Diabetes Risks, Symptoms, Causes, Diagnosis, and Treatment
Diabetes Medicines
Your doctor may prescribe one or more medicines to help control your blood sugar, along with your plan to eat healthy and stay active.
Several kinds of medicines may help control blood sugar. Most people take pills while others take insulin. Some newer medicines for type 2 diabetes are injected. Your doctor will tell you which kind of medicine you need and why.
Over time, as your body changes, your doctor may make some changes in your treatment to help control your blood sugar. He or she may:
Change your dose
Add a new medicine or insulin
Switch pills
Types of pills
Several types of pills are prescribed to treat type 2 diabetes:
Alpha-glucosidase inhibitors prevent the breakdown of starches, such as bread, potatoes, and pasta in the intestine. They also slow the breakdown of some sugars. Their action slows the rise in blood glucose levels after a meal.
Biguanides reduce the amount of sugar produced by the liver and make muscle tissue more sensitive to insulin so that sugar can be absorbed.
DPP-4 inhibitors help improve A1C without causing low blood sugar (hypoglycemia). They work by preventing the breakdown of a naturally occurring compound in the body.
Sulfonylureas and meglitinides stimulate the beta cells in the pancreas to release more insulin.
Thiazolidinediones help insulin work better in the muscle and fat and also reduce the liver’s sugar production. They target insulin resistance.
Diabetes pills don't work for everyone. Although you may find that your blood glucose levels go down when you start taking pills, your blood sugar levels may not reach the normal range.
What are the chances that diabetes pills will work for you? Your chances are good if you developed diabetes recently or have needed little or no insulin to keep your blood glucose levels near normal.
Remember, medicine is just part of your treatment. You also need to eat healthy, get regular physical activity, and check your blood sugar.
Actos (Generic) is used to treat type 2 diabetes by reducing the resistance your body has to insulin.
Actoplus Met is a combination of two oral diabetes medicines that help control blood sugar levels.
Actoplus Met is for people with type 2 diabetes who do not use daily insulin injections. This medication is not for treating type 1 diabetes.
Avandamet (metformin + rosiglitazone) is used for improving blood sugar levels, with diet and exercise, in patients with type 2 diabetes.
Avandia (Generic) reduces insulin resistance by helping to make your body more sensitive to the natural insulin it produces.
Diabecon increases the peripheral utilization of glucose. Diabecon increases the hepatic and muscle glycogen content. Diabecon promotes cell repair/regeneration and increases the C-peptide level. As it has antioxidant properties, Diabecon protects the cells
from oxidative stress.
Glucophage (Generic) is a biguanide used to treat diabetes mellitus (sugar diabetes) in patients who may or may not also require insulin.
Glucovance (metformin + glyburide) is a combination of 2 drugs that attack high blood sugar levels in several ways.
Micronase (glyburide) is a sulfonylurea used to treat diabetes mellitus (sugar diabetes).
Prandin (Generic) is used to treat Type 2 (non-insulin dependent) diabetes, either alone or with other anti-diabetes medicines.
Starlix works by helping your pancreas release insulin, a hormone that controls the amount of sugar in your blood.
Learn about diabetes - causes (low blood sugar, glucose, insulin levels), symptoms, risks, diagnosis, types (i.e. type 1, type 2) and treatment options such as medication, diet, exercise, and other lifestyle changes.
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About Type 2 Diabetes
When you have type 2 diabetes, high levels of sugar build up in your blood. This can lead to serious health complications. That's why controlling your blood sugar is key to managing diabetes. Keeping your blood sugar under control lowers your risk for complications later. High blood sugar can harm your organs and raise your risk of heart disease.
Having type 2 diabetes means that your body doesn't make enough insulin, or doesn't properly use the insulin your body makes. Insulin is a hormone that is made in your pancreas. It helps your body's cells use sugar (also called glucose), which comes from foods and drinks. Sugar is a source of energy for cells.
This site focuses on type 2 diabetes, the most common form of the disease. Typically, with type 2 diabetes, the body still makes insulin, but its cells can't use it. This is called insulin resistance. Over time, high levels of sugar build up in the bloodstream. Being overweight and inactive increase the chances of developing type 2 diabetes.
