E34: Types of Diabetes, Risk Complications and Treatment
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.
Table of Contents
Types of Diabetes
Type 1 Diabetes: Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake). This reaction stops your body from making insulin. Approximately 5-10% of the people who have diabetes have type 1. It’s usually diagnosed in children, teens, and young adults. If you have type 1 diabetes, you’ll need to take insulin every day to survive.
World Diabetes Day 2022
AfyaFitness20 HealthCare aims in improving integrated, quality and sustainable healthcare solutions in Health, Lifestyle, and Mental Wellness. We have been in operation since Covid-19 outbreak. We also provide care and necessary medical attention our clients. Monday 14th November will be WORLD DIABETES DAY. We are joining the whole world to curb the prevalence of diabetes through THIS PLATFORM. Please help us fill this form. Thank you.
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Type 2 Diabetes: Excluding all causes of hyperglycemia and type 1 diabetes, This a condition associated with resistance to action of insulin followed by impairment of more than 50% pancreatic b-cells function thus leading to insulin deficiency.
Gestational diabetes : This develops in pregnant women who have never had diabetes. If you have gestational diabetes, your baby could be at higher risk for health problems. Gestational diabetes usually goes away after your baby is born. However, it increases your risk for type 2 diabetes later in life. Your baby is more likely to have obesity as a child or teen and develop type 2 diabetes later in life.
Pre-diabetes: This type is the stage before Type 2 diabetes. Your blood glucose levels are higher than normal but not high enough to be officially diagnosed with Type 2 diabetes.
OTHER FORMS OF DIABETES
- Drug induced diabetes due to drugs like glucocorticoids, thiazides and phentoin
- Diabetes associated with genetic syndromes ie downs syndrome, cushin syndrome
- Pancreatic diseases ie pancreatitis, cystic fibrosis, and hemochrotosis
Who Are at Risk of Diabetes?
- Individuals who have overweight or obesity.
- Individuals who are 45 years of age or older.
- Individuals with first-degree relatives with diabetes (such as parents, children, or siblings).
- People who developed diabetes while they were pregnant or gave birth to large babies (9 pounds or more).
- Individuals with high blood pressure (140/90 or higher).
- Individuals with high-density lipoprotein (HDL, the “good cholesterol level”) below 25 mg/dl or triglyceride levels at or above 250 mg/dl.
- Individuals who have impaired fasting glucose or impaired glucose tolerance.
- Individuals who are physically inactive; engaging in exercise less than three times a week.
- Individuals who have polycystic ovary syndrome, also called PCOS.
What Are Common Signs and Symptoms of Diabetes?
If you have any of the following diabetes symptoms, see your doctor about getting your blood sugar tested:
- Urinate (pee) a lot, often at night
- Are very thirsty
- Lose weight without trying
- Are very hungry
- Have blurry vision
- Have numb or tingling hands or feet
- Feel very tired
- Have very dry skin
- Have sores that heal slowly
- Have more infections than usual
What are Complications That Arise When Diabetes is not Managed?
- Eye problems (retinopathy): Some people with diabetes develop an eye disease called diabetic retinopathy which can affect their eyesight. If retinopathy is picked up – usually from an eye screening test – it can be treated and sight loss prevented.
- Foot problems: Diabetes foot problems are serious and can lead to amputation if untreated. Nerve damage can affect the feeling in your feet and raised blood sugar can damage the circulation, making it slower for sores and cuts to heal. That’s why it’s important to tell your GP if you notice any change in how your feet look or feel.
- Heart attack and stroke: When you have diabetes, high blood sugar for a period of time can damage your blood vessels. This can sometimes lead to heart attacks and strokes.
- Kidney problems (nephropathy): Diabetes can cause damage to your kidneys over a long period of time making it harder to clear extra fluid and waste from your body. This is caused by high blood sugar levels and high blood pressure. It is known as diabetic nephropathy or kidney disease.
- Nerve damage (neuropathy): Some people with diabetes may develop nerve damage caused by complications of high blood sugar levels. This can make it harder for the nerves to carry messages between the brain and every part of our body so it can affect how we see, hear, feel and move.
- Hyperosmolar Hyperglycaemic State (HHS)– a life-threatening emergency that only happens in people with type 2 diabetes. It’s brought on by severe dehydration and very high blood sugars.
- Diabetic ketoacidosis (DKA) – a life-threatening emergency where the lack of insulin and high blood sugars leads to a build-up of ketones.
Can Diabetes be Managed?
- Planning what you eat and following a healthy meal plan. Follow a Mediterranean diet (vegetables, whole grains, beans, fruits, healthy fats, low sugar) or Dash diet. These diets are high in nutrition and fiber and low in fats and calories. See a registered dietitian for help understanding nutrition and meal planning.
- Exercising regularly. Try to exercise at least 30 minutes most days of the week. Walk, swim or find some activity you enjoy.
- Achieving a healthy weight. Work with your healthcare team to develop a weight-loss plan.
- Taking medication and insulin, if prescribed, and closely following recommendations on how and when to take it.
- Monitoring your blood glucose and blood pressure levels at home.
- Keeping your appointments with your healthcare providers and having laboratory tests completed as ordered by your doctor.
- Quitting smoking (if you smoke).
NB: DON’T INTIATE TREATMENT ON YOUR OWN UNLESS PRESCRIBED BY DOCTOR.
Diabetes medication drug classes include:
- Sulfonylureas: These drugs lower blood glucose by causing the pancreas to release more insulin. Examples include glimepiride (Amaryl®), glipizide (Glucotrol®) and glyburide (Micronase®, DiaBeta®).
- Glinides (also called meglitinides): These drugs lower blood glucose by getting the pancreas to release more insulin. Examples include repaglinide (Prandin®) and nateglinide (Starlix®).
- 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 the example.
- 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 acarbose (Precose®).
- 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®).
- 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®).
- DPP-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®), saxagliptin (Onglyza®) and linagliptin (Tradjenta®).
- SGLT2 inhibitors (also called sodium-glucose cotransporter 2 inhibitors): These drugs work on your kidneys to remove glucose in your body through your urine. Examples include canagliflozin (Invokana®), dapagliflozin (Farxiga®) and empagliflozin (Jardiance®).
- Bile acid sequestrants: These drugs lower cholesterol and blood sugar levels. Examples include colestipol (Colestid®), cholestyramine (Questran®) and colesevelam (Welchol®).
- Dopamine agonist: This medication lowers the amount of glucose released by the liver. An example is bromocriptine (Cyclocet®).
- Many oral diabetes medications may be used in combination or with insulin to achieve the best blood glucose management. Some of the above medications are available as a combination of two medicines in a single pill. Others are available as injectable medications, for example, the GLP-1 agonist semaglutide (Ozempic®) and lixisenatide (Adlyxin®).
Always take your medicine exactly as your healthcare prescribes it. Discuss your specific questions and concerns with them.
What Insulin Medications are Approved to Treat Diabetes?
There are many types of insulin for diabetes. If you need insulin, you healthcare team will discuss the different types and if they are to be combined with oral medications. To follow is a brief review of insulin types.
Rapid-acting insulins: These insulins are taken 15 minutes before meals, they peak (when it best lowers blood glucose) at one hour and work for another two to four hours. Examples include insulin glulisine (Apidra®), insulin lispro (Humalog®) and insulin aspart (NovoLog®).
Short-acting insulins: These insulins take about 30 minutes to reach your bloodstream, reach their peak effects in two to three hours and last for three to six hours. An example is insulin regular (Humulin R®).
Intermediate-acting insulins: These insulins reach your bloodstream in two to four hours, peak in four to 12 hours and work for up to 18 hours. An example in NPH.
Long-acting insulins: These insulins work to keep your blood sugar stable all day. Usually, these insulins last for about 18 hours. Examples include insulin glargine (Basaglar®, Lantus®, Toujeo®), insulin detemir (Levemir®) and insulin degludec (Tresiba®).