There are six main groups of tablets you may be prescribed to control your diabetes. The way in which they work to help control your diabetes is described below.
1. METFORMIN
This belongs to a group known as Biguanides
Taken 2- 3 times a day with or after food.
How It Works: Metformin improves your body’s responses to insulin and also stops it making too much sugar. Metformin may be used alone or in combination with other treatments e.g Gliclazide or any of those listed below.
2. GLIBENCLAMIDE, GLICLAZIDE, GLIPIZIDE,GLIMEPIRIDE
These belong to the group known as Sulphonylureas
Taken 1-3 times daily, shortly before food.
How It Works: These stimulate the body to make more insulin because it may not be making enough for your needs. This should then lower your blood sugar levels. These may be used alone or in combination with other treatments such as those below.
3. ACARBOSE, Miglitol,Voglibose;
Belongs to a group known as Alpha-Glucosidase Inhibitors
Taken 1-3 times day
How It Works: by delaying the rate at which you digest sugar, which in turns slows down the rate at which your blood sugar rises after you have eaten. It slows down the uptake of starchy and sugary foods from the intestines.It may be used alone or in combination with other medications. It should be chewed with first mouthful of food or swallowed whole with a little liquid immediately before food.
4. ROSIGLITAZONE and PIOGLITAZONE
These belong to a group called Thiazolidinediones
Taken 1-2 times a day with or without food.
How It Works: Glitazone tablets increase the action of your body’s insulin by helping it work more effectively. It may be used alone or in combination with other medication.
5. REPAGLINIDE and NATEGLINIDE
These belong to a group called Prandial Glucose Regulators
Taken up to 3 times a day before food.
How It Works: These help your body produce the right amount of insulin after meals to cope with the increase in sugar in your blood stream.They work very quickly and should be taken shortly before each main meal.
6. Sitagliptin,Vildagliptin
These belong to a group called DPP4 Inhibitors.
How it works: It works by increasing Insulin secretion and also by decreasing sugar production by Liver.
Friday, August 22, 2008
Wednesday, August 13, 2008
Type 2 Diabetes Patients Who Lost Weight Soon After Diagnosis Had Better Control
People diagnosed with type 2 diabetes who lose excess weight soon after their diagnosis are up to twice as likely to maintain control of their disease than those who do not lose weight or who gain weight, according to a new study. The study is published in online in Diabetes Care, the journal of the American Diabetes Association.
Even if they regain the weight, as most in this study did, the benefits remain, the researchers found.
People who lose (excess) weight are more likely to attain their blood sugar and blood pressure goals than people who gain weight or maintain a stable weight.
When a patient is newly diagnosed with type 2 diabetes, he/she might already have lost some weight, but may still be over-weight for their height. If they try to control blood sugar with medications alone(especially medicines that increase secretion of Insulin), they will gain weight. So, if an already over-weight patient gains weight on treatment for diabetes, the chances of them attaining target treatment goals is remote.
If vigorous exercise and dieting along with Insulin sensitisers like Metformin are used, the patients may continue to loose weight while attaining normal blood sugar levels. In the long run, such patients attain treatment goals more often, as per the study.
So in management of type 2 diabetes in over-weight patients, the most important treatment is life style modification with low-carb diet and exercise.
Even if they regain the weight, as most in this study did, the benefits remain, the researchers found.
People who lose (excess) weight are more likely to attain their blood sugar and blood pressure goals than people who gain weight or maintain a stable weight.
When a patient is newly diagnosed with type 2 diabetes, he/she might already have lost some weight, but may still be over-weight for their height. If they try to control blood sugar with medications alone(especially medicines that increase secretion of Insulin), they will gain weight. So, if an already over-weight patient gains weight on treatment for diabetes, the chances of them attaining target treatment goals is remote.
If vigorous exercise and dieting along with Insulin sensitisers like Metformin are used, the patients may continue to loose weight while attaining normal blood sugar levels. In the long run, such patients attain treatment goals more often, as per the study.
So in management of type 2 diabetes in over-weight patients, the most important treatment is life style modification with low-carb diet and exercise.
