What is Diabetes?
Actually, Diabetes is a brunch of metabolic diseases, produced from the presence of excessive glucose (Hyperglycemia) in the bloodstream for short(acute) or long(chronic) periods of time due to the destruction of the insulin secretion from the beta cells of pancreas or no actions of insulin to the cells at all. At the moment, this ailment is very common to almost all people around the world but more expose to native Americans, African-Americans, Hispanics.
What are the common symptoms of Diabetes?
Initially, acute hyperglycemia shows some symptoms like frequent urination(Polyuria), increase the appetite(Polyphagia), great thirst(Polydipsia),confusion, drowsiness, weight loss etc.
On the other hand, chronic hyperglycemia causes retinopathy(eyes problem), nephropathy(kidney problems), neuropathy (nerves problem), heart problems, blood vessel related problems, headache, shakiness, weakness, poor wound healing, often women genital organ infections and so on.
To reduce the diabetes related severe complications in future, make sure that the treatment is going on according to the diabetes specialist.How many Types of Diabetes have?
There are several types of diabetes. Among them, most importantly, people are more prone to either type 1 diabetes mellitus or type 2 diabetes mellitus. However, below are mentioning some of the categories of diabetes -
1. Type 1 diabetes mellitus (T1DM): This is characterized by the completely absence of insulin secretion from the pancreatic beta cells inside the body which may have detected at an early age below 20 to 30 years of old. Exogenous insulin is needed to correct the glucose levels in the patient body. Genetical, environmental and some body producing autoimmune component (antibodies) play a vital role behind T1DM.
2. Type 2 diabetes mellitus (T2DM): This is the most common form of diabetes which normally appears in middle aged people those holding the age above 40 or near to 40. Some others factors may trigger as a positive effect to develop T2DM are
- Obesity or overweight ( those having BMI greater than 18.5 to 25)
- Family history of diabetes
- Growing up insulin resistance
- Augmenting the low density lipoprotein (LDL), very low density lipoprotein (VLDL) and triglycerides, lowering the high density lipoprotein (HDL).
- Eating more carbohydrate containing foods.
- Doing very little or no exercises at all.
3. Gestational Diabetes mellitus(GDM): This manifests typically in case of pregnant women. After delivery, gradually diminishes the elevated blood glucose level to normal level.
4. Some other issues may contribute to grow diabetes, for examples, few diseases are Acromegaly, Polycystic ovary syndrome(POS), Cushing syndrome, problems related to pancreas. Along with these, some medications (Steroids or psychotics) also can increase the blood glucose levels.
How to evaluate or measure the blood glucose level?
There are several ways to evaluate the blood glucose. The most popular one is home blood glucose monitor by using glucometer whenever anybody desires even in fasting condition or after meals and another one is called HbA1C (Glycated hemoglobin) measurement during two to three months period of regular basis to diagnose the diabetes of individuals except any issues that decline the red blood cell counts, such as, anemias, pregnancy, blood loss due to the major injuries. In addition to these, other two are Oral Glucose Tolerance Test (OGTT) and Random Blood Sugar Test.
Additionally, Gestational Diabetes Mellitus (GDM) also measures based on oral glucose tolerance test by drinking 75 g glucose solution in fasting condition as well as taking the record of fasting (Below 92 mg/dL is normal) glucose, postprandial data just after 1 hour (Below 180 mg/dL is normal) & 2 hours (Below 153 mg/dL is normal).
What are the standard ranges of blood glucose level?
a. Fasting(At least 8 hours staying without intaking calories items) :
Normal ranges: Below 100 mg/dL (5.6 mmol/L)
Pre-diabetes ranges: 100 to 125 mg/dL (5.6 to 6.9 mmol/L)
Diabetes: Above 125 mg/dL or from 126 mg.dL onwards ( 7 mmol/L)
b. Glycated Hemoglobin(A1C): This is showing the average blood sugar level of two to three months at where calculating in percentage the attached blood sugar to blood protein hemoglobin.
