Diabetes is a disease in which the body is unable to properly use the sugar called glucose to fuel our bodies for energy and growth the body needs. Virtually all of the food we consume is broken down into glucose sugar that enters into the bloodstream. The pancreas produces insulin which takes the glucose from the bloodstream into body cells, where it is then used for body fuel. If the pancreas doesn’t produce enough insulins or the cells don’t use insulin properly, the glucose builds up in the bloodstream while the cells that fuel the body are starved of energy. Overtime, if not treated diabetes can lead to serious health complications such as risk for heart disease, kidney renal disease, blindness, and nerve problems.

There are three types of diabetes. Type 1 and 2 diabetes and gestational

diabetes.

Type 1 diabetes:

Type 1 of diabetes is more serious than type 2 diabetes, in that the pancreas can no longer produce insulin, which control blood sugar (glucose) resulting in having to take insulin shots or other medication for diabetes. Sometimes referred to as juvenile diabetes, type 1 diabetes, although developing most often in children and teenagers, type 1 diabetes can occur at any age. Early diagnosis is crucial in preventing other serious complications brought about by diabetes disease and the effects of diabetes, such as heart disease, chronic kidney disease, being blind, nerve damage, and high blood pressure level. Some symptoms for diabetes are:

* Loss of weight

* Fatique-no energy

* Excessive thirst

* Increase in appetite

* Vision eyesight blurred

* Frequent urinating

Type 2 diabetes:

Type 2 of diabetes is the more common form of diabeties and although there is no cure for type 2 diabetes it can usually be controlled by losing weight and getting rid of excess fat, exercise, and eating healthy foods. Those with type 2 diabetes are able to create insulin; however, the pancreas can’t create enough insulin for a healthy blood sugar level or a normal glucose range to enter body cells to be used for self energy. Some of the diabetes risk factors associated with type 2 diabetes are:

* Genetic ancestry: If a parent or sibling has diabetes two the risk is higher for another family member of getting the disease.

* Being overweight

* Type 2 diabetes increases with age 45 and up

* Race or ethnic background. The risk of type 2 diabetes is greater in Africans, Latin Americans, Native Americans and Asians

* Non active. Health and fitness exercise is important for keeping type 2 diabetes under control

* Elevated blood pressure

Gestational diabetes: what is gestational diabetes?

Gestational diabetes, sometimes called glucose intolerance pregnancy, affects women who have high blood glucose levels during pregnancy. Usually, for most women there are no signs of symptoms. Most women are routinely screened between 24 and 28 weeks of pregnancy with a gestational diabetes testing glucose screening test. Screening is usually done by what’s known as the oral glucose tolerance test. This test measures blood sugar glucose to see if the body is handling the breaking down of blood sugars. Controlling gestational diabetes consist of diet & nutrition and exercise.

With any one of these diabetes types, controlling diabetes with diet, exercise and keeping blood glucose levels as close to normal as possible is crucial for a diabetic.



Racingdiabetic.com a blog about racing

To compare the role of glibenclamide and pioglitazone drugs in type 11 non- insulin dependent diabetes mellitus patients.

Authors:Raj kumar chohan,Mashori Ghulam Rasool,Bhurgri Ghulam Rasool,Shamim-u-Rehman,DahriGhulam mustafa,Anis-u-rehman.



Introduction:-



Diabetes comes from the greek word for ‘SIPHON” which one is the first term and implies for a lot of urine is made .The trm “mellitus” comes from a laton word, “met” which means “honey” and was used because the urine was sweet (Wheeler,2004)

Diabetic ketaocidosis is one of life threatening condition requiring some data hospitalization and treatment. Recognition of this condition is of almost importance, because even small delays can have an impact on survival (Nattrass, 2006). Hypoglycaemia are involved in insulin induced episodes in individuals with diabetes. Probably the major factor prescribing, insulin treated patient from achieving the glucose targets needed to prevent diabetic complications. The incidence of hypoglycaemia reflects the inadequancy of current mathods of insulin delievery which lead ot inappropriately high insulin concentration, particularly some persons after eating more foods at night onset of blindness and also a major risk factor heart disease and stroke

(Heller, 2003).



