Diabetes is a medical condition marked by high levels of glucose in the blood. This is caused by the body's inability to properly regulate blood sugar, usually due to inadequate insulin production by the pancreas or decreased insulin effectiveness.
Understanding Diabetes
Diabetes, also known as diabetes mellitus, is identified when fasting blood sugar levels exceed 126mg/dL, or when blood sugar levels hit 200mg/dL or higher two hours after an oral glucose tolerance test. It can also be diagnosed if blood sugar levels are 200mg/dL or higher at any point, regardless of meal times.
Recognizing the Symptoms and Types of Diabetes
Increased blood sugar levels can lead to excessive thirst, frequent urination, and weight loss. If blood sugar levels remain high for an extended period, it can raise the risk of eye disease (retinopathy), kidney problems, nerve damage (neuropathy), and heart-related diseases.
Type 1 Diabetes: Formerly known as juvenile diabetes, this type happens when the insulin-producing beta cells in the pancreas are destroyed. It usually affects children or adolescents and necessitates insulin treatment.
Type 2 Diabetes: More common in adults, this type arises when the body becomes less responsive to insulin, making blood sugar control difficult. Environmental factors like a high-calorie, high-fat, high-protein diet, lack of exercise, and stress contribute significantly. Treatment involves adjusting the diet, exercising, and taking oral hypoglycemic agents.
Insulin Resistance: The effectiveness of insulin in lowering blood sugar diminishes, and cells struggle to metabolize glucose efficiently.
Treating Diabetes
Oral hypoglycemic agents are divided into two categories: insulin secretion stimulants and insulin sensitivity enhancers. Insulin secretion stimulants include sulfonylureas (Amaryl, Diamicron, Daonil) and meglitinides (Novonorm, Pastic, Gluconorm). Insulin sensitivity enhancers include biguanides (Metformin) and thiazolidinediones (Avandia, Actos). Other medications include Glucobay, Vason, etc.
Newer medications include GLP-1 (glucagon-like peptide-1, a hormone that reduces blood sugar) and GLP-1 agonists (exenatide, liraglutide). DPP-1 inhibitors, which prevent the enzyme "DPP-1 (dipeptidyl peptidase-4)" from quickly deactivating GLP-1, include Januvia, Gabs, and Saxagliptin.
Insulin is primarily given through subcutaneous injection. The method of administration varies depending on the duration of action. While insulin has a more immediate effect and no dosage limit compared to oral medications, it needs injection, which can be tricky. Insulin types include ultra-short-acting, short-acting, intermediate-acting, long-acting, etc. Ultra-short-acting includes Insulin Lispro, Insulin Aspart, Insulin Glulisine, etc., which usually start working within 15 minutes and last for 3-4 hours. It's given before or after meals, making it useful for managing post-meal blood sugar levels. Short-acting includes Regular Insulin, which starts working 30 minutes to 1 hour after administration and usually lasts for 2-4 hours.