We have covered a great deal of the preliminaries of borderline diabetes.
I did read one fact, on Medscape discussing the role of Wegovy and other GLP drugs in diminishing diabetes by almost 90% . That is because diabetes, also called diabesity is common in the overweight. The second thing I recently read on the Cleveland Clinic site, was by the year 2050 there would be 260 million diabetics in the US. That is not just adults, it includes children.
We are better than that. Let's change these statistics. We don't have to let this happen.
If you are diagnosed with Type 2 Diabetes, also known as Adult Onset Diabetes, it is a red flag and you need to get busy and get healthy.
In Part 1,2,3 we discussed symptoms, work ups, some treatment, exercise, and diet.
Tonight, let's discuss when all else fails and medication is needed.
Metformin is generally the first medication prescribed for diabetes. It lowers glucose production in the liver and helps with the sensitivity to the insulin your body secretes.
Sulfonylureas, Glyburide, Glucotrol, etc help the body secrete more insulin to meet your daily food intake.
Glynides stimulate the pancreas to secrete more insulin.
Thiazolidinediones, Actos, make the bodies' tissues more sensitive to your own insulin.
DPP-4 inhibitors help to reduce blood sugar levels. Januvia, Ongglyza, etc
GLP-1receptor agonists are in the news a lot now. They are injectables that slow the digestion and help lower the blood sugar. These drugs are also targeted for weight loss as you have seen in many articles.
SGLT2 inhibitors affect the blood filtering functions in the kidneys by blocking the return of the glucose to the bloodstream and removed in the urine.
Insulin may be needed if the weight is not lost, no exercise and not following a fairly healthy diet. Many of the previous drugs will be tried before insulin, but if a reasonable blood sugar is not attained, insulin will be used. It is also possible to have a patient come to the HCP's office or the ER with such a high blood sugar, insulin would be started at that time.
The purpose of this article is to give a brief description of the drugs and their purpose.
It will be necessary to follow with your HCP for every 3 month monitoring, labs and also do home blood sugar testing via a glucometer. Your insurance should cover the glucometer and the test strips. Be sure you do not leave the office of your HCP without careful instructions on the use of the monitor. If your blood glucose is not stable, it may be recommended twice a day. It is high advisable to get used to the monitor for a multitude of reasons.
If you feel your blood sugar is high, hyperglycemia, due to eating too much food, recent illness, and notice frequent urination, increased thirst, dry mouth, blurred vision, fatigue and headache, check your blood sugar. Be sure to keep a diary of these readings to show your HCP. It is very important to watch for a life threatening condition in which the blood sugar reading is higher than 600 mg/dl. It may be caused by an infection, not taking meds, or taking steroids. It can be extreme with a dry mouth, extreme thirst, drowsiness, confusion, dark urine or seizures. It is a MEDICAL EMERGENCY.
Low blood sugar can also be dangerous. Hypoglycemia. It is caused by many reasons, such as skipping a meal, accidentally taking more medication than normal, or being more physically active than usual. It can also be caused by eating a meal with many simple carbohydrates, not enough protein and your blood sugar drops about 90 minutes later. A quick glass of juice, a glucose tablet or a mint can bring you out of it, but you need to have a small amount of complex carbs and protein to avoid a yo-yo effect. Symptoms include, sweating, shakiness, weakness, hunger, irritability, dizziness, headache, blurred vision, heart palpitations, slurred speech, or confusion. Be sure to recheck your monitor approximately 15 minutes later. This, too, can be a medical emergency. If you are driving, pull over and stop. It is a good idea to carry a few pieces of hard candy in your purse or pocket for such symptoms.
Again, this is an overview of diabetes. With children we watch for the very same thing. Please watch their weight and not too much screen time inside. You hopefully are a person that monitors your weight, pays attention to your diet, see diabetic.org or other diabetic websites, watches your blood pressure, checks your skin daily for open cuts, observes your gums, brush 2-3 times a day with flossing daily. We all need regular trips to the dentist twice a year, vision checks, etc. We get into trouble when we ignore our health.
We only have one body, so let's don't abuse it.
Thank you to Cleveland Clinic, Medscape, American Diabetic Association.
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