TYPES OF DIABETE MELLITUS

TYPE 1 DIABETES MELLITUS (IDDM):

Type I diabetes affect children of all ages, both sexes and all athenic groups. type 1 diabetes usually occurs by mechanisms. It is most common metabolic condition in children and adolescents (Bui, 2004). Type1diabetes is characterized by immune mediated destruction of pancreatic b -cells resulting in insulin deficiency. This results in a common biochemical end point of hyperglycaemia and risk of ketoacidosis, but the clinical presentaion varies, widely depending on the rate and degree of b -cells failure (Lambert & Bingley. 2005).

Type II diabetes mellitus (NIDDM):



Type II diabetes is a complex metabolic disorder associated with, b -cells dysfunction and with varying degree of insulin resistance primary pathogenic factors leading insulin resistance leading to type 2 diabetes and decreased insulin, secretion which arise from abnormalities with in liver, skeletal muscle and pancreatic b -cells (charles & clark, 1996).



GESTATIONAL DIABETUS MELLITUS

:

Women who develop glucose intolerance in late pregnancy and womens who with previously undiagnosed diabetes.





SECONDARY DIABETUS MELLITUS:



Secondary diabetes is due to disease of the pancreatic and endocrime system, genetic disorders, or exposure to chemical agents.

Type – I diabetes formerly known as insluin dependent diabetes mellitus (IDDM), is characterized by the destruction of the pancreatic beta cells that produces inslulin

Type – I diabetes formerly known as insulin dependent diabetes(IDDM),is characterized by the destruction of pancreatic beta cells that produces insulin.Type-1 diabetes occures most often in children and young adults but it can occures at any age.(Anderson et al 2007).

Type-11 diabetes is not straight uprward. A pancreas that does not produce enough insulin. Liver that release too much glucose,muscle cells that do not readily take in glucose.(Carren 2008)

Many genetic factors are involved in the development of diabetes.Because of new genetic methodology researchers are closers to identifying all of the cadidate gene for both non –insulin dependent and insulin dependent diabetes(Bernhard,1995).

Woman who had gestation diabetes are more likely to develop Type-11diabetes themselves.Pergnant women with diabetes are another disadvantaged group.They need much more intensive antenatal care and close monitoring of blood sugar,blood pressure and weight.(jawed2006)

Over weight children the progression of child obesity into adulthood is associated with early develop of complications, including IgpG2 diabetes and cardiovascular disease.Type diabetes is the most common clinical form of diabetes accountingforabout 90% of all cases,it is currently undergoing world wide epidemic. Type 11diabetes mellitus is caused by body’s infective use of insulin, it is often results from excess body weight and physical inactivity(WHO 2007).



PREVALACES& IINCIDENCE

:

Diabetes mellitus increases with aging, in 200 the prevalance of diabetes,it was estimated to be 0.19% people<20 years old and 8.6% in people>20 years old.There is considered geographic variation in the incidence of both type-1 and type-11 diabetes mellitus.Scavandinvian has the highest incidence of type-1 diabetes mellitus e.g in Finland, the incidence is 35/100,000 per year the pacific rim has a much lower rate in japan and china the incidence is 1 to 3/100,00 per year of type-1 diabetes mellitus, Northern Europe and the United States share an intermediate rate (8to17/100,000 per year).The prevalence of type 11 diabeties mellitus is highest in certain pacific island, intermediate in countries such as India and the United States, and relatively low in Russia and China.This variability is likely due to genetic, beharioral and enviromental factors(Power 2005).Diabettes mellitus prevalance also arises among different ethic population within a given countries it is common inall ethnic groups its prevalance increased with age and more than 5% of individuals of more than 65 years of age have diabetes mellitus (David Owerback 1988).The World wide prevalence of diabetes mellitus has risen dramatically over past two decades.The prevalence of type11 diabettes mellitus is expected, type 11 diabetes mellitus is more prevalent among Hispanies Native Americas,African,American,and Asians, pacific Islanders than in non- Hispanic whites,the incidence is essentially equal in woman and men in all populations. Type 11 diabetes is becoming increasingly common because people are living longer,and the prevalence of diabetes increases with age it is also seen more frequently now than before in young people, in association with the rising prevalenceof childhood obesity although type11 diabetes still countries with the estimated nubers of cases of diabetes in 2000and 2030.

