Oral medication and insulin

  India having the highest   number of diabetic patients in the world, the sugar disease is posing an enormous heath problem in the country. The international Journal of Diabetes in Developing Countries calling India the diabetes capital of the World.


 Top 10 countries with diabetes population (20-78 age group).
Figures in million

   India leads the world in the number of people suffering from diabetes.
                                                                                                    Health News

What is diabetes Diabetes is a disorder of metabolism, the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine.

Thus it is a disease that affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. It results from defects in insulin secretion, insulin action, or both. In diabetes too much glucose stays in the blood. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine. As a result of elevated levels of blood glucose, two problems occur: body cells become starved for energy, and, over time, the high glucose levels can damage the nerves, eyes, kidneys, heart and blood vessels. Diabetes is a lifelong disease.  Men with diabetes often have erectile dysfunction which can begin before the diagnosis of diabetes is made. It is therefore recommended that men with unexplained erectile dysfunction be screened for diabetes with a fasting blood glucose test. Types of  Blood Sugar are:    Normal blood sugar: 65 -140.     High blood sugar: 250-350     Very high blood sugar: (over 350)   When blood sugar falls too low, the body will begin a process to increase Then (i) The pancreas releases a hormone called glucagon (ii) The muscles and liver convert their stored glycogen back into glucose. (iii) When the stored glycogen is used up, the liver, kidneys, and small intestines can break down protein into glucose.  Symptoms of Diabetes:    The common symptoms includes:  excessive thirst   excessive urination  infections (thrush)  extreme hunger  unusual weight loss  extreme fatigue  irritability  nausea  vomiting  sweet smelling breath.   Types of diabetes:  The three main types of diabetes are   type 1 diabetes    type 2 diabetes    gestational diabetes  Type 1 Diabetes:  Type 1 diabetes is an autoimmune disease, results when the body’s system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live. Scientists  believe that autoimmune, genetic, and environmental factors, possibly viruses, are involved. It develops most often in children and young adults but can appear at any age. Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms may include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a  life-threatening diabetic coma, also known as diabetic ketoacidosis. Type 2 Diabetes:   About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.  When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases. The result is the same as for type 1 diabetes, glucose builds up in the blood and the body cannot make efficient use of its main source of fuel.  The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue, frequent urination, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms. Gestational Diabetes:  Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 20 to 50  percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.  Gestational diabetes is caused by the  hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.   Diagnosis of diabetes: The fasting blood glucose test is the preferred test for diagnosing diabetes in children and nonpregnant adults. It is most reliable when done in the morning. However, a diagnosis of diabetes can be made based on any of the following test results, confirmed by retesting on a different day:  (i) A blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an 8-hour fast. This test is called the fasting blood glucose test.  (ii) A blood glucose level of 200 mg/dL or more 2 hours after drinking a beverage containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT).  (iii) Gestational diabetes is diagnosed based on blood glucose levels measured during the OGTT. Glucose levels are normally lower during pregnancy. Blood glucose levels are measured before a woman drinks a beverage containing glucose. Then levels are checked 1, 2, and 3 hours afterward. If a woman has two blood glucose levels meeting or exceeding any of the following numbers, she has gestational diabetes.    Pre-diabetes:  People with pre-diabetes have blood glucose levels that are higher than normal but not high enough for a diagnosis of diabetes. This condition raises the risk of developing type 2 diabetes, heart disease, and stroke. Pre-diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Some people have both IFG and IGT. IFG is a condition in which the blood glucose level is high (100 to 125 mg/dL) after an overnight fast, but is not high enough to be classified as diabetes.  IGT is a condition in which the blood glucose level is high (140 to 199 mg/dL) after a 2-hour oral glucose tolerance test, but is not high enough to be classified as diabetes.  Impact of diabetes:  Diabetes is widely recognized as one of the leading causes of death and disability. About 65 percent of deaths among those with diabetes are attributed to heart disease and stroke. Diabetes is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.

