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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  • 3 Answers
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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 DPP-4 inhibitor is a type of medication used to treat type 2 diabetes. By helping your body achieve a better glucose-insulin balance, they work to lower blood glucose only when it’s too high. Even though DPP-4 inhibitors don’t actually cause hypoglycemia (or low blood glucose), you may take other diabetes medications that do increase the risk of hypoglycemia. For this reason, it’s good for you and your family to know the symptoms of hypoglycemia. These include feeling shaky, sweaty, hungry, and irritable. If you have these symptoms, test your blood glucose and take some quick-acting sugar if it is low. Good sources are three or four glucose tablets, a half-cup of fruit juice or regular soda, or a tablespoon of honey or sugar.
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    Only people with type 2 diabetes can use pills to manage their diabetes. These pills work best when used with meal planning and exercise. This way you have three therapies working together to lower your blood glucose levels.

    Diabetes pills don't work for everyone. Although most people find that their blood glucose levels go down when they begin taking pills, their blood glucose levels may not go near the normal range.

    What are the chances that diabetes pills will work for you? Your chances are low if you have had diabetes for more than 10 years or already take more than 20 units of insulin each day. On the other hand, your chances are good if you developed diabetes recently or have needed little or no insulin to keep your blood glucose levels near normal.

    Diabetes pills sometimes stop working after a few months or years. The cause is often unknown. This doesn't mean your diabetes is worse. When this happens, oral combination therapy can help.

    Even if diabetes pills do bring your blood glucose levels near the normal range, you may still need to take insulin if you have a severe infection or need surgery. Pills may not be able to control blood glucose levels during these stressful times when blood glucose levels shoot up.

    Also, if you plan to become pregnant, you will need to control your diabetes with diet and exercise or with insulin. It is not safe for pregnant women to take oral diabetes medications.

    There is no "best" pill or treatment for type 2 diabetes. You may need to try more than one type of pill, combination of pills, or pills plus insulin.
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    A , Endocrinology Diabetes & Metabolism, answered
    Diabetes medicine levels and treatments can vary significantly between individuals. Now, if your neighbor takes the same diabetes medication that you do, but takes more of it, that does not make her sicker than you are. Everyone’s diabetes is a personal affair and there are all kinds of different things that dictate how much and what kind of medication you need. Some medications are pills, some are shots. Medication, dosage and and desired effects are all to be set by your doctor.
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    A DPP-4 inhibitor is a type of medication used to treat type 2 diabetes. Its side effects include a stuffy or runny nose, sore throat, headache and diarrhea. Call your doctor if any of these side effects are severe or don’t go away.

    Also call your doctor right away if you have any of these serious symptoms:
    • Nausea and vomiting
    • Ongoing pain that begins in the upper left or middle of the stomach but may spread to the back (this pain could be pancreatitis, a serious complication of some DPP-4 inhibitors)
    • Rash or hives
    • Swelling of the face, lips, tongue or throat
    Even though DPP-4 inhibitors don’t actually cause hypoglycemia (or low blood sugar), you may take other diabetes medications that do increase the risk of hypoglycemia. For this reason, it’s good for you and your family to know the symptoms of hypoglycemia. These include feeling shaky, sweaty, hungry, and irritable. If you have these symptoms, test your blood glucose and take some quick-acting sugar if it is low. Good sources are three or four glucose tablets, a half-cup of fruit juice or regular soda, or a tablespoon of honey or sugar.
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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 DPP-4 inhibitor is a type of medication used to treat type 2 diabetes. A DPP-4 inhibitor can’t cure your diabetes, but by helping control your blood glucose, it lowers the chance that your diabetes will cause serious problems.

    As you know, when you have diabetes, you tend to have high blood glucose. Over time, this can damage your blood vessels and nerves, leading to heart attack or stroke, kidney and eye disease, and problems with your teeth, feet and skin. If you have high blood pressure or high cholesterol -- like many people with diabetes -- you have an even greater risk for these problems. (This is why you should always take your blood pressure or cholesterol medications as well as your diabetes medications.)
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    A , Pharmacy, answered
    The important thing to know about oral diabetes drugs is that they can be used only by people with type 2 diabetes -- not type 1. Oral diabetes drugs are also not considered safe for use by pregnant women.

    It's also important to recognize that oral diabetes drugs can't take the place of good lifestyle habits. You still need to eat a healthy diet and exercise regularly to control your blood sugar and stay healthy overall. Finally, oral diabetes drugs work best in people who are newly diagnosed with type 2 diabetes. If you already take significant amounts of insulin or have had diabetes for 10 years or longer, oral diabetes drugs may not be the right choice for you. Talk to your doctor about whether you are a good candidate for oral diabetes drugs.
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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. Like almost every medication, it comes with its own set of side effects. Common side effects from GLP-1 agonists include nausea, diarrhea, gas, a “jittery” feeling, dizziness, headache, weakness and upset stomach. Weight loss is also common. Call your doctor if any of these side effects are severe, as some side effects are serious.

    Call your doctor immediately if you have any of these potentially serious symptoms:
    • Ongoing pain that begins in the upper left or middle of the stomach but may spread to the back -- or any ongoing pain or ache in the mid or lower back
    • Hives, rash or itching
    • Difficulty breathing or swallowing
    • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles or lower legs
    • Lump or swelling in the neck
    • Hoarseness
    • Changes in the color or amount of urine
    • Swelling of the arms, hands, feet, ankles or lower legs
    GLP-1 agonists don’t cause hypoglycemia (or low blood glucose) by themselves. But combined with other medications, vigorous exercise or not eating enough, they can make your blood glucose drop too low. Since low blood glucose can be dangerous, make sure that you and your family know the symptoms. These include feeling shaky, sweaty, hungry and irritable. If you have these symptoms, check your blood glucose and take some quick-acting sugar if your glucose is low. Good sources are three or four glucose tablets, a half-cup of fruit juice or regular soda, or a tablespoon of honey or sugar.
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    A , Pharmacy, answered
    The best time to take your diabetic medication will vary depending on the medicine you're taking. For example, among pills for diabetes, some are meant to be taken before a meal, some at the first bite of a meal and some with food. Some are taken twice a day while others might be taken three times daily. Insulin may be taken as injections a few times a day or given by pump as a steady dose throughout the day. You and your doctor need to choose not only the best medications for controlling your diabetes, but also the best times to take those medications.
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