an insulin pump.
What percentage of diabetes cases are T1D?
Frequency. ~7.5% of diabetes cases. Type 1 diabetes ( T1D ), previously known as juvenile diabetes, is an autoimmune disease that is a form of diabetes in which very little or no insulin is produced by the islets of Langerhans (containing beta cells) in the pancreas. Insulin is a hormone required for the cells to use blood sugar for energy ...
How much insulin should I use for type 1 diabetes?
People with type 1 diabetes always need to use insulin, but treatment can lead to low BG ( hypoglycemia ), i.e. BG less than 70 mg/dL (3.9 mmol/L). Hypoglycemia is a very common occurrence in people with diabetes, usually the result of a mismatch in the balance among insulin, food and physical activity.
How long does it take for diabetes symptoms to develop?
Symptoms typically develop over a short period of time, often a matter of weeks. The cause of type 1 diabetes is unknown, but it is believed to involve a combination of genetic and environmental factors. Risk factors include having a family member with the condition.
Why do people with diabetes have sexual dysfunction?
Sexual dysfunction in people with diabetes is often a result of physical factors such as nerve damage and poor circulation, and psychological factors such as stress and/or depression caused by the demands of the disease.
What chemical destroys pancreatic beta cells?
Chemicals and drugs. Some chemicals and drugs selectively destroy pancreatic cells. Pyrinuron (Vacor), a rodenticide introduced in the United States in 1976, selectively destroys pancreatic beta cells, resulting in type 1 diabetes after accidental poisoning.
When was diabetes mellitus first treated?
There has been long history of dietary treatment of diabetes mellitus. Dietary treatment of diabetes mellitus was used in Egypt since 3,500 BC and was used in India by Sushruta and Charaka more than 2000 years ago. In the 18th century, John Rollo argued that calorie restriction could reduce glycosuria in diabetes.
What is the best diet for diabetics?
Low glycemic index diet. Further information: Low-carbohydrate diet. Lowering the glycemic index of one's diet may improve the control of diabetes. This includes avoidance of such foods as potatoes cooked in certain ways (i.e.: boiled and mashed potatoes are higher GI than fried) and white bread.
How much fat should diabetics consume daily?
The ADA does not make a specific recommendation about the total amount of fat that should be consumed by diabetics on a daily basis.Yet at Mastering Diabetes, the recommendation is no more than 30grams per day. They do note that studies have shown that high fat diets that have replaced carbohydrates with fat have shown improved glycemic control and improved blood lipid profiles (increased HDL concentration and decreased triglycerides) compared to low fat diets. The ADA recommends avoiding all foods that have artificial sources of trans fats but note that the small amount of trans fats that naturally occur in meat and dairy are not a concern.
Why is it important to eat carbs when you are dependent on insulin?
For people dependent on insulin injections (both type 1 and some type 2 diabetics), it is helpful to eat a consistent amount of carbohydrate to make blood sugar management easier. They find out when people with high biomarker score level have a half percentage risk developing into type 2 diabetes.
Can diabetics eat sugar?
People with diabetes can eat any food that they want, preferably a healthy diet with some carbohydrates, but they need to be more cognizant of the carbohydrate content of foods and avoid simple sugars like juices and sugar sweetened beverages. For people dependent on insulin injections (both type 1 and some type 2 diabetics), it is helpful to eat a consistent amount of carbohydrate to make blood sugar management easier.
Can a diabetic lose weight with low carbs?
The ADA say low-carbohydrate diets can be useful to help people with type 2 diabetes lose weight, but that these diets were poorly defined, difficult to sustain, unsuitable for certain groups of people and that, for diet composition in general". Overall, the ADA recommends people with diabetes develop "healthy eating patterns rather ...
Is a low carb diet good for diabetics?
A low-carbohydrat e diet gives slightly better control of glucose metabolism than a low-fat diet in type 2 diabetes.
What are the two forms of diabetes?
Two additional less common forms of diabetes are diabetes insipidus, which is a condition of insufficient antidiuretic hormone or resistance to it, and gestational diabetes. Gestational diabetes usually occurs during pregnancy. It may be a result of glucose intolerance during the pregnancy period.
What is the best diet for diabetics?
Diet. Most of the commercially available prescription diabetes foods are high in fiber, complex carbohydrates, and have proven therapeutic results. Of primary concern is getting or keeping the animal eating, as use of the prescribed amount of insulin is dependent on eating full meals.
What are the different types of diabetes in dogs?
At present, there is no international standard classification of diabetes in dogs. Commonly used terms are: 1 Insulin deficiency diabetes or primary diabetes, which refers to the destruction of the beta cells of the pancreas and their inability to produce insulin. 2 Insulin resistance diabetes or secondary diabetes, which describes the resistance to insulin caused by other medical conditions or by hormonal drugs.
What type of diabetes is caused by the loss of beta cells?
Permanent damage to these beta cells results in Type 1, or insulin-dependent diabetes, for which exogenous insulin replacement therapy is the only answer. Diabetes mellitus is a disease in which the beta cells of the endocrine pancreas either stop producing insulin or can no longer produce it in enough quantity for the body's needs.
How long does it take for a diabetic dog to get insulin?
