Wednesday, 28 December 2016

Treatments

Treatment for Type 1 Diabetes

Treatment for type 1 diabetes includes:
  • Taking insulin
  • Carbohydrate counting
  • Frequent blood sugar monitoring
  • Eating healthy foods
  • Exercising regularly and maintaining a healthy weight
The goal is to keep the blood sugar level as close to normal as possible to delay or prevent complications. Although there are exceptions, generally, the goal is to keep blood sugar levels before meals between 70 and 130 mg/dL (3.9 to 7.2 mmol/L) and after meal numbers below 180 mg/dL (10 mmol/L) two hours after eating.

Other Medications

Additional medications also may be prescribed for people with type 1 diabetes, such as:
Pramlintide (Symlin) -  An injection of this medication before eating can slow the movement of food through the stomach to curb the sharp increase in blood sugar that occurs after meals.
Cholesterol-lowering drugs - Cholesterol guidelines tend to be more aggressive for people with diabetes because of the elevated risk of heart disease. The American Diabetes Association recommends that:
  • Low-Density Lipoprotein (LDL, or "bad") cholesterol to be below 100 mg/dL (2.6 mmol/L), and for individuals with heart disease, their LDL goal is to be below 70 mg/dL (1.8 mmol/L)
  • High-Density Lipoprotein (HDL, or "good") cholesterol to be over 50 mg/dL (1.3 mmol/L) in women and over 40 mg/dL (1 mmol/L) in men. Triglycerides, another type of blood fat, are ideal when they're less than 150 mg/dL (1.7 mmol/L).
For example, drugs like lipitor and pravachol are prescribed to lower LDL.





Treatment for Type 2 Diabetes

Medications in the form of tablets:
  • Biguanide - prescribed to patients if a healthy diet and physical activity alone are not sufficient to help control the high blood glucose levels.
  • Sulphonylureas - stimulates the cells in the pancreas to secrete more insulin, helping it to work more effectively within the body.
  • Alpha glucosidase inhibitor (arcarbose) - used to slow down the intestine's absorption of starchy foods. This will slow down any rise in blood glucose levels after meals.

  • Prandial glucose regulators - has the same effect as sulphonylureas; stimulating the pancreas cells to secrete more insulin. This will take effect quicker but last shorter than sulphonylureas. It is advised to be consumed half an hour before a meal.

  • Thiazolidinediones (glitazones) - reduces insulin resistance and improves insulin sensitivity; leading to an increase in the effectiveness of insulin produced by the body. It also protects the cells in the pancreas. Thus, allowing the pancreas cells to produce insulin for a longer period of time.


Another way of managing type 2 diabetes is losing weight. It can be seen as a trend that many patients who are diagnosed with type 2 patients are overweight or obese. This is because the extra body fat in their body increases insulin resistance. Hence, by losing weight, patients are able to reduce insulin resistant in the body.

Weight loss can be done is various ways. The first approach would be to manage a healthy weight range through a healthy lifestyle that consists of a balanced diet with adequate exercise. However, often times, this may not be sufficient to help patients manage type 2 diabetes. Thus, weight loss surgery can be done. Medical research has shown that obesity surgery can directly affect how the body uses insulin. This form of treatment will directly benefit the patients in losing weight and regulating blood glucose levels. Moreover, it can help patients in better managing their type 2 diabetes through these few ways:
  • Change the way hormones in the gut work. Thus, affecting how produces body makes insulin
  • Increase the amount of bile acids that the body makes. Thus, causing the body cells to be more sensitive to insulin
  • Improve the way the cells use insulin, leading to lower blood sugar levels.


Various forms of obesity surgery, also known as bariatric surgery, can be offered to type 2 diabetic patients. It can be the removal of a part of the stomach to reduce stomach size. Alternatively, a surgical re-route of the digestive system to bypass the stomach can be done. Both forms of surgery allow patients to reduce their food intake since they require less food to feel full.

Treatment for Other Types of Diabetes

Type 3 Diabetes - Medications
  • Incretin mimetic drugs (like liraglutide (Victoza) and lixisenatide (Lyxumia)) - Are being studied to become possible treatments for type 3 diabetes as they have proved to potentially prevent the development of Alzheimer’s disease.
  • Pioglitazone (Actos) - A type of thiazolidinediones (insulin sensitizer) which increases the body’s sensitivity to insulin. It is also another medication that may help to prevent the development of Alzheimer’s disease.  


Gestational Diabetes
  • Healthy diet
    • Eat regularly
    • Eat starchy and low glycaemic index foods - these foods releases sugar slowly
    • Eat Fruits and Vegetables
    • Avoid sugary foods and drinks
  • Regular physical activities and exercises so as to keep the blood glucose level under control.
  • Medications will be given if blood glucose level still does not decrease following healthy diet and regular exercises. Medications includes tablets and insulin injection.
  • Taking tablets such as Metformin or Glibenclamide.
  • Insulin injection will only be given if patient cannot take Metformin, if there are side effects with Metformin or when the blood glucose level is very high.
  • Patients should also monitor their blood glucose level regularly using a finger-pricking device and putting a drop of blood on the testing strip.




