1. Types of diabetes
3 Types
• Type 1 diabetes can develop at any age, but occurs most frequently in children and adolescents. When you have type 1 diabetes, your body produces very little or no insulin, which means
...
1. Types of diabetes
3 Types
• Type 1 diabetes can develop at any age, but occurs most frequently in children and adolescents. When you have type 1 diabetes, your body produces very little or no insulin, which means that you need daily insulin injections to maintain blood
glucose levels under control.
• Type 2 diabetes is more common in adults and accounts for around 90% of all diabetes cases. When you have type 2 diabetes, your body does not make good
use of the insulin that it produces. The cornerstone of type 2 diabetes treatment is healthy lifestyle, including increased physical activity and healthy diet.
However, over time most people with type 2 diabetes will require oral drugs and/or insulin to keep their blood glucose levels under control.
• Gestational diabetes (GDM) is a type of diabetes that consists of high blood glucose during pregnancy and is associated with complications to both mother
and child. GDM usually disappears after pregnancy but women affected and their children are at increased risk of developing type 2 diabetes later in life.
Diagnostic criteria
• A fasting plasma glucose (FPG) level of 126 mg/dL (7.0 mmol/L) or higher, or
• A 2-hour plasma glucose level of 200 mg/dL (11.1 mmol/L) or higher during a 75g oral glucose tolerance test (OGTT), or
• A random plasma glucose of 200 mg/dL (11.1 mmol/L) or higher in a patient with classic symptoms of hyperglycemia or hyperglycemic crisis
Whether a hemoglobin A1c (HbA1c) level of 6.5% or higher should be a primary diagnostic
Initial treatment
The American Diabetes Association recommends routine screening for type 2 diabetes beginning at age 45, If the results are normal, repeat the test every three years. Screening is also recommended for people who are under 45 and overweight if there are other heart disease or diabetes risk factors present, such as a sedentary lifestyle, a family history of type 2 diabetes, a personal history of gestational diabetes or blood pressure above 140/90 millimeters of mercury
For patients with type 2 diabetes with overweight (BMI ≥25 to 29.9 kg/m2) or obesity (BMI ≥30 kg/m2)
Examples of possible treatments for type 2 diabetes include:
Biguanides
Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes. It works by lowering glucose production in
the liver and improving your body's sensitivity to insulin so that your body uses insulin more effectively.
Nausea and diarrhea are possible side effects of metformin. These side effects may go away as your body gets used to the medicine or if you take the medicine with a meal. If metformin and lifestyles changes aren't enough to control your blood sugar level, other oral or injected medications can be added.
Medications
• Metformin (Fortamet, Glucophage, others Action
• Inhibit the release of glucose from the liver
• Improve sensitivity to insulin
Advantages
• Very effective
• May promote modest weight loss
• Low cost
Possible side effects
• Nausea
• Diarrhea
• Very rarely, the harmful buildup of lactic acid (lactic acidosis) when used in patients with kidney or liver failure
Alpha-glucosidase inhibitors
Medications
• Acarbose (Precose)
• Miglitol (Glyset)
Action
• Slow the breakdown of starches and some sugars
Advantages
• Don't cause weight gain
• Don't cause hypoglycemia (unless combined with insulin or a sulfonylurea)
Possible side effects
• Stomach pain
• Gas
• Diarrhea
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