Diabetes management:  The goal of diabetes management is to keep levels of blood glucose, blood pressure, and cholesterol as close to the normal range as safely possible. A cure for Diabetes has not been found yet. However, it can be controlled. Ways to control diabetes are: maintaining blood glucose levels, blood fat levels and weight. Blood glucose levels can be maintained by following a diet designed by your doctor, exercising, and eating at regular intervals. Today, healthy eating, physical activity, and taking insulin are the basic therapies for type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose checking. People with diabetes also monitor blood glucose levels several times a year with a laboratory test called the A1C. Results of the A1C test reflect average blood glucose over a 2- to 3-month period.   Healthy eating, physical activity, and blood glucose testing are the basic management tools for type 2 diabetes. In addition, many people with type 2 diabetes require oral medication, insulin, or both to control their blood glucose levels.  Aspirin therapy, if recommended by the health care team, and smoking cessation can also help lower risk.  People with diabetes must take responsibility for their day-to-day care.  Much of the daily care involves keeping blood glucose levels from going too low or too high. When blood glucose levels drop too low, a condition known as hypoglycemia, a person can become nervous, shaky, and confused. Judgment can be impaired, and if blood glucose falls too low, fainting can occur. A person can also become ill if blood glucose levels rise too high, a condition known as hyperglycemia.  People with diabetes should see a health care provider who will help them learn to manage their diabetes and who will monitor their diabetes control. Most people with diabetes get care from primary care physicians, internists, family practice doctors, or pediatricians. The goal of diabetes management is to keep levels of blood glucose, blood pressure, and cholesterol as close to the normal range as safely possible.  Treatment  for Diabetes:   The common treatment options are: oral medicines (Diabetes pills), dietary changes, exercise, insulin and islet Cell Transplantation. The oral medicines may have negative side effects. The side effects of the oral medicines include: nausea, diarrhea, metallic taste in mouth, low blood glucose, skin rash or itching, and weight gain. Rare side effects  are Liver failure, Respiratory infection, Headache, and Pain.    Diabetes can be diagnosed by performing a fasting plasma glucose test. The test is as follows:    After the person has fasted overnight (at least 8 hours), a sample of blood is drawn and sent to the laboratory for analysis. Normal fasting plasma glucose levels are less than 110 milligrams per deciliter (mg/dl).  Fasting plasma glucose levels of more than 126 mg/dl on two or more tests on different days indicate diabetes.    The pregnant woman will have special health concerns, such as keeping blood glucose (sugar) levels in good control, managing diabetes medications, adjusting meal plans, and exercising regularly.   Exercise is very important to maintaining a healthy life and managing diabetes. Combining diet, exercise, and medicine ( prescribed by your doctor) will help control your weight and blood sugar level.  Exercise is good for you because: (i) It lowers blood sugar by speeding the transport of glucose in the cells. (ii) It helps promote weight loss and maintenance of ideal body weight. (iii) It decreases cardiovascular risk by making heart pump more efficiently. (iv) It improves circulation. (v) It reduces demands on the pancreas. (vi) It improves our muscular tone. It reduces stress. Complications of Diabetes:   Common complications of diabetes are:  Heart disease  Stroke  Diabetic retinopathy  Kidney disease  Sciatica   Research work on diabetes:  In recent years, advances in diabetes research have led to better ways of managing diabetes and treating its complications. Major advances include development of quick-acting, long-acting, and inhaled insulin's better ways to monitor blood glucose and for people with diabetes, to check their own blood glucose levels, development of external insulin pumps that deliver insulin, replacing daily injections, laser treatment for diabetic eye disease, reducing the risk of blindness, successful kidney and pancreas transplantation in people whose kidneys fail because of diabetes, better ways of managing diabetes in pregnant women, improving their chances of a successful outcome, new drugs to treat type 1 and type 2 diabetes and better ways to manage this form of diabetes through weight control etc.  Researchers continue to look for the cause or causes of diabetes and ways to manage, prevent, or cure the disorder. Some genetic markers for type 1 diabetes have been identified, and it is now possible to screen relatives of people with type 1 diabetes to determine whether they are at risk. Researchers are working on a way for people with type 1 diabetes to live without daily insulin injections. In islet transplantation, islets are taken from a donor pancreas and transferred into a person with type 1 diabetes. Once implanted, the beta cells in these islets begin to make and release insulin. The goal of islet transplantation is to infuse enough islets to control the blood glucose level without insulin injections.  The research findings showed that people at high risk for type 2 diabetes could sharply lower their chances  of developing the disorder through diet and exercise. In addition, treatment with the oral diabetes drug metformin also reduced diabetes risk, though less dramatically. Metformin lowers the amount of glucose released by the liver and also fights insulin resistance, a condition in which the body doesn't use insulin properly.

Tomatoes useful in