Diabetes is often quoted as a 'silent killer.' According to available statistics, the total number of diabetics patients in India is estimated about 50 million. In 2030, it is expected that about 80 million of our population will suffer from diabetes. About 50,000 of the affected have their legs removed every year, and many become heart patients. The data mentioned above demonstrates the ferocious face of diabetes.
Diabetes mellitus, commonly called sugar diabetes, is a metabolic disorder characterized by hyperglycemia (surplus amount of glucose in the bloodstream), glycosuria (excess sugar in urine), ketonuria (excess amount of ketones in urine) and ketonemia (abnormal presence of ketones in the blood). The World Health Organization (WHO) recognizes three main forms of diabetes: Type I, II, and gestational. Gestational diabetes occurs in women only during pregnancy. All forms have similar signs, symptoms, and consequences, but different immediate causes. The ultimate cause of all of them is the inability of pancreatic beta cells to produce sufficient insulin to prevent hyperglycemia.
- Type II Diabetes occurs when there is insufficient insulin production by the body or when there is insulin resistance.
- Gestational diabetes is due to insulin resistance.
- Insulin is a hormone that regulates your blood sugar level/BSL.
- Insulin resistance is a condition wherein the body produces enough insulin, but your body is not able to utilize that insulin.
- In its initial stages, Type II can be corrected with diet and exercise. But if it is beyond that, your doctor may prescribe medicines.
- If you are having gestational diabetes, your doctor may straight away prescribe medicines along with diet and exercise to protect you and your baby.
What are the symptoms of diabetes?
Fatigue, increased appetite, thirst, frequent urination, weak eyesight, wounds that take a long time to heal, and persistent infections are some of the early symptoms of diabetes. People often are inattentive to these symptoms. Identifying these as soon as possible can avoid future risks.
This is the stage before actual diabetes. Here, a person's blood glucose level increases abnormally, but he/she hasn't got diabetes yet. If necessary precautions are not taken during this stage, within the next 5-10 years, you may develop type II diabetes.
Who needs to be tested?
Testing for diabetes is necessary if you have the following:
1. For those whose parents or relatives have diabetes.
2. Over weight people, with a BMI exceeding 23, (hip 80cm in the case of women and 90 cm in case of men).
3. High blood pressure or high cholesterol.
4. If you are above 35 years and suffer from heart disease.
5. Mothers who have given birth to a child weighing more than 4 kilograms, or who have undergone abortion.
6. Those who completely abstain from physical activities.
Oral medicines that are prescribed for diabetes act in the following ways
1. They stop the production of glucose by the liver
Usually liver produces glucose only when you are starving, or when your body needs glucose/sugar but it is not readily available in your blood.
In diabetes, this function works differently. There is a case of hyperglycemia, or high BSL. This is because your body is not able to utilize glucose. So your body starves. The liver releases glucose because your body is starving. This further increases your BSL.
2. They boost insulin production
Few oral medicines boost Insulin production, thus improving BSL.
3. They improve insulin sensitivity
Muscle and various organs are able to utilize glucose/sugar better.
Drugs commonly used to treat type II diabetes
Biguanides work by improving your insulin sensitivity and stopping production of glucose by the liver.
- Lowers triglycerides. Triglycerides are harmful substances that increase fat.
- No weight gain.
- No high BP.
- Less chances of hypoglycemia/low BSL.
- Contraindicated for people with heart and kidney diseases.
- High chances of nausea, gas and loose stools.
- You need 2 to 3 doses per day.
Generic: Glimepiride, Glipizide and Glyburide
Sulfonylureas help your body secrete more Insulin.
- Acts fast
- No high BP
- No increase in LDL or cholesterol. Bad cholesterol increases chances of heart disease.
- Taken once a day
- Higher chances of hypoglycemia/low BSL.
- 5 to 10 pounds increase in weight.
Thiazolidinediones work by improving your insulin sensitivity.
- Raises HDL/good cholesterol, to some extent.
- Lowers triglycerides
- Lower chances of Hypoglycemia/ Low BSL than Sulphonylureas
- 5 to 10 pounds increase in weight
- Higher risk of heart failure
- Higher risk of heart attack with Avandia (Trade name)
- Higher risk of bladder cancer with Actos (Trade name)
- Higher risk of iron deficiency anemia
- Increase in LDL/bad cholesterol
- Higher risk of edema (fluid buildup)
Meglitinides help your body secrete more insulin.
- Acts fast
- Does not increase cholesterol
- Low risk of Hypoglycemia with Starlix (Trade name) than Sulphonylureas
- High risk of hypoglycemia with Prandin (Trade name)
- High risk of weight gain with Prandin (Trade name)
- Low risk of Hypoglycemia
- Less effective than other medicines
6. Alpha-glucosidase Inhibitors
- Lowers triglycerides
- No weight gain
- Less chances of hypoglycemia/low BSL
- No increase in cholesterol
- Less efficient than other diabetes medicines
- High chances of nausea, gas and loose stools
Diet and exercise play an valuable role in preventing and controlling Type II diabetes. The earlier you begin, the faster and surer are the results. If your diabetes is not coming under control through diet and exercise, your doctor may prescribe medicine. He may try a combination of several medicines to bring your BSL to normal levels. If you have not achieved normal values yet, you may have to start insulin!
- Diabetes is a very common disease that has certain courses of medication to alleviate its symptoms.
- Medication is usually prescribed for Type II diabetes.
- There are a number of signs that suggest you need to get checked for the disease.