Normal ranges: Below 5.7 %
Pre-diabetes ranges: Between 5.7 % to 6.4 %
Diabetes: Above 6.4 % (6.5 % or higher)
c. Oral Glucose Tolerance Test (OGTT): This test is done by drinking a sugary solution first, and just after two hours passing, take the blood sugar reading which is determined by the following ranges.
Normal ranges: Below 140 mg/dL (7.8 mmol/L)
Pre-diabetes ranges: Between 140 mg/dL (7.8 mmol/L) and 199 mg/dL (11.0 mmol/L)
Diabetes: Above 200 mg/dL (11.1 mmol/L)
d. Random Blood Sugar Test: This test is performed randomly at any time without considering eating time.
Normal ranges: Below 200 mg/dL (11.1 mmol/L)
Diabetes: Above 200 mg/dL (11.1 mmol/L)
What are the medicine used to treat or control the blood Glucose level?
Based on the patient body conditions and years of experienced, treatment plan may change from single oral agent to mixed or multiple drug regimens. At the beginning of the therapy, normally select the single drug. If blood sugar level remains high rather than normal whenever using the one medicine only, then combined drugs therapy are taking into account as a proper treatment. Finally, Injectable preparations, such as, insulin or other products, are considered whenever blood glucose level is too much high as well as immediately required to reduce the blood sugar level to avoid further complications, and also save the vital organs inside our body.
A. Oral Hypoglycemic Agents:
1. Sulfonylureas:
Gliclazide (Glyka MR, Diamicron,Dacadis)
Glipizide (Glucotrol & Glucotrol XL, Minodiab)
Glimepiride (Amaryl, Glim, Diapride)
Glyburide or Glibenclamide (Melix, DiaBeta)
2. Biguanide:
Metformin ( Dialon, Pivox Glucophage & Glucophage XR, Neomet & Neomet XR)
3. Thiazolidinediones(TZDs):
Pioglitazone ( Actos, Zolid, Diavista)
Rosiglitazone (Avandia 4mg / 8mg)
4. Glucagon Like Phosphate-1(GLP-1):
Exenatide (Bydureon 2mg/vial, Byetta 250ug/ml)
Liraglutide (Saxenda 6mg/ml, Victoza)
5. Amylin Agonists:
Pramlintide (Symlin 0.6 mg/ml)
6. Meglitinides:
Repaglinide(NovoNorm, Hirepa, Eurepa, Ripadep)
7. Phenylalanine Derivatives:
Nateglinide (Starlix, Glinate)
8. Alpha- Glucosidase Inhibitors:
Acarbose ( Glucobay 100mg, Precose 50 mg or Precose 100mg Acboz 25mg or Acboz 50mg)
Miglitol (Migtor, Glyset 25 mg or Glyset 50 mg or Glyset 100 mg)
9. Dipeptidyl Peptidase IV(DPP-IV) Inhibitors:
Linagliptin (Trajenta)
Sitagliptin (Januvia, Janumet)
Saxagliptin (Onglyza)
Vidagliptin (Galvus)
10. Bile Acid Sequestrants:
Colesevelam (Welchol)
11. Dopamine Agonists:
Bromocriptine (Parlodel, Cycloset)
B. Insulin and Its Analog:
1. Rapid-acting Insulin:
Insulin Lispro (Humalog 100units/ml)
Insulin Aspart (Fiasp, Novolog, Novorapid)
Insulin Glulisine (Apidra SoloStar 100 units/ml)
2. Short-acting Insulin:
Regular insulin (Humulin, Novolin, Actrapid)
3. Intermediate-acting Insulin:
NPH (Neutral Protamine hagedorn) or Isophane Insulin (Jusline N, Humulin R, Novolin N)
4. Long-acting Insulin:
Insulin Glargine (Lantus SoloStar, Basaglar,Optisulin Toujeo)
Insulin Detemir (Levemir, Tresiba)
Insulin Degludec (Tresiba)
