Diabetes Information

What is diabetes?

Diabetes is a disorder of the way our bodies use food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood which is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells and be used, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

 

When we eat, the pancreas is supposed to automatically produce the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. The body is unable to correctly use its main source of fuel even though the blood contains large amounts of glucose.

 

What are the types of diabetes?

  • Type 1 Diabetes
  • Type 2 Diabetes
  • Gestational Diabetes

Type 1 Diabetes

Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States.  

In Type 1 diabetes, the immune system attacks insulin-producing cells (beta cells) in the pancreas and destroys them. The pancreas then produces little or no insulin. Someone with type 1 diabetes needs to take injections of insulin daily to live. Scientists do not know exactly what causes the immune system to attack beta cells. They believe that both genetic factors and environmental factors are involved.

Type 1 diabetes usually develops children and young adults, but the disorder can appear at any age. Symptoms of type 1 diabetes usually develop over a short period of time. Symptoms may include:

  • Increased thirst and urinationConstant hungerWeight lossBlurred vision
  • Extreme fatigue

If not diagnosed and treated with insulin, a person can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis.

Type 2 Diabetes

Type 2 diabetes accounts for about 90 to 95 percent of diagnosed diabetes in the United States. It is the most common form of diabetes.

In Type 2 diabetes, the pancreas usually makes enough insulin, but the body can’t use the insulin correctly. This is called insulin resistance. After several years insulin production also declines.

Type 2 diabetes usually develops after age 40. It is most common in adults over age 55. About 80 percent of people with type 2 diabetes are overweight. Unfortunately, as more children become overweight, type 2 diabetes is becoming more common in young people.

The symptoms of type 2 diabetes develop gradually. They are not as sudden as in type 1 diabetes.

Some people have no symptoms.

Symptoms may include:

  • Fatigue or nausea
  • Frequent urination
  • Unusual thirst
  • Weight loss
  • Blurred vision
  • Frequent infections
  • Slow healing of wounds or sores

Gestational Diabetes

Gestational diabetes develops only during pregnancy. It usually disappears after delivery. However, the mother is at higher risk of having type 2 diabetes later in life.

 

What are the symptoms of diabetes?

People with diabetes may experience certain symptoms, which include:

  • Increased thirst
  • Frequent urination
  • Weight loss
  • Increased hunger
  • Feeling very tired
  • Blurry vision
  • Frequent infections, slow-healing cuts or sores
  • Problems with sexual function in males
  • Dry, itchy skin
  • Numbness or tingling in hands or feet

In some cases, there are no symptoms with Type 2 diabetes or they may come on so gradually that they are not recognized. Therefore, people can live for months, even years without knowing they have the disease.

What can I do to help control my diabetes?

Nutrition and exercise, along with medications, are the cornerstones of controlling diabetes. Good nutrition improves overall health. A healthy diet keeps your weight under control and blood sugar levels closer to their normal levels. Your physician or dietitian can help design a diet that works for you. Exercise can lower your blood sugar by helping your body use its food supply more efficiently. Exercise also increases blood flow to small blood vessels to help improve overall circulation. Before starting an exercise regimen talk to your physician to see what type of exercise and how much are best suited for you.

Diabetics are at risk for many long term health complications such as:

  • Heart disease
  • Stroke
  • Poor blood flow which can lead to infection or amputation
  • Kidney disease
  • Blindness
  • Impotence in men

 Keep your blood sugar as normal as possible to help prevent complications. Good oral health is important for people with diabetes, so see the dentist regularly.  Good skin and foot care is also important for people with diabetes. Other ways to improve overall health and blood sugar control are to quit smoking and limit alcohol.

What medications are used to treat diabetes?


Alpha-glucosidase inhibitors slow digestion and absorption of carbohydrates. They stop the sharp rise in blood sugar that can occur after meals.

 

Examples include:
acarbose (Precose®)

miglitol (Glyset®)

 

Important reminders when taking these medications:

  • Take your dose with the first bite of meals as directed by your physician.
  • Gastrointestinal symptoms (abdominal pain, flatulence, and diarrhea) are common when taking these medications, but usually decrease over time.

