WHAT IS DIABETES Diabetes happens when your body isn't able to take up sugar (glucose) into its cells and use it for energy. This results in a build-up of extra sugar in your bloodstream. Poorly controlled diabetes can lead to serious consequences, causing damage to a wide range of your body's organs and tissues – including your heart, kidneys, eyes, and nerves. Control Your Diabetes or Glucose Level what is diabetes? If you have diabetes, your body isn’t able to work properly process and use glucose from the food you eat. There are multiple types of diabetes, each with different causes, but they all share the common problem of having too much glucose in your bloodstream. Treatments include medications and/or insulins. Some types of diabetes What are the symptoms of diabetes? ⦁ Increased thirst. ⦁ Weak, tired feeling. ⦁ Dry mouth. ⦁ Frequent unexplained infections. ⦁ Slow-healing sores or cuts. ⦁ Blurry vision. ⦁ Numbness or tingling in the hands or feet. ⦁ Frequent urination. ⦁ Nausea ⦁ Constant thirst ⦁ Unplanned weight loss ⦁ Irritation and mood changes Who should be tested for diabetes? If you have symptoms or risk factors for diabetes, you should get tested. The earlier diabetes is found, the earlier management can begin and complications can be lessened or prevented.If a blood test determines you have prediabetes, you and your healthcare professional can work together to make lifestyle changes (e.g. weight loss, exercise, healthy diet) to prevent or delay developing Type 2 diabetes. Additional specific testing advice based on risk factors: ⦁ Gestational diabetes: Test all pregnant women who have had a diagnosis of diabetes. Test all pregnant women between weeks 24 and 28 of their pregnancy. If you have other risk factors for gestational diabetes, your obstetrician may test you earlier. ⦁ Testing for type 01 diabetes: Test in children and young adults who have a family history of diabetes. Less commonly, older adults may also develop Type 1 diabetes. Therefore, testing in adults who come to the hospital and are found to be in diabetes-related ketoacidosis is important. Ketoacidosis is a dangerous complication that can occur in people with Type 1 diabetes. ⦁ Testing for Type 02 diabetes: Test adults age 45 or older, those between 19 and 44 who are overweight and have one or more risk factors, women who have had gestational diabetes, children between 10 and 18 who are overweight and have at least two risk factors for type 2 diabetes. What are the different types of diabetes? Type 1 diabetes: what is diabetes? This type is an autoimmune disease, meaning your body attacks itself. In this case, the insulin-producing cells in your pancreas are destroyed. Up to 10% of people who has diabetes have Type 1. It’s usually diagnosed in children and young adults (but can develop at any age). It was once better known as “juvenile” diabetes. People with Type 1 diabetes need to take insulin every day. This is why it is also called insulin-dependent diabetes. Type 2 diabetes: With this type, your body either doesn’t make enough insulin or your body’s cells don’t normally respond to the insulin. This is the most common type of diabetes. Up to 90% of people with diabetes have Type 2. It usually occurs in middle-aged and older people. Other common names for Type 2 include adult-onset diabetes and insulin-resistant diabetes. Your parents or grandparents may have called it “having a touch of sugar.” Gestational diabetes: Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes. Every year, 2% to 10% of pregnancies in the United States are affected by gestational diabetes. Managing gestational diabetes will help make sure you have a healthy pregnancy and a healthy baby. Related Health Problems Having gestational diabetes can increase your risk of high blood pressure during pregnancy. It can also increase your risk of having a large baby that needs to be delivered by cesarean section (C-section). If you have gestational diabetes, your baby is at higher risk of: ⦁ Being very large (9 pounds or more), can make delivery more difficult ⦁ Being born early can cause breathing and other problems ⦁ Having low blood sugar ⦁ Developing type 2 diabetes later in life Your blood sugar levels will usually return to normal after your baby is born. However, about 50% of women with gestational diabetes go on to develop type 2 diabetes. You can lower your risk by reaching a healthy body weight after delivery. Visit your doctor to have your blood sugar tested 6 to 12 weeks after your baby is born and then every 1 to 3 years to make sure your levels are on target. What causes diabetes? & what is diabetes? The cause of diabetes, regardless of the type, is having too much glucose circulating in your bloodstream. However, the