Rank Country

2000 Individuals country with diabetes (milloins)

Country

2030 Individuals with diabtes (Million)

India

31.7

India

79.47

China

20.8

China

42.3

USA

17.7

USA

30.3

Indonesia

8.4

Indonesia

21.3

Japan

6.8

Pakistan

13.9

Pakistan

5.2

Brazil

11.3

Russian federation

4.6

Bangladesh

11.1

Brazil

4.6

Japan

8.9

Italy

4.3

Philippines

7.8

Bangladesh

3.2

Egypt

6.7

(Wareham& FOROUHI 2OO6)



DRUG TREATMENT OF DIABETIES MELLITUS

:

Biguanides lower blood glucose, they increase glucose uptake and utilize in skeletal muscle there by reducing insulin resistance, and reduce hepatic glucose production (gluconeogenesis).Lower blood glucose, addionally reduces low denisity and very low denisity lipoproteins (LDL and VLDL) respectively. Metformin has a half life of about 3 hours and is excreted unchanged in the urine.Clinically metformin used in type 2 diabetic who are obese and who fail treatment with diet alone.Adverse effects are produced dose related gastrointestinal disturbances e.g anorexia,diarrhoea,nausea,lactic acidosis rare but potentially fatal toxic effect.(Dale,2003).

Improving insulin sensitivity by activating certain genes involved in fat synthesis and carbohydrate metabolism Rosigilitazone and Piogiltazone are currently approved.Thiazolidinediones. Thiazolidinediones do not cause hypoglycemia when used alone,although they are usually taken in combination with sulfonylurease.

In some incouraging studies, thaiazolidiniones have produced very favorable effects on the heart, including reducing blood pressure and improving triglycerides and cholestrol levels including increasing HDL level,the good cholestrol. They may also block a molecule called 11 Best HSK that may play a significant role in metabolic syndrome,as well as diabetes type11. One study also sugessted that Rosiglitazone may even improve beta cells functions and so help prevent progression of diabetes.Anemia, weight gain, increased risk of fluid buildup, may worson heart failure.Troglitazone,was withdrawn after a few reports of heart failure.Liver failure abd death.Current Thiazoldinediones don not appear to pose the same effects on the liver although there have been a few reports of liver injury.

In patients with dietry failur the choice of a sulfonylurea agent or insulin therapy has been controversial and empric in favour of insulin therapy are the studies, who reported marked improvement post receptor diagnostic after intensive short term therapy in untreated type 2 diabetes mellitus (Scarlett et al,1984) Sulfonylureas further classified into two groups or generations based on their potency,duration,drug interaction,side effects profiles. Sulfonylureas enhance insulin action in cells in culture and stimulate the synthesis of glucose transporters (Jacobes et al 1998).A sulfonylurea drug should normally be the insulin secretagogue of choice, NICE (National Institute for Clinical Excellence) also recommends that a generic ,drug should be perscribed (Scsade et al1998).



RESEARCH DESIGN AND MATERIAL AND METHODS:



This study was conducted in the deprtment of Pharmacololgy and Therapeutics,Basic Medical Science Institute,Jinnah,Postgraduate Medical Centre,karachi under kind supervision od DRr:GhulamRsool Mashori,Associate Professoer and Head OF Department Of Pharmacology and Therapeutics in colloboration with Medical Outpatient Department Unit111 and Filter Clinic, Medical Department, JPMC,Karachi.

Seventy NIDDM (type-II)diabetic patients were initially enrolled in the study from the filter clinic/ out patient department Medical Unit III ,and diabetic clinic.Out of this 60 diabetic patients were associated in whole period of study, remaining 10 patients were dropped due to poor comlpiance or change in residential place.All the patients were divided in two main groups,groupI and in group II these patients were selected in this study according of inclusion and exclusion criteria.