Saturday, August 9, 2008
Hypoglycemia
If you are a diabetic and is taking medicines to reduce your blood sugar, you should know about Hypoglycemia (low blood sugar).
Hypoglycemia (also known as an "insulin reaction," or just "low blood glucose") occurs when blood glucose goes too low. Hypoglycemia can be caused by many things: too much insulin, too much tablets, not enough food, too much exercise, eating late, or eating too little carbohydrate. In short, it happens when insulin and blood glucose are out of balance.
People without diabetes usually don't get hypoglycemia. Their body can tell when it has enough insulin and stops releasing it automatically, but people with diabetes have to figure out how much insulin or how much Insulin-secreting tablets they need. Once the insulin is injected, or tablet is taken, it keeps working until it's gone, even if the blood glucose goes too low.
Mild or moderate hypoglycemia is pretty common for children and adults who take insulin or Insulin-secreting drugs like Daonil, Glimepride, Glipizide, or Gliclazide, but it can be dangerous if it's not treated right away. Mild or moderate hypoglycemia can get dangerously low pretty quickly. Severe hypoglycemia could lead to coma. So knowing about hypoglycemia is very important, not just for you, but for family, friends, co-workers etc.
Each person reacts to hypoglycemia differently. You may only have a few symptoms. It's important for you and your family to observe what symptoms are unique to you. That way, you can recognize it sooner, and treat it before it becomes serious.
Most common triad of symptoms of hypoglycemia are
Shivering
Excessive Sweating (clothes drenched with sweat)
Unusual Hunger
If this three happens together, especially just before your next meal and if the symptoms reverse quickly on eating, then you are having a mild hypoglycemia.
Other symptoms include
Nervousness
Irritability, sadness, or anger
Impatience
Chills and cold sweats
Fast heartbeat
Light-headedness or dizziness
Drowsiness
Lack of coordination
Blurred vision
Nausea
Tingling or numbness of lips or tongue
Nightmares or crying out during sleep
Headaches
Strange behavior
Confusion
Personality change
Passing out
Treating Hypoglycemia
When you notice symptoms of hypoglycemia, it's important to treat it right away. If you're feeling a little "off" but not too bad, you should do a blood glucose check first. A blood sugar value below 70mgs means it is hypoglycemia, but if you feel fairly sick and is not able to check, go ahead and treat for hypoglycemia. Here's how.
Step 1
Eat food or drink fluid that is easily digestible that contain at least 10 to 15 grams of carbohydrate.For example you can eat Iddly, Rice, Kanji, Roti, Glucose biscuits, toffees, Bun, Sweet Bread, Honey, Glucose tablets or powder, or you can drink a sugary tea or a sugary fruit juice ,or even a soft drink.
Step 2
Wait for 15 minutes and if possible check your blood sugar again. If you feel better and sugar is rising up take a complete meal so that it wont become low again.
Step 3
If blood sugar is not rising up or if you don't feel better eat another 15 grams of carbohydrate. If you feel better with this eat a complete meal.
Step 4
If your blood glucose is still too low (or you don't feel better), go to a hospital directly and tell the duty doctor or nurse that you are a diabetic on Insulin/tablets, and you think it is hypoglycemia.Don't wait for an appointment to see the doctor who is treating you.
Don't use fear of hypoglycemia as an excuse to eat your favourite sweet stuff. You will have the opposite problem - high blood glucose - later in the day. Also, stick to sugary foods that don't have a lot of fat. Fat slows down the movement of sugar into your blood. So oily sweets are not the best choices for treating hypoglycemia, unless they're the only high-carb foods nearby.
If mild or moderate hypoglycemia is not treated promptly, it can turn into severe hypoglycemia. People with severe hypoglycemia have so little glucose in their system that it affects their brain. When that happens, they pass out.
The best way to avoid severe hypoglycemia is catch it early. Be alert to any symptoms of hypoglycemia. Check your blood glucose if you have any doubt. Always carry some glucose tabs or other carbohydrate with you to treat hypoglycemia.
If you do develop severe hypoglycemia, you will need help from the people around you. You cannot drink juice or chew glucose tablets when you're unconscious. Glucagon is useful here, but is not widely available in India. Glucagon is a substance that makes the liver release sugar into your bloodstream. It can be injected to treat severe hypoglycemia.If no glucagon is available you must be taken to the hospital right away.