References:
http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/basics/treatment/con-20019573
http://www.webmd.com/cholesterol-management/guide/cholesterol-lowering-medication#1
https://www.diabetes.org.uk/Guide-to-diabetes/Managing-your-diabetes/Treating-your-diabetes/Tablets-and-medication/

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Other Types of Diabetes

Other than Type 1 and Type 2 Diabetes, there are other types of diabetes such as Type 3 Diabetes, Gestational Diabetes, Maturity Onset Diabetes of the Young (MODY) and Latent Autoimmune Diabetes of Adults (LADA).
For this blog post, we will be focusing on Type 3 Diabetes and Gestational Diabetes.
Type 3 Diabetes
Type 3 Diabetes refers to the resistance to insulin in the brain. This is similar to that in Alzheimer’s disease. And thus, it is also a title proposed for Alzheimer’s disease.
In Type 1 Diabetes, either no insulin or not enough insulin is produced for the cells to utilise glucose or for glucose to be converted into glycogen for storage. And in Type 2 Diabetes, the body does not respond to the insulin produced; this is known as insulin resistance. In both cases, the body’s functions are affected.
As for Alzheimer's disease, it is shown that similar problems also occur but instead of affecting the entire body’s function, they affect the brain. As a result, Alzheimer’s disease is often referred to as “Type 3 Diabetes”.

Symptoms:
Since Type 3 Diabetes was only recently discovered in 2005, many symptoms remain uncovered as compared to Type 1 and 2 Diabetes. Currently, there are only very few symptoms of Type 3 Diabetes; and the known symptoms include memory loss, confusion and dementia. Type 3 Diabetes can be diagnosed using a functional Magnetic Resonance Imaging (fMRI) scan which measures the brain activity.

Gestational Diabetes
Gestational Diabetes is diagnosed in pregnant women during their second or third trimester.
These pregnant women do not have diabetes before their pregnancy and Gestational Diabetes usually goes away after giving birth.
Causes:
The hormones that are produced during pregnancy increases the risk of insulin resistance as they make it difficult for the body to utilize insulin properly. In addition, heavy demand on the body during pregnancy decreases the ability of some women to produce sufficient insulin to overcome this resistance. The body is thus unable to use glucose properly for energy and this causes glucose to remain in the blood and the blood glucose level will rise, leading to Gestational Diabetes.
Symptoms:
Gestational diabetes generally does not have any significant noticeable signs or symptoms.
However, patients may experience these symptoms if their blood glucose level is too high:
  • Fatigue
  • Increased thirst
  • Dry Mouth
  • Increased urination
  • Blurred vision

Gestational diabetes can be diagnosed using blood tests such as glucose tolerance test and Oral Glucose Challenge Test (OGCT). Glucose tolerance test involves drinking a beverage high in sugar. A blood sample will then be drawn after an hour to test the blood glucose level. Additional testings will be required if the screening test showed abnormal results.


References:
https://www.diabetes.co.uk/type3-diabetes.html
https://www.verywell.com/why-is-alzheimers-called-type-3-diabetes-98797
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Type 2 Diabetes

What is type 2 diabetes?

Type 2 diabetes is the most common form of diabetes that is more frequently diagnosed in overweight and obese middle-aged and older people. However, this disease that was rarely diagnosed in youth before is becoming more common in overweight and obese youth.


Causes:

Type 2 diabetes usually begins with insulin resistance, a condition whereby the body’s muscle, liver, and fat cells do not effectively use insulin. Hence, the body requires more insulin to help cells take in glucose. Initially, the pancreas is able to produce more insulin to keep up with the increased demand. Unfortunately, over time, the pancreas is unable to make enough insulin to meet the body’s demands. Thus, blood glucose levels rise in the body.
Symptoms (they often develop slowly):


  • Increased thirst and frequent urination
  • Increased hunger
  • Weight loss
  • Fatigue
  • Blurred vision
  • Slow-healing sores or frequent infections
  • Areas of darkened skin


References:
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Type 1 Diabetes

Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease.
Although the disease usually starts in people under 20, it can happen at any age.


Causes:
In the case of people who have type 1 diabetes, it happens when their body’s immune system destroys cells in the pancreas called beta cells. They’re the ones that make insulin. Type 1 diabetes can also occur alongside with other autoimmune disease like Grave’s disease or vitiligo.



Symptoms:
These are often subtle, but they can become severe. They include:
  • Increased thirst
  • Increased hunger (especially after eating)
  • Pain in the belly
  • Unexplained weight loss (even though you’re eating and feel hungry)
  • Fatigue (weak, tired feeling)
  • Blurred vision
  • Heavy, labored breathing (also known as Kussmaul respiration)
  • Frequent infections of the skin, urinary tract, or vagina

Signs of emergency for type 1 diabetic patients include:
  • Shaking and confusion
  • Rapid breathing
  • Pain in the belly
  • Loss of consciousness (rare)


References:
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Monday, 28 November 2016

What Is Diabetes?

Diabetes is a group of metabolic diseases whereby the blood glucose level remains persistently high. It affects how the body uses glucose. In all cases of diabetes, blood glucose in the body does not get converted into glycogen for storage and this results in high blood glucose level. Even though there is high blood glucose level, the cells will be deprived from energy as the glucose cannot be converted into energy.

Generally, people who consume large amount of sugar will develop a higher risk of getting diabetes.



What is insulin and how does it function?

 The body breaks down the sugars and starches you eat into a simple sugar(monosaccharide) called glucose, which is used to provide energy. Insulin is a hormone that the body requires to get glucose from the bloodstream into the cells of the body. With the help of insulin therapy and other treatments, even young children with diabetes can learn to manage their condition and live long, healthy lives.  
Reference:

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