What is diabetes?
Before we can discuss diabetes, we should discuss what insulin is.
Insulin is a hormone produced by the pancreas that allows your body to use sugar (glucose) from carbohydrates in the food we are eating for energy or to store glucose for future use. insulin keeps blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia).
The cells in our body need sugar for energy. However, sugar cannot go into most of the cells directly.
Consumption of food cause the blood sugar level to rise, cells in the pancreas (known as beta cells) are signaled to release insulin into the bloodstream. Then the insulin attaches to the cells and signals them to absorb glucose from the bloodstream. insulin is often described as a “key”, which unlocks the cell to allow sugar to enter and be converted into energy.
Diabetes is caused by either deficiency in insulin production by the pancreas or an improper response of the cells to the insulin produced.
Diabetes-mellitus, commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period.
There are three main types of diabetes mellitus:
- Type 1 diabetes is usually diagnosed in children and young adults. Was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease.
Treatment must include insulin, typically with a combination of regular and NPH insulin or synthetic insulin analogs.
- Type 2 diabetes is also called non-insulin-dependent diabetes mellitus or adult-onset diabetes. It is the most common form of diabetes, a condition in which cells fail to respond to insulin properly.
This type of diabetes is commonly caused by excessive body weight and insufficient exercise. Can be managed with a healthy lifestyle.
- Gestational diabetes occurs in about 2–10% of all pregnancies and may improve or disappear after delivery. Usually developed in pregnant women during their 24th week of pregnancy.
Less common types include monogenic diabetes, which is an inherited form of diabetes, and cystic fibrosis-related diabetes.
Prevention and treatment
Prevention and treatment involve maintaining a healthy diet, regular physical exercise, normal body weight and avoiding the use of tobacco.
Diet and Exercise
Eating well-balanced meals during the day is an essential part of taking better care of yourself and managing diabetes. So is regular physical activity, which is especially important for people with diabetes and those at risk of diabetes.
There are more than one specific diet or exercise routine that are suitable, hence it is recommended to consult a professional Dietician.
Medications are usually used to treat diabetes by lowering blood sugar levels.
There are several different types of anti-diabetic medications including oral medication (such as Metformin), injection (such as GLP-1 agonists).
There are several groups of drugs that are given orally:
Medications that decrease glucose production and increase insulin sensitivity:
Metformin is generally recommended as a first-line treatment for type two diabetes.
It works by decreasing the liver's production of glucose and by making the muscle more sensitive to insulin.
Medications that increase insulin production/release:
The earliest oral diabetes drugs were the sulfonylureas. These work by stimulating the pancreas to produce more insulin, such as chlorpropamide, glipizide, glyburide and glimepiride.
Medications that slow the breakdown of carbohydrates:
Alpha-glucosidase inhibitors address the blood glucose issue in a different way. By inhibiting the breakdown of starches in the intestine, these medications slow the rise in blood sugar normally seen after a meal.
Medications that increase insulin secretion and decrease glucose production:
The DPP-4 inhibitor sitagliptin works by inhibiting the action of an enzyme in the body that leads to an increase in insulin release. It also decreases the production of glucose by the liver.
During digestion, pancreatic beta cells release not only insulin but also, in a much smaller amount, the hormone amylin, which helps mediate sharp rises in blood glucose levels following meals.
Pramlintide (Symlin) is a synthetic form of amylin that was approved by the FDA in 2005.
Pramlintide slows gastric emptying, blocks the release of glucagon (a hormone that raises blood sugar), reduces after-meal glucose release from the liver, and helps to reduce food intake, possibly leading to weight loss.
Overall, the Pramlintide leads to a lower blood sugar level after a meal.
Pramlintide is only used in people with diabetes who take insulin. People with Type 2 diabetes can take this medication if they also take mealtime or fast-acting insulin.
This drug must be injected before each major meal. It can’t be mixed with insulin, so it means taking more injections
The main side effect of pramlintide is nausea, and this is why the dose is started low. Low blood sugar is another side effect, as it’s taken with insulin. Other side effects may include loss of appetite, fatigue, headache, and weight loss.
The other class of non-insulin injectables that is more widely used than the amylin analog is known as GLP-1 receptor agonists. The action of these drugs is based on incretins, which are gut hormones that work to increase insulin secretion in response to eating. Incretin hormones work in several ways: they increase satiety (feelings of fullness), slow stomach emptying, increase insulin release and decrease glucagon release.
Available GLP-1 receptor agonists are the following:
• exenatide (Byetta and Bydureon)
• liraglutide (Victoza)
• albiglutide (Tanzeum)
• dulaglutide (Trulicity)
These medications help the pancreas release insulin after eating. They also limit glucagon and slow down digestion, which increases the feeling of fullness.
GLP-1 receptor agonists are approved for people who have Type 2 diabetes and who may not be having success with oral medications.
These drugs are not approved for people who have Type 1 diabetes.
GLP-1 agonists are taken by injection in the thigh, upper arm, or abdomen twice a day, once a day or once a week, depending on the drug.
Nausea is the main side effect; others include vomiting, diarrhea, upset stomach, dizziness, weight loss, and headache. Low blood sugar can occur if you take insulin or pills that raise the risk for lows. Pancreatitis (inflammation of the pancreas) is a less common, but possible side effect as well.
Weight loss surgery
Nearly all individuals who have weight loss surgery show improvement in their diabetic state.
In most cases this surgery improves type two diabetes by lowering blood sugar levels, reducing the dosage and type of medication required and improving diabetes-related health problems.
In other cases, this surgery can eliminate the need for diabetes medications.
Weight loss surgery isn't for everyone, though. Doctors usually recommend it only for patients who have BMI of 35 to 40 at least. However, many of them are unsuitable for invasive surgery or unwilling to go through a nonreversible procedure which could have many complications.
For these patients there is a new solution which presents a new treatment method, using the Nobix System, to manage and treat Diabetics Type two.