INCLUSION CRITERIA

:



Newly diagnose patients of non Insulin Dependent Diabtes Mellitus.

Diagnsed patients of diabetes also including having no any history medication.

Having either sex of age between 30 to 60 years.

Diagnosed patients who were Non Insulin Depedent Diabetes Mellitus who were treated with Pioglitazone.

Diagnosed patients who were Non Imsulin Depedent Mellitus, who were treated with drug Glibenclamide.





EXCLUSION CRIRERIA

:



Patients suffering from blood pressure.

Patients suffering from liver disease.

Patients suffering from cardiac disease.

Pregnancies and lactating women.

Patient suffering from renal disorders.

Patients having serious complications.





MATERIAL:





Lacets.

Lancet Hlder(Abbots easy touch TM2 lot 03 Asee).

Glucometer(Medisense) optilim one touch(Abbotts).

Blood glucose nest trpis (IVD for Invitro diagnostic use (Abbott Labortries,Medisense UK Ltd,Abigngdon,Ox14ITR,Masde in UK). Stored between minimum 30?, (4°-30° C) and Maximum 40°C (39°-86°F).

Weight Machine Model No 1101 Lot No.312. TANTIATA.





DRUGS



Tab:Daonil 5 mg (Aventis Pharma)

Drug category:Sulphonylurea.

Generic Name: Glibenclamide.

MFGLIC:No.000007 RegistrationNO.000220

MFG Date:0-06

EXP Date:7-10

Lot NO:B230

Tab:piozer (Hilton Pharm) PvtLTd.

Tab:Poizer 15mg

Drug category:Thaiazolinedione.

Generic Name:Pioglitazone Hydrochloride.

MFG LIC: O.000136 Registration No.03270

MFG Date:3-06

EXP Date:3-o9

Lot No:6287

Tab: Poizer (Hilton Pharma)pvt ltd.

PARAMETERS:

Fasting Blood Sugar (FBS).

Random Blood Sugar (RBS).

Weight.

Key words:Diabetes mellitus,Non-insulin diabetes mellitus,Insulin depedent diabetes mellitus, Daonil,poizer,Insulin.



RESULTS:





Table 1



Weight and Blood Sugar level observed on baseline day 0

In group1 and group11

 

Group 1

Group 11

 

Pioglitazone n=27

Glibenclamide n=33

Weight

63.37

+ 2.25

¯

62.7

+ 15.56

¯

Fasting Blood Sugar

172.7

+ 13.32

¯

188.42

+ 12.o5

¯

Random Blood Sugar

285.11

+ 15 .532

¯

284.18

+ 17.07

¯

All Values are expressed in Means± SEM.

FIGURE-1 weight and blood sugar levels observed on baseline (day-o)



In table No shpwing the weight (KG’S) and blood sugar (msg/dl0 levels which is observed on baseline (day-0) in both groups 9group: 1 & group11)

Group: 1 Weight in (Kg’s) mean + SEM) IS 63.37±2.25 Fasting blood sugar 172.7±13.32,and Random

blood sugar 285.11±15.32



Group:11

Weight (KG’s0 (mean +SEM)62.7±1.56 Fasting blood sugar (mg/dl0 188.42±12.05, Random blood sugar is 284.18±17.03.

Figure 2: showing the weight and blood sugar levels observed in base line (day-0) in group: 1 and group 11 weight in 9kg’s) its mean values are 63.37,62.7, Fasting blood sugar in (mg/dl) is 172.71, 188.42 Random blood sugar (mg/dl) is 285.11 &284.18.

TABLE: 2

Peroidic Observation In All Parameters Group1

Goup1(Pioglitazon) n=27

 

P-value

 

Day-0

Day-45

Day-90

Day-0to45

Day-45-90

Weight

63.37

±2.25

63.63

±2.26

63.63

±2.23

>0.05

(NS)

>0.05

(NS)

Fasting blood sugar

172.7

±13.32

165.04

±8.98

153.37

±7.59

>0.05

(NS)

0.05

(NS)

Randomblood sugar

285.11

±15.32

279.78

±13.63

255.56

±12.65

>0.05

(NS)

>0.05

(NS)

All values are expressed in Mean±SEM .(NS) Non significant.