Do not forget to wear a medical ID bracelet or necklace that says you have diabetes and take insulin/tablets. You cannot tell anyone about your diabetes if you're unconscious or confused, but the medical ID can.
Keep something containing sugar like glucose powder or toffees with you at all times to treat hypoglycemia.
Tips to prevent hypoglycemia.
1.Always take the correct dose of Insulin/tablets.
2.If you plan to do some unusual physical activity, eat an additional snack before doing that.
3.If you feel unwell or have some illness like loose motions or vomiting and is not able to consume your usual calories, reduce the dosage of Insulin/tablets.
4.Never delay your meal
Hypoglycemia (also known as an "insulin reaction," or just "low blood glucose") occurs when blood glucose goes too low. Hypoglycemia can be caused by many things: too much insulin, too much tablets, not enough food, too much exercise, eating late, or eating too little carbohydrate. In short, it happens when insulin and blood glucose are out of balance.
People without diabetes usually don't get hypoglycemia. Their body can tell when it has enough insulin and stops releasing it automatically, but people with diabetes have to figure out how much insulin or how much Insulin-secreting tablets they need. Once the insulin is injected, or tablet is taken, it keeps working until it's gone, even if the blood glucose goes too low.
Mild or moderate hypoglycemia is pretty common for children and adults who take insulin or Insulin-secreting drugs like Daonil, Glimepride, Glipizide, or Gliclazide, but it can be dangerous if it's not treated right away. Mild or moderate hypoglycemia can get dangerously low pretty quickly. Severe hypoglycemia could lead to coma. So knowing about hypoglycemia is very important, not just for you, but for family, friends, co-workers etc.
Each person reacts to hypoglycemia differently. You may only have a few symptoms. It's important for you and your family to observe what symptoms are unique to you. That way, you can recognize it sooner, and treat it before it becomes serious.
Most common triad of symptoms of hypoglycemia are
Shivering
Excessive Sweating (clothes drenched with sweat)
Unusual Hunger
If this three happens together, especially just before your next meal and if the symptoms reverse quickly on eating, then you are having a mild hypoglycemia.
Other symptoms include
Nervousness
Irritability, sadness, or anger
Impatience
Chills and cold sweats
Fast heartbeat
Light-headedness or dizziness
Drowsiness
Lack of coordination
Blurred vision
Nausea
Tingling or numbness of lips or tongue
Nightmares or crying out during sleep
Headaches
Strange behavior
Confusion
Personality change
Passing out
Treating Hypoglycemia
When you notice symptoms of hypoglycemia, it's important to treat it right away. If you're feeling a little "off" but not too bad, you should do a blood glucose check first. A blood sugar value below 70mgs means it is hypoglycemia, but if you feel fairly sick and is not able to check, go ahead and treat for hypoglycemia. Here's how.
Step 1
Eat food or drink fluid that is easily digestible that contain at least 10 to 15 grams of carbohydrate.For example you can eat Iddly, Rice, Kanji, Roti, Glucose biscuits, toffees, Bun, Sweet Bread, Honey, Glucose tablets or powder, or you can drink a sugary tea or a sugary fruit juice ,or even a soft drink.
Step 2
Wait for 15 minutes and if possible check your blood sugar again. If you feel better and sugar is rising up take a complete meal so that it wont become low again.
Step 3
If blood sugar is not rising up or if you don't feel better eat another 15 grams of carbohydrate. If you feel better with this eat a complete meal.
Step 4
If your blood glucose is still too low (or you don't feel better), go to a hospital directly and tell the duty doctor or nurse that you are a diabetic on Insulin/tablets, and you think it is hypoglycemia.Don't wait for an appointment to see the doctor who is treating you.
Don't use fear of hypoglycemia as an excuse to eat your favourite sweet stuff. You will have the opposite problem - high blood glucose - later in the day. Also, stick to sugary foods that don't have a lot of fat. Fat slows down the movement of sugar into your blood. So oily sweets are not the best choices for treating hypoglycemia, unless they're the only high-carb foods nearby.