- Other main types of diabetes include:
- Type 1 diabetes, which often affects children (although adults can develop it, too). In this form of diabetes, the body can't make insulin. The immune system mistakenly attacks the cells in the pancreas that make and release insulin. As these cells die, blood sugar levels rise. People with type 1 diabetes need insulin shots.
- Gestational diabetes, which occurs in some pregnant women. It can cause problems during pregnancy, labor, and delivery. Women who get gestational diabetes are more likely to develop type 2 diabetes.
- Life with type 2 diabetes
Managing type 2 diabetes means making some changes to how you live. Talk with your doctor about which changes are right for you. For example, it helps to:
- Eat healthy, and lose weight if your doctor says you should
- Be more active
- Test your blood sugar regularly
- Have your doctor check your A1C level (your average blood sugar over the past two to three months)
- Take one or more diabetes medicines as prescribed by your doctor
Diabetes + Smoking = Trouble
Medical Author: Ruchi Mathur, M.D.
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
I can summarize this little article in one quick sentence: Smoking is bad. In the general population, and particularly in patients with diabetes....
Smoking is bad.
Cigarette smoking is the leading cause if avoidable death in the United States, and accounts for almost 500,000 deaths a year. Smoking plays a role in one out of every five deaths in the United States per year.
Smoking is indeed bad.
Where the health of diabetic smokers is concerned, the statistics are even worse. There is an increased risk of premature death and the development of heart disease in patients who have diabetes and continue to smoke. There is also evidence that links cigarette smoking with microvascular disease (kidney and eye damage) in diabetes. Additionally, there is data that shows that smoking may actually play a role in the development of type 2 diabetes. Smoking is bad.
Diabetes Overview
Diabetes mellitus (DM) is a set of related diseases in which the body cannot regulate the amount of sugar (specifically, glucose) in the blood. Glucose in the blood gives you energy to perform daily activities, walk briskly, run for a bus, ride your bike, take an aerobic exercise class, and perform your day-to-day chores. From the foods you eat, glucose in the blood is produced by the liver (an
organ on the right side of the abdomen near your stomach).
In a healthy person, the blood glucose level is regulated by several hormones, including insulin. Insulin is produced by the pancreas, a small organ between the stomach and liver. The pancreas secretes other important enzymes that help to digest food. Insulin allows glucose to move from the blood into liver, muscle, and fat cells, where it is used for fuel. People with diabetes either do not produce enough insulin (type 1 diabetes) or cannot use insulin properly (type 2 diabetes), or both (which occurs with several forms of diabetes).
In diabetes, glucose in the blood cannot move into cells, so it stays in the blood. This not only harms the cells that need the glucose for fuel, but also harms certain organs and tissues exposed to the high glucose levels. Type 1 diabetes: The body stops producing insulin or produces too little insulin to regulate blood glucose level. Type 1 diabetes comprises about 10% of total cases of diabetes in the United
States.
Type 1 diabetes is typically recognized in childhood or adolescence. It used to be known as juvenile-onset diabetes or insulin-dependent diabetes mellitus.
Type 1 diabetes can occur in an older individual due to destruction of pancreas by alcohol, disease, or removal by surgery. It also results from progressive failure of the pancreatic beta cells, which produce insulin. People with type 1 diabetes require daily insulin treatment to sustain life.
Type 2 diabetes: The pancreas secretes insulin, but the body is partially or completely unable to use the insulin. This is sometimes referred to as insulin resistance. The body tries to overcome this resistance by secreting more and more insulin. People with insulin resistance develop type 2 diabetes when they do not continue to secrete enough insulin to cope with the higher demands. At least 90% of patients with diabetes have type 2 diabetes.
Type 2 diabetes is typically recognized in adulthood, usually after age 45 years. It used to be called adult-onset diabetes mellitus, or
non-insulin-dependent diabetes mellitus. These names are no longer used because type 2 diabetes does occur in younger people, and some people with type 2 diabetes need to use insulin.
Type 2 diabetes is usually controlled with diet, weight loss, exercise, and oral medications. More than half of all people with type 2 diabetes require insulin to control their blood sugar levels at some point in the course of their illness. Gestational diabetes is a form of diabetes that occurs during the second half of pregnancy. Although gestational diabetes typically goes away after delivery of the baby.
Women who have gestational diabetes are more likely than other women to develop type 2 diabetes later in life.