The goal of treatment is to regulate blood glucose using insulin and some probable diet and daily routine changes. The process may take a few weeks or many months and is similar as in type 1 diabetic humans.
What is the difference between diabetes type 1 and type 2?
The condition is commonly divided into two types, depending on the origin of the condition: type 1 and type 2. Type 1 diabetes, sometimes called "juvenile diabetes", is caused by destruction of the beta cells of the pancreas. The condition is also referred to as insulin-dependent diabetes, meaning exogenous insulin injections must replace ...
How long does it take for a dog to survive diabetes mellitus?
In survival rates from almost the same time, only 50% survived the first 60 days after diagnosis and went on to be successfully treated at home.
Why do you need a glycated hemoglobin test?
Glycated hemoglobin testing is recommended for both checking the blood sugar control in people who might be prediabetic and monitoring blood sugar control in patients with more elevated levels, termed diabetes mellitus. For a single blood sample, it provides far more revealing information on glycemic behavior than a fasting blood sugar value. However, fasting blood sugar tests are crucial in making treatment decisions. The American Diabetes Association guidelines are similar to others in advising that the glycated hemoglobin test be performed at least twice a year in patients with diabetes who are meeting treatment goals (and who have stable glycemic control) and quarterly in patients with diabetes whose therapy has changed or who are not meeting glycemic goals.
Why is the blood glucose test limited to 3 months?
The test is limited to a three-month average because the average lifespan of a red blood cell is four months. Since individual red blood cells have varying lifespans, the test is used as a limited measure of three months. Normal levels of glucose produce a normal amount of glycated hemoglobin.
What is the process by which sugars attach to hemoglobin called?
A1C is of particular interest because it is easy to detect. The process by which sugars attach to hemoglobin is called glycation. HbA 1c is a measure of the beta-N-1-deoxy fructosyl component of hemoglobin.
What happens to hemoglobin when glucose is high?
This second conversion is an example of an Amadori rearrangement. When blood glucose levels are high, glucose molecules attach to the hemoglobin in red blood cells . The longer hyperglycemia occurs in blood, the more glucose binds to hemoglobin in the red blood cells and the higher the glycated hemoglobin.
What is the A1C?
A1c is a weighted average of blood glucose levels during the life of the red blood cells (117 days for men and 106 days in women ).
What happens when blood glucose levels are high?
When blood glucose levels are high, glucose molecules attach to the hemoglobin in red blood cells. The longer hyperglycemia occurs in blood, the more glucose binds to hemoglobin in the red blood cells and the higher the glycated hemoglobin. Once a hemoglobin molecule is glycated, it remains that way.
What is glycohemoglobin?
Glycated hemoglobin ( glycohemoglobin, HbA1c, hemoglobin A1c, A1c, or less commonly HbA1c, HgbA1c, Hb1c, etc.) is a form of hemoglobin (Hb) that is chemically linked to a sugar. Most monosaccharides, including glucose, galactose and fructose, spontaneously (i.e. non-enzymatically) bond with hemoglobin, when present in the bloodstream of humans. However, glucose is less likely to do so than galactose and fructose (13% that of fructose and 21% that of galactose), which may explain why glucose is used as the primary metabolic fuel in humans.
Overview
- Goals
The treatment goals are related to effective control of blood glucose, blood pressure and lipids, to minimize the risk of long-term consequences associated with diabetes. They are suggested in clinical practice guidelinesreleased by various national and international diabetes agencies. The … - Issues
The primary issue requiring management is that of the glucose cycle. In this, glucose in the bloodstream is made available to cells in the body; a process dependent upon the twin cycles of glucose entering the bloodstream, and insulin allowing appropriate uptake into the body cells. B…
Blood Sugar Level
- Blood sugar level is measured by means of a glucose meter, with the result either in mg/dL (milligrams per deciliter in the US) or mmol/L (millimoles per litre in Canada and Eastern Europe) of blood. The average normal person has an average fasting glucose level of 4.5 mmol/L (81 mg/dL), with a lows of down to 2.5 and up to 5.4 mmol/L (65 to 98 mg/dL). Optimal manage…
Monitoring
- Relying on their own perceptions of symptoms of hyperglycemia or hypoglycemia is usually unsatisfactory as mild to moderate hyperglycemia causes no obvious symptoms in nearly all patients. Other considerations include the fact that, while food takes several hours to be digested and absorbed, insulin administration can have glucose lowering effects for as little as 2 hours o…
Lifestyle Modification
- The British National Health Servicelaunched a programme targeting 100,000 people at risk of diabetes to lose weight and take more exercise in 2016. In 2019 it was announced that the programme was successful. The 17,000 people who attended most of the healthy living sessions had, collectively lost nearly 60,000 kg, and the programme was to be doubled in size.
Research
- Type 1 diabetes
Diabetes type 1 is caused by the destruction of enough beta cells to produce symptoms; these cells, which are found in the Islets of Langerhans in the pancreas, produce and secrete insulin, the single hormone responsible for allowing glucose to enter from the blood into cells (in addition t… - Type 2 diabetes
Type 2 diabetes is usually first treated by increasing physical activity, and eliminating saturated fat and reducing sugar and carbohydrate intake with a goal of losing weight. These can restore insulin sensitivity even when the weight loss is modest, for example around 5 kg (10 to 15 lb), m…
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