If mild or moderate hypoglycemia is not treated promptly, it can turn into severe hypoglycemia. People with severe hypoglycemia have so little glucose in their system that it affects their brain. When that happens, they pass out.
The best way to avoid severe hypoglycemia is catch it early. Be alert to any symptoms of hypoglycemia. Check your blood glucose if you have any doubt. Always carry some glucose tabs or other carbohydrate with you to treat hypoglycemia.
If you do develop severe hypoglycemia, you will need help from the people around you. You cannot drink juice or chew glucose tablets when you're unconscious. Glucagon is useful here, but is not widely available in India. Glucagon is a substance that makes the liver release sugar into your bloodstream. It can be injected to treat severe hypoglycemia.If no glucagon is available you must be taken to the hospital right away.
Do not forget to wear a medical ID bracelet or necklace that says you have diabetes and take insulin/tablets. You cannot tell anyone about your diabetes if you're unconscious or confused, but the medical ID can.
Keep something containing sugar like glucose powder or toffees with you at all times to treat hypoglycemia.
Tips to prevent hypoglycemia.
1.Always take the correct dose of Insulin/tablets.
2.If you plan to do some unusual physical activity, eat an additional snack before doing that.
3.If you feel unwell or have some illness like loose motions or vomiting and is not able to consume your usual calories, reduce the dosage of Insulin/tablets.
4.Never delay your meal
Saturday, August 2, 2008
How often I should test my Blood sugar?
How often I should test my blood sugar?
All Diabetes patients need to know this.
Usually my answer is, if I have the choice I want to know your blood sugar 24 hrs a day, 7 days a week and 365 days a year. Then only I can be sure that your blood sugar is under control, but I can do that only by CGMS [Continuous Glucose Monitoring System] which is very expensive. So as a compromise, I decide a schedule for testing of Blood sugar. The schedule depends on the type of diabetes, its duration, presence of complications, affordability of the patient etc.
For example, in case of type 1 diabetes patients, I want them to check their blood sugar at least once a day. In many type 1 patients, it is much better if they could check several times a day.
In case of type 2 diabetes, the chances of fluctuation of blood sugar is less, especially if the duration of diabetes is short. So, in such patients I will want them to check their blood sugars at least once a week or if not possible once in 2 weeks.
If the blood sugar values are very high or very low you may need frequent testing till the sugars stabilise.
The easiest method of testing is by Blood glucose meter [Glucometer] at home. This is called SMBG [Self Monitoring of Blood Glucose].
Unfortunately, the practise in India is that type 2 diabetics test their blood sugars only once in a month. Many do it still less often. The less number of tests they do, the poorer the blood sugar control.
Increasing the number of blood sugar measurements is one of the easiest [may be expensive] way of keeping your blood sugar under control.
All Diabetes patients need to know this.
Usually my answer is, if I have the choice I want to know your blood sugar 24 hrs a day, 7 days a week and 365 days a year. Then only I can be sure that your blood sugar is under control, but I can do that only by CGMS [Continuous Glucose Monitoring System] which is very expensive. So as a compromise, I decide a schedule for testing of Blood sugar. The schedule depends on the type of diabetes, its duration, presence of complications, affordability of the patient etc.
For example, in case of type 1 diabetes patients, I want them to check their blood sugar at least once a day. In many type 1 patients, it is much better if they could check several times a day.
In case of type 2 diabetes, the chances of fluctuation of blood sugar is less, especially if the duration of diabetes is short. So, in such patients I will want them to check their blood sugars at least once a week or if not possible once in 2 weeks.
If the blood sugar values are very high or very low you may need frequent testing till the sugars stabilise.
The easiest method of testing is by Blood glucose meter [Glucometer] at home. This is called SMBG [Self Monitoring of Blood Glucose].
Unfortunately, the practise in India is that type 2 diabetics test their blood sugars only once in a month. Many do it still less often. The less number of tests they do, the poorer the blood sugar control.
Increasing the number of blood sugar measurements is one of the easiest [may be expensive] way of keeping your blood sugar under control.
Subscribe to:
Posts (Atom)
Posts