reason why your blood glucose levels are high differs depending on the type of diabetes. What is Diabetes? ⦁ Causes of Type 1 diabetes: This is an immune system disease. Your body attacks and destroys insulin-producing cells in your pancreas. Without insulin to allow glucose to enter your cells glucose builds up in your bloodstream. Genes may also play a role in some patients. Also, a virus may trigger an immune system attack. ⦁ Gestational diabetes: Hormones produced by the placenta during your pregnancy make your body’s cells more resistant to insulin. Your pancreas can’t make enough insulin to overcome this resistance. Too much glucose remains in your bloodstream. ⦁ Cause of Type 2 diabetes and prediabetes: Your body’s cells don't allow insulin to work as it should to let glucose into its cells. Your body's cells have become resistant to insulin. Your pancreas can’t keep up and make enough insulin to overcome this resistance. Glucose levels rise in your bloodstream. Who should be tested for diabetes? Ask your healthcare team what your blood glucose level should be. They may have a specific target range for you. In general, though, most people try to keep their blood glucose levels at these targets: ⦁ About two hours after the start of a meal: less than 180 mg/dL. ⦁ Before a meal: between 80 and 130 mg/dL. What happens if my blood glucose level is low? ⦁ Blurred vision. ⦁ Headaches, seizures. ⦁ Numbness in mouth or tongue. ⦁ Irritability, nervousness. ⦁ Unsteadiness. ⦁ Nightmares, bad dreams, restless sleep. ⦁ Weakness or shaking. ⦁ Moist skin, sweating. ⦁ Confusion. ⦁ Pale skin. ⦁ Fast heartbeat. ⦁ Dizziness. ⦁ Sudden hunger. ⦁ You might pass out if your hypoglycemia is not managed. What happens if my blood glucose level is high? If you have too much glucose in your blood, you have a condition called hyperglycemia. Hyperglycemia is defined as. ⦁ A blood glucose level greater than 125 mg/dL while in the fasting state (nothing to eat or drink for at least eight hours). AND ⦁ A blood glucose level greater than 180 mg/dL one to two hours after eating. What oral medications are approved to treat diabetes? Over 40 medications have been approved by the Food and Drug Administration for the treatment of diabetes. It’s beyond the scope of this article to review all of these drugs. Instead, we’ll briefly review the main drug classes available, and how they work, and present the names of a few drugs in each class. Your healthcare team will decide if the medication is right for you. If so, they’ll decide which specific drug(s) are best to treat your diabetes. Diabetes medication drug classes include ⦁ Glinides (also called meglitinides): These drugs lower blood glucose by getting the pancreas to release more insulin. Examples include repaglinide (Prandin®) and nateglinide (Starlix®). ⦁ Alpha-glucosidase inhibitors: These drugs lower blood glucose by delaying the breakdown of carbohydrates and reducing glucose absorption in the small intestine. An example is an acarbose (Precose®). ⦁ Sulfonylureas: These drugs lower blood glucose by causing the pancreas to release more insulin. Examples include glimepiride (Amaryl®), glipizide (Glucotrol®), and glyburide (Micronase®, DiaBeta®). ⦁ Biguanides: These drugs reduce how much glucose the liver produces. It also improves how insulin works in the body, and slows down the conversion of carbohydrates into sugar. Metformin (Glucophage®) is an example. ⦁ GLP-1 analogs (also called incretin mimetics or glucagon-like peptide-1 receptor agonists): These drugs increase the release of insulin, reduce glucose release from the liver after meals and delay food emptying from the stomach. Examples include exenatide (Byetta®), liraglutide (Victoza®), albiglutide (Tanzeum®), semaglutide (Rybelsus®), and dulaglutide (Trulicity®). ⦁ Thiazolidinediones: These drugs improve the way insulin works in the body by allowing more glucose to enter into muscles, fat, and the liver. Examples include pioglitazone (Actos® and rosiglitazone (Avandia®). ⦁ Dopamine agonist: This medication lowers the amount of glucose released by the liver. An example is a bromocriptine (Cyclocet®). ⦁ Bile acid sequestrants: These drugs lower cholesterol and blood sugar levels. Examples include colestipol (Colestid®), cholestyramine (Questran®), and colesevelam (Welchol®). ⦁ PP-4 inhibitors (also called dipeptidyl peptidase-4 inhibitors): These drugs help your pancreas release more insulin after meals. They also lower the amount of glucose released by the liver. Examples include alogliptin (Nesina®), sitagliptin (Januvia®), and saxagliptin What oral medications are approved to treat diabetes? (Onglyza®) and linagliptin (Tradjenta®). Thank you!
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