TABLE NO:2



Showing the periodic observations in all parameters in group 1 (piogiltazone) (n+27) weight P.value (day 0 to day 45)>0.05 (NS). Fasting blood sugar >0.05 (NS) Random blood sugar >0.05 (NS) P.values day 90 weight >0.05 (N.S), FBS>0.05 (N.S) 7RBS >0.05(N.S) NON SIGNIFICANT

FIGURE:2 Showing the periodic observation in all parameters in group 1 on day0 day 45& day-90.Mean values in weight (Kg) is 63.37,63.26,63.63, fbs (mg/dl) 172.7,165.04,153.37,RBS(mg/dl) 285.11,279.78,255.56.

TABLE NO3

Peroidic Observation in All Parameters Group11

 

Group 11 (Glibenclamide)

N=33

P-value

 

Day-0

Day-45

Day-90

Day-0 to 45

Day-45 to 90

Weight

62.7

±1.56

65.64

±2.10

64.55

±1.92

>0.05(NS)

0.05(NS0

Fasting blood sugar

188.42

±12.05

168.45

±10.99

140.06

±5.68

>0.05(NS)

>0.05(S)

Random blood sugar

284.18

±17.03

220.12

±13.39

170.94

±5.80

<0.005 (MS)

0.002(MS0

(s) significant, (MS) moderate significant

All values are expressed in Mean±SEM.



Table No3:



Showing the periodic observation in all parameter in goup:11, Group:11 containing drug (Glibenclamide),no of patients (n=33).It’s P-value on day 0 to day 45 on weight >0.05(NS),FBS>0.05(N.S) RBS<0.005 (MS) <0.01- AND DAY 45 TO DAY 90 WEIGHT >0.05 (NS) FBS (0.05) RBS <0.002(M.S0 moderately significant.



Figure 3:Shwing the periodic observations in all parameters in Group 11 weight 62.7,65.64,64.55,FBS (MG/DL) 188.42,168.45 140.06,RBS(mg/dl) 284.18 220.12, 170.94 (on day-0-day 45 to 90).



DISCUSSION:



In Denmark Beck-Nielsenet al,skillman TG (1981) published studies demonstation that glyburide increased he number of receptors on the monocytes of patients with type 11 diabetes mellitus. Some patients were treated with diet and in cobination of second generation sulfonyureas agents Wie. The numbers of insulin receptors all patients were measured before and after the treatment.Intrvenous glucose test shows the persistent impairent of insulin secretion afterthe starting of drug therapy.However those patient who were on drug Pioglitazone some results were obtained of insulin secretion in the impairment in early drug drug therapy.Clinical observations have suggested that the second generation sulfonylureas may exert their effects by potentiating insulin released by other primary stimulators Insulin secreting drug.

According to the study of WilliamC Dukworth et al(1972), aftr the chronic treatment with sulfonylureas it is well documented that plasma insulin levels were decreased in response to oral glucose load. This apparently occures even though glucose tolerance is improved over pre-treatment, levels,present study clearly support that study.

The result og group 11 correlates with the research conducted by Bonnie &Kimmel (2005) produces the same results as FBS reduces from baseline, and at the end of study,with an overall 23.44%,reduction,while with the results showed at the end of study peroid p-value were (p<0,001).

Similarly Michael Alvarsson et al (2003) conducted a similar type of study and the found and overall changes of change of 22.11% in Fbs and 40.88% in Rbs at the end of trial p-value were (p<0.001).

However a study conducted by (Stone &Brown in (2003) didnot match to our results in the parameter of FBS and observer a reduction of 26.22%.