Women with gestational diabetes are more likely to have large babies. Metabolic syndrome (also referred to as syndrome X) is a set of abnormalities in which insulin-resistant diabetes (type 2 diabetes) is almost always present along with hypertension, high fat levels in the blood (increased serum lipids, predominant elevation of LDL cholesterol, decreased HDL cholesterol, and elevated triglycerides), central obesity, and abnormalities in blood clotting and inflammatory responses. A high rate of cardiovascular disease is associated with the metabolic syndrome. Pre-diabetes is a common condition related to diabetes. In people with pre-diabetes, the blood sugar level is higher than normal but not high enough to be considered diabetic. Pre-diabetes increases your risk of developing type 2 diabetes and of heart
disease or stroke. Pre-diabetes can typically be reversed without insulin or medication by losing a modest amount of weight and increasing your physical activity. This weight loss can prevent, or at least delay, the onset of type 2 diabetes.
An international expert committee of the American Diabetes Association redefined the criteria for pre-diabetes, lowering the blood sugar level cut-off point for pre-diabetes. Approximately 20% more adults are now believed to have this condition and may develop diabetes within 10 years if they do not exercise or maintain a healthy weight. About 17 million Americans (6.2% of adults in North America) are believed to
have diabetes. About one third of diabetic adults do not know they have diabetes. About 1 million new cases occur each year, and diabetes is the direct or indirect cause of at least 200,000 deaths each year.
The incidence of diabetes is increasing rapidly. This increase is due to many factors, but the most significant are the increasing incidence of obesity and the prevalence of sedentary lifestyles.
Complications of diabetes
Both forms of diabetes ultimately lead to high blood sugar levels, a condition called hyperglycemia. Over a long period of time, hyperglycemia damages the retina of the eye, the kidneys, the nerves, and the blood vessels. Damage to the retina from diabetes (diabetic retinopathy) is a leading cause of blindness.
Damage to the kidneys from diabetes (diabetic nephropathy) is a leading cause of kidney failure.
Damage to the nerves from diabetes (diabetic neuropathy) is a leading cause of foot wounds and ulcers, which frequently lead to foot and leg amputations.
Damage to the nerves in the autonomic nervous system can lead to paralysis of the stomach (gastroparesis), chronic diarrhea, and an inability to control heart rate and blood pressure during postural changes.
Diabetes accelerates atherosclerosis, (the formation of fatty plaques inside the arteries), which can lead to blockages or a clot (thrombus). Such changes can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral vascular disease).
Diabetes predisposes people to high blood pressure and high cholesterol and triglyceride levels. These conditions independently and together with hyperglycemia increase the risk of heart disease, kidney disease, and other blood vessel complications. In the short run, diabetes can contribute to a number of acute (short-lived) medical problems. Many infections are associated with diabetes, and infections are frequently more dangerous in someone with diabetes because the body's normal ability to fight infections is impaired. To compound the problem, infections may worsen glucose control, which further delays recovery from infection.
Hypoglycemia, or low blood sugar, occurs from time to time in most people with diabetes. It results from taking too much diabetes medication or insulin (sometimes called an insulin reaction), missing a meal, doing more exercise than usual, drinking too much alcohol, or taking certain medications for other conditions. It is very important to recognize hypoglycemia and be prepared to treat it at all times. Headache, feeling dizzy, poor concentration, tremors of hands, and sweating are common symptoms of hypoglycemia. You can faint or have a seizure if blood sugar level gets too low.
Diabetic ketoacidosis is a serious condition in which uncontrolled hyperglycemia (usually due to complete lack of insulin or a relative
deficiency of insulin) over time creates a buildup in the blood of acidic waste products called ketones. High levels of ketones can be very harmful. This typically happens to people with type 1 diabetes who do not have good blood glucose control. Diabetic ketoacidosis can be precipitated by infection, stress, trauma, missing medications like insulin, or medical emergencies like stroke and heart attack.
Hyperosmolar hyperglycemic nonketotic syndrome is a serious condition in which the blood sugar level gets very high. The body tries to get rid of the excess blood sugar by eliminating it in the urine. This increases the amount of urine significantly and often leads to dehydration so severe that it can cause seizures, coma, and even death. This syndrome typically occurs in people with type 2 diabetes who are not controlling their blood sugar levels, who have become dehydrated, or who have stress, injury, stroke, or are taking certain
medications, like steroids.
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Diabetes Medicines
