Diabetes

Diabetes

Diabetes mellitus (MEL-ih-tus), often referred to as diabetes, is characterized by high blood glucose (sugar) levels that result from the body’s inability to produce enough insulin and/or effectively utilize the insulin. Diabetes is a serious, life-long condition and the sixth leading cause of death in the United States. Diabetes is a disorder of metabolism (the body's way of digesting food and converting it into energy). There are three forms of diabetes. Type 1 diabetes is an autoimmune disease that accounts for five- to 10-percent of all diagnosed cases of diabetes. Type 2 diabetes may account for 90- to 95-percent of all diagnosed cases. The third type of diabetes occurs in pregnancy and is referred to as gestational diabetes. Left untreated, gestational diabetes can cause health issues for pregnant women and their babies. People with diabetes can take preventive steps to control this disease and decrease the risk of further complications.

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    A , Internal Medicine, answered
    Dr. Robin Miller - diabetes drugs and the brain

    Inexpensive diabetes drugs may do more than regulate insulin. In this video, Dr. Robin Miller explains how both metformin and glucophage can boost brain health, and who can benefit.

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    Different diabetes pills work in different ways to keep your blood glucose, blood pressure, and cholesterol on track. That's why you might be taking two or more pills for your blood glucose, blood pressure, or cholesterol. All the pills keep your ABCs (A1C level, blood pressure, and cholesterol) of diabetes on track. Keeping your ABCs of diabetes on target will keep you healthier. It will lower your chances of getting diabetes problems.
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    A , Endocrinology Diabetes & Metabolism, answered
    In a nut shell, diabetes makes it hard for your body to deal with sugar, and all of our diabetes meds take different approaches to try and fix that.

    For Type-1s, our bodies don’t produce insulin, so we need to replace it with injections. We can also take a medication called Symlin that is a hormone that works with insulin that makes the absorption of the sugars after a meal a smoother affair.

    For the more common Type-2 Diabetes, there are a host of options to choose from, and some can be mixed and matched. Two primary features of T-2 are insulin resistance and Leaky Liver Syndrome. OK, I just made up that last one, but we do find that in many T-2 their liver’s release too much stored sugar in their sleep. (The liver is a giant sugar battery, and one of its jobs is to keep your cells fed between meals.) If your blood sugar is higher when you wake up than when you went to bed, you have a Leaky Liver. Don’t freak out on me, your liver is fine, you just have some wires crossed in the hormone department and the simple, safe, effective, and cheep generic medication Metformin can fix this for you.

    Insulin resistance itself can be addressed by the TZD class of meds, Actos and the recently controversial Avandia. These meds treat your diabetes by serving as anti-insulin resistance drugs, they cause your body to use your own native insulin better.

    On the other side of the coin, drugs like Glipizide cause your body to over-produce insulin to overwhelm the insulin resistance. These drugs are also now generic, so they are cheep, and highly effective at first. They are falling out of popularity because it's now realized that causing a body that was already over-producing insulin in the face of insulin resistance to overproduce even more will lead to “burn out,” causing the patient to become insulin dependent sooner than would otherwise happen.

    And of course, T-2s can take insulin too. Insulin is simply a hormone that removes sugar from your blood and puts it in the cells where it belongs.

    Lastly there are a whole new class of drugs that deal specifically with the digestion side of diabetes and help prevent spikes in blood sugar after eating. They come in both shots and pills and (yikes!) I’ve run out of room, so I can’t give you details right here. They are Byetta and Victoza in injections; and Januvia and Onglyza in pills.
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    A , Nutrition & Dietetics, answered

    The nutritional management of diabetes is complicated, and is discussed in detail in my textbook, Nutritional Medicine (www.doctorgaby.com).

    People with type 1 diabetes do not make insulin in their body, and will therefore need to continue insulin therapy indefinitely. In many cases, people with type 2 diabetes can be managed effectively with dietary modifications and nutritional supplements. Dietary modifications that may be beneficial include losing weight if overweight; avoiding refined sugar and other refined carbohydrates; and emphasizing foods that are high in fiber (particularly legumes). Nutritional supplements that may lower blood sugar levels include chromium and biotin.

    For diabetics with advanced kidney disease, dietary changes can be dangerous. In addition, starting a diet-and-supplement program may require a change in the dosage of diabetes medication. For these and other reasons, people with diabetes should always consult a knowledgeable healthcare practitioner before starting a nutrition program for diabetes.

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    A GLP-1 agonist is a medication used to treat type 2 diabetes. If you are pregnant or plan to become pregnant, call your doctor. Based on your medical history, your doctor will be able to tell you if you should stay on your GLP-1 agonists or if you should switch to a different type of diabetes medication.
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    A answered
    In 2006, the FDA approved the first DPP-IV inhibitor, an oral medication that increases the body’s ability to produce insulin.

    Both DPP-IV inhibitors and GLP-1 agonists help glucose remain stable for longer periods and have few side effects. Unlike the sulfonylureas, used decades earlier, these medications do not increase the risk of hypoglycemia.
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    Most people have a hard time taking all of their diabetes pills. Here are some tips that others find helpful:

    • Try using a pill organizer.
    • Link your pill-taking to something in your daily routine. For example, put your pills by your toothbrush.
    • Use a chart to check off when you've taken your medicines.
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    A GLP-1 agonist is a type of medication used to treat type 2 diabetes. It is taken by injection (shot) using a prefilled dosing pen.

    You should always follow your doctor’s specific instructions for taking any medication, including a GLP-1 agonist. But there are some general rules that will probably apply to you:
    • If you don’t notice a change in your blood glucose right away, don’t stop taking your medication.
    • If your symptoms go away or you decide you feel fine now, don’t stop taking your medication. You need this medication to stay well.
    • If you forget to take a dose, take it as soon as you remember. If it’s almost time for your next dose, just do your usual injection at the usual time. Don’t inject a double dose to try to make up for the one you missed.
    • If you’re scheduled for a medical procedure, make sure that the doctor and nurses know that you take medication for diabetes. You might need to stop taking it for a short time if you have to fast beforehand or if you’re having a surgery or x-ray that uses contrast dye. Ask for instructions.
    • If you’re taking birth control pills or antibiotics, take them at least one hour before your injection.
    • If you become pregnant while you’re taking a GLP-1 agonist medication, call your doctor.
    • If you drink alcohol, ask your doctor or diabetes educator about combining alcohol with your GLP-1 agonist medication.
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    There are lots of new diabetes medications available, and the number is growing rapidly. So it makes sense to stay informed about ones that might be right for you. New insulins are being introduced all the time, and we now have diabetes pills to help you control your blood glucose levels in different ways. There are pills that help you make more insulin, pills that control the release of glucose from your liver into your blood, pills that help your body use insulin better, and pills that slow the absorption of food. Since different medications help control glucose in different ways, many people take two or more diabetes pills to get the most benefit. Your health care provider is your best source of information about new diabetes medications, because your provider knows you and your diabetes.
    You can find information on new diabetes medications from other places as well, including publications of the American Diabetes Association, such as Diabetes Forecast, and on the ADA website (www.diabetes.org). Many pharmaceutical companies also maintain websites with information about their new products.
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    A , Endocrinology Diabetes & Metabolism, answered
    Many CGMers tell me that they find it much less invasive in the bedroom than the insulin pump is. In a moment of passion you can pretty much just drop the CGM monitor on the floor and take care of business. And the transmitter takes up very little skin landscape, and it isn’t normally worn on a part of your body that your partner is likely to be paying much attention to anyway.