CONCLUSION:



In the light of study discussion it is obiovus the glibenclamide was more effective,tolerable and safer than pioglitzone in a short duration.Diabetes Mellitus is chronic prolong disease for whole life.Poor community can afford it easily,on base of marketing of this drug in pakistan diabetes patients easily go and purchase economically,in fact ,mostly people buy it from pharmacy without dr’s perscription,because pharmacist and patient both of know about this disease.Just like dispirin as analgesic,it is famous anti-diabetic drug in our states as compared of other anti-diabetic drugs.



REFERNCES:





Anderson J,Kendall,Perryman.S etal,”Diet and Diabettes” Diabetes 2006,16(3):17-19-

Bui H- Type 1 diabetes in childhood-Medicine 2006,3 ,1-3

Bernhard –Diabetes-type 11 diabetes mellitus Diabetes care 1995,19(100:12-17-

Clark CM-Oral therapyin type11 diabetes-pharmacological properties and clinical use of current use of currently available agents-Diabetes spectrum 1998,11(4):211-221.

Carren M.Types of Diabetes mellitus-Diabettes 2006 10 (3),07-

David Owerback NJ-Prevalence in diabetes population-Diabetes 1988,02(6):31-32

Dale MM,-Treatment of Diabetes mellitus –pharmacology 20035th edition:287-391.

Heller SR –Hypoglycemic in diabetes Ketoacidosis and hypoglycemic-Medicine 2006:34(03):102-110.

Jawad F Untraveling the mystry of Diabetes’Diabetes 2006;15(3):13-15.

Jacobes D-Insulin-Diabetes 1998;6(3);1160126.

Lambert and Bingliy-basic facts-medicine 2006,34(6):3-7.

Natters M-Ketoacdosis and hyperglycemia-Medicine 2006;34(3):104-106.

Power AC-Epidemiology of type11 diabetes Basic facts of diabetes –Diabetes 2005;1(1)7-9

Scarlet Oral therapy in type 11 diabetes sulfonylureas 1984;16(10);3-9.

Schade DS et al A placebo controlled randomized study of glimepiride in patients of Diabetes mellitus- Diabetes 19998, 38(7);636-641.

Warchman and Forouhi-Epidimology of Diabetes- Diabetes basic facts- Medicine 2006 ;34(2);57-60

Wheeler Gd- Aaccident dicovery led to the noble prize for canadian reseachers,2005,01-02.

WHO Report-Health-Diabetes Mellitus-Defiition and types of Diabetes 2007;1:1-4.





Diabetes

Type 1 diabetes

Treatment almost always involves the daily injection of insulin, usually a combination of short-acting insulin such as regular or Lispro or Aspart insulin and a longer-acting insulin such as NPH, lente, glargine, detemir, or ultralente insulins.

* Insulin must be given as an injection. If taken by mouth, insulin would be destroyed in the stomach before it could get into the blood where it is needed.

* Most people with type 1 diabetes give these injections to themselves. Even if someone else usually gives you your injections, it is important that you know how to do it in case the other person is not available.

* A trained professional will show you how to store and inject the insulin. Usually this is a nurse who works with the health care provider or a diabetes educator.

* Insulin is usually given in 2 or 3 injections per day, generally around mealtimes. Dosage is individual and is tailored to suit the person. Longer acting insulins are typically administered 1 or 2 times per day.

* It is very important to eat if you have taken insulin, as the insulin will lower your blood sugar regardless of whether you have eaten. If you take insulin without eating, you could have hypoglycemia. This is called an insulin reaction.

* There is an adjustment period while you learn how insulin affects you and how to time your mealtimes and exercise times with your insulin injections to keep your blood sugar level as even as possible.

* Keeping accurate records of your blood sugar levels and insulin dosages is crucial in helping your health care provider take care of your diabetes.

* Eating a consistent, healthy diet appropriate for your size and weight is essential in controlling your blood sugar level.

Type 2 diabetes

Depending on how elevated your blood sugar and glycosylated hemoglobin are at the time of your diagnosis, you may be given a chance to lower your blood sugar level without medication.

* The best way to do this is to lose weight if you are obese and begin an exercise program.

* This will generally be tried for 3-6 months, and then your blood sugar and glycosylated hemoglobin will be rechecked. If they remain high, you will be started on an oral medication, usually a sulfonylurea or biguanide (Metformin), to help control your blood sugar level.