 

Meglitinides cause the pancreas to release more insulin.

 

Examples include:
repaglinide (Prandin®)
nateglinide (Starlix®)

Important reminders when taking these medications:

  • Take 15 to 30 minutes before a meal.
  • If you add or skip a meal, you may be instructed by your physician to add or skip the dose associated with that meal.

 

Biguanides lower glucose production by the liver and lower absorption of glucose in the intestines. They also make the body more sensitive to insulin.

Examples include:
metformin (Glucophage® / Glucophage XR®)

Important reminders when taking these medications:

  • Take medication with food. Gastrointestinal symptoms (nausea, diarrhea, weight loss, and cramping) are common when taking these medications.
  • Avoid or limit use of alcohol.

 

Thiazolidinediones lower insulin resistance and production of glucose by the liver. They also make the body more sensitive to insulin.

Examples include:

pioglitazone (Actos®)
rosiglitazone (Avandia®)

Important reminders when taking these medications:

  • May be taken without regards to meals.
  • Your liver function will need to be monitored by your physician while taking these medications.
  • Report any chest pain, rapid heartbeat, abdominal pain, fever, rash, yellowing of the skin or eyes, dark urine, light stools, unusual fatigue, or nausea and vomiting to your physician.
  • Avoid alcohol.

 

Sulfonylureas cause the pancreas to release more insulin.

Examples include:
glimepiride (Amaryl®)
glyburide (DiaBeta / Micronase / Glynase®)
glipizide (Glucotrol / Glucotrol XL®)
tolbutamide (Orinase®)

Important reminders when taking these medications:

  • Take 30 minutes before breakfast or the first main meal.
  • Combination Examples include: Glucovance® (glyburide and metformin)

 

Incretin mimetics cause the pancreas to release more insulin and slow stomach emptying.

 

Examples include:

Exenatide (Byetta®)

 

Important reminders when using this medication:

  • This is an injectable medication.
  • Give injection within 60 minutes of meal.
  • Gastrointestinal symptoms (nausea, diarrhea, anorexia, and cramping) are common when taking these medications.

 

 Amylinomimetics slow stomach emptying. They also lower the body’s level of glucagon (a hormone that raises blood sugar).

 

Examples include:

Pramlintide (Symlin®)

 

Important reminders when taking this medication:

  • This is an injectable medication.
  • This medication is only used when a person is also on insulin.
  • Gastrointestinal symptoms (nausea, diarrhea, anorexia, and cramping) are common when taking these medications.

 

Insulin is the principal hormone required for proper glucose use. It lowers blood sugar by causing glucose uptake in the body. It also lowers glucose production in the liver.

Examples include:
Humalog, Humalog Mix, Humulin 50/50, Humulin 70/30, Humalog 75/25, Humulin N, Humulin R, Lantus, Novolin 70/30, Novolin N, Novolin R, Novolog, Novolog 70/30, Lantus, Levemir, Apidra

Important things all diabetics should know

  • Wear a medical identification bracelet or carry something that identifies you as having diabetes.
  • Be aware of the signs and symptoms of hypoglycemia (low blood sugar), which can be any of the following:
    -feeling shaky
    -becoming sweaty
    -feeling tired
    -becoming hungry
    -feeling crabby or confused
    -having rapid heartbeat
    -having blurred vision
    -having headaches
    -passing out
  • Carry glucose tabs or candy with you at all times in case of hypoglycemia
  • Ensure those around you are familiar with the signs and symptoms of hypoglycemia and what to do in case it occurs.
  • Have an eye exam annually.
  • Have a dental exam twice a year.
  • Check your feet daily for problems (sores, blisters, cracks).
  • Ask your provider about enrolling in a diabetic education course.
  • Maintain regular office visits with your physician.
  • Check your blood glucose at home.
  • Consult your physician or pharmacist before starting any new prescription or over-the-counter drugs.