Everything you need to know about Diabetes: Sweetness is the key for peace of mind, whether it’s about family relationships or about peers in office, whether we talk about servants at home or peons at the workplace, the most important thing is how we create positivity everywhere without losing our peace of mind.
But do you know as the sweetness in nature helps in smoother survival of all of us the opposite happens when this sweetness comes into the blood, it threatens you; as well as people connected to you. yes, you are correct I am talking about high blood sugar which ultimately leads to a life-threatening disease “Diabetes”.
You might be thinking that why I am marking Diabetes as a life-threatening disease, around you there are several people who have Diabetes but no one died just because of Diabetes so why to take extra care??
So here I would like to grab your attention that Diabetes never come alone it comes along with a bundle of diseases which targets your heart and causes heart diseases which further leads to macro and microvascular complications like coronary artery diseases (CAD), hypertension, renal impairment etc.
Types of Diabetes
1. Type 1 Diabetes mellitus
It’s usually called juvenile-onset because it is early diagnosed in children and youngsters as in most of the cases it’s genetically appearing whether this may affect a person at any age. This type is also known as insulin-dependent diabetes mellitus (IDDM) where the beta cells are completely destroyed by the immune system(no insulin production) or in some cases, more than 80% beta cells are damaged and very minute insulin is produced.
This may happen due to genetic disorders in the pancreas, any disease, infection or illness which affects pancreatic beta cells. Thus the patient is left with the only choice of drug I.e insulin which is administered subcutaneously.
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2. Type 2 Diabetes Mellitus (T2DM)
usually known as Non-insulin-dependent diabetes mellitus(NIDDM) generally it’s found in adults but due to change in lifestyle and eating habits the cases are increasing in children’s do young adults as well. There are many risk factors which may result in T2DM like:- a smoking, sedentary lifestyle, family history, Age, Obesity ( central obesity), ethnicity.
A patient is affected by T2DM when there is insulin resistance or impaired glucose tolerance in the body and the drug of choice are insulin, oral hypoglycemic agents. Cholesterol also plays an important role in managing diabetes so it’s better to add on fenofibrate which helps in reducing triglyceride levels.
3. Gestational diabetes
this is a temporary increase in blood glucose levels during pregnancy so that facilitates the better development of a baby in the womb. But if there is an imbalance in demand and output of the insulin the blood sugar levels rises too high which results in Gestational Diabetes. Gestational diabetes resolved and come to normal levels after delivery but has to be taken care because extra amount of glucose present in the body may act to be harmful to the mother as well as her baby. Here the drug of choice is oral antidiabetic(OAD) medication and insulin.
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Elaborating Oral Anti Diabetic drugs
- Sulfonylureas – Glimepiride, glipizide, glyburide, tolazamide, tolbutamide.
- MOA- Act on beta cells in the pancreas and facilitate insulin secretion. Also known as secretagogues.
- Biguanides – Metformin
- MOA- decreases hepatic glucose output, improve insulin sensitivity.
- Thiazolidinediones – Pioglitazone, rosiglitazone
- MOA- increase insulin receptor sensitivity and further initiate lipid and glucose metabolism.
- Alpha-glucosides inhibitors – Acarbose, Miglitol
- MOA- inhibit enzyme alpha-glucoside an enzyme present in the gastrointestinal tract which converts dietary supplements like starch and carbohydrates into simple sugars.
- DPP4 inhibitors – sitagliptin, vildagliptin, saxagliptin, linagliptin, teneligliptin
- MOA- inhibit DPP4 enzyme which is responsible for destroying incretins. Incretins are useful hormones to inhibit glucagon release, increase insulin secretion, decrease blood glucose levels and decrease gastric emptying and thus decrease blood glucose levels.
- Gliflozin – Dapagliflozin, Canagliflozin, Empagliflozin.
- MOA- SGLT2 inhibitors- inhibit the reabsorption of glucose in kidneys thus lower blood sugars.
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Injectables Drugs for Diabetes:-
- GLP 1 Agonist – Exenatide
- MOA- facilitates GLP1 analogues to normalize fasting and postprandial blood glucose.
- Insulin
- MOA- same as human insulin released from beta cells (regulate blood glucose levels in the body)
- Amylin – pramlintide(synthetic Amylin)
- MOA- Act like amylin in the body which is released by beta cells along with insulin to regulate blood glucose levels.
Note:- “So it’s better to have a sweet soul rather than a sweet blood”
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