* Even if you are on medication, it is still important to eat a healthy diet, lose weight if you are overweight, and engage in moderate physical activity as often as possible.

* Your health care provider will monitor your progress on medication very carefully at first. It is important to get just the right dose of the right medication to get your blood sugar level in the recommended range with the fewest side effects.

* Your doctor may decide to combine two types of medications to get your blood sugar level under control.

* Gradually, even people with type 2 diabetes may require insulin injections to control their blood sugar levels.

* It is becoming more common for people with type 2 diabetes to take a combination of oral medication and insulin injections to control blood sugar levels.



Diabetes Treatment

Learn About Diabetes – Information & Facts

The Diabetes is one of the deadliest diseases in world, one in four people in America have this disease. The diabetes disease touches everybody, kids, young and old. It becomes important for everyone to learn what is Diabetes? The real reason is when body is unable to utilize or accumulate glucose. The Glucose is a form of Sugar. The level of glucose when goes high in bloodstream, it causes blood glucose to rise in individuals body. The Diabetes can be categorized into three stages. The three stages of diabetes are “Pre Diabetes”, “Type 1 Diabetes” and “Type 2 Diabetes”. The diabetes has become so common in people that it is common to find kids, teenagers, young adults diagnosed with Diabetes.

How does Glucose affects body?

It is a disorder in the body that affects the way body utilizes the food for energy. All food contains sugar, the digested food in body is broken into sugar known as Glucose. The glucose is used to produces energy. The individual glucose keeps circulating in blood and enters into body cells, once inside the cell the glucose is used as fuel to developed energy. The Insulin is a hormone, which body uses to push Glucose into body cells, if this process stops working then the blood sugar level rises in body.

 Categories of Diabetes

What is Pre-Diabetes? – This is first stage to being diagnosed as Diabetes, under “Pre-diabetes” category either there is shortage of insulin required for pushing Glucose into body cells or body has become resistant to insulin. The people who get diagnosed with “Pre-Diabetes” are venerable and need precautions and changes in life style to keep out of diabetes diseases. Another pointer is your blood sugar numbers, if your blood sugar readings are above normal and not enough to be classified as diabetes. The “Pre-Diabetes is also known as “Impaired Fasting Glucose” or “Impaired Glucose Tolerance”. The good news is that early sign gives you God sent opportunity to prevent your condition changing from pre-diabetes to type 2 diabetes. There is no medication required in “Pre-Diabetes” condition, with control over food, exercise and changes in lifestyle will help to keep out of diabetes danger.

What is Type 1 Diabetes? – Juvenile-Onset or Insulin-Dependent

In Type 1 Diabetes, a person’s body can’t produce any insulin. This type of diabetes usually occurs in early age but can happen any time is life period. The research is still going on diabetes type one, how it happens. As of now the reasons are that body has little or not enough insulin to use Glucose to make energy.

What is Type 2 Diabetes? – Formerly called adult-onset or non insulin-dependent

In Type 2 Diabetes a person’s body has become resistant to insulin. This type of diabetes happens after 35-40 years of age. This form of diabetes is 90 percent common in people. The reasons for “Type 2 Diabetes” are due to genetic reasons, being overweight, because of lack of exercise are some of the reasons.

 



Diabetes

Having been Type I diabetic for over 14 years, I am always looking to improve my diabetes treatment. I have gone through teenage hormonal changes, two pregnancies and general illness all without much incidence, and I would like to keep it that way. Diabetes can be a very scary thing but with the proper diabetes treatment, it is most certainly a manageable disease.

There are two types of diabetes; Type I which is usually diagnosed during childhood, and Type II which is generally diagnosed after the age of 18. Each require a different set of diabetes treatment, mainly because a person with Type I does not produce any insulin on their own while a person with Type II is just extremely insulin resistant or makes very little insulin.

Type I diabetics basically have to take insulin in some form. There are now several options of diabetes treatment, though, which can make the process much more manageable especially for those weary of needles. The standard treatment is to use insulin by needle self injection as little as once per day and as much as six to eight times per day. There are both short and long acting insulins and most likely a person with Type I diabetes will need to take a mixture of both. If you are not fond of the idea of needles, there is now an insulin inhaler that has just been introduced to the market. It is not widely used yet, but when discussing your diabetes treatment with your doctor be sure to ask about it.

In addition, the most cutting edge diabetes treatment is the use of an insulin pump. An insulin pump site is inserted once every three days and acts like an external pancreas, giving the patient continuous short acting insulin to keep the constant blood sugar levels in normal ranges. When eating, the patient self administers insulin through the pump rather than giving shots.

Realistically, I have found this to be the best diabetes treatment for myself because I have been able to adjust my insulin rates down to the half hour rather than taking shots and waiting for the insulin to react. While on the pump, I have been able to take my A1C levels (a three month overview of sugar levels) from 7.1 to as low as 4.2 during pregnancy. Normal ranges are 4.0 to 7.0, so my doctors were quite pleased with this as was I.

Be sure to check out all of your options and take an active role in your diabetes treatment. The disease is quite manageable, especially if you take control and ask questions.



www.racingdiabetic.com

The treatment of diabetes is highly individualized. It will depend on the type of diabetes, whether you have other active medical problems, as well as your age and general health at time of diagnosis. However, one fact remains constant in treatment: if you have diabetes, you must make healthier lifestyle choices in diet, exercise, and other habits. These will help to improve glycemic (blood sugar) control and prevent or minimize complications of diabetes.

Diet: A healthy diet is key to controlling blood sugar levels and preventing diabetes complications.

*If you are obese and have had difficulty losing weight on your own, talk to your health care provider. He or she can recommend a dietician or a weight modification program to help you reach your goal.

*Eat a consistent, well-balanced diet that is high in fibre, low in saturated fat, and low in concentrated sugars.

*A consistent diet that includes roughly the same number of calories at about the same times of day helps your health care provider prescribe the correct dose of medication or insulin.

*It will also help to keep your blood sugar at a relatively even level and avoid excessively low or high blood sugar levels, which can be dangerous and even life threatening.

Exercise: Regular exercise, in any form, can help reduce the risk of developing diabetes. Activity can also reduce the risk of developing complications of diabetes such as heart disease, stroke, kidney failure, blindness, and leg ulcers.

*As little as 20 minutes of walking 3 times a week has a proven beneficial effect. Any exercise is beneficial; no matter how light or how long, some exercise is better than no exercise.

*If you have complications of diabetes (eye, kidney, or nerve problems), you may be limited both in type of exercise and amount of exercise you can safely do without worsening your condition. Consult with your health care provider before starting any exercise program.

Alcohol use: Moderate or eliminate your consumption of alcohol. Try to have no more than 7 alcoholic drinks in a week and never more than 2-3 in an evening. One drink is considered 1.5 ounces of liquor, 6 ounces of wine, or 12 ounces of beer. Excessive alcohol use is a known risk factor for type 2 diabetes. Alcohol consumption can cause low or high blood sugar levels, nerve pain called neuritis, and increase in triglycerides, which is a type of fat in our blood.

Smoking: If you have diabetes, and you smoke cigarettes or use any other form of tobacco, you are raising your risks markedly for nearly all of the complications of diabetes. Smoking damages blood vessels and contributes to heart disease, stroke, and poor circulation in the limbs. If you need help quitting, talk to your health care provider.

Self-monitored blood glucose: Check your blood sugar levels frequently, at least before meals and at bedtime, and record the results in a logbook.

*This log should also include your insulin or oral medication doses and times, when and what you ate, when and for how long you exercised, and any significant events of the day such as high or low blood sugar levels and how you treated the problem.

*Better equipment now available makes testing your blood sugar levels less painful and less complicated than ever. Your daily blood sugar diary is invaluable to your health care provider in seeing how you are responding to medications, diet, and exercise in the treatment of your diabetes.

*Medicare now pays for diabetic testing supplies, as do many private insurers and Medicaid.



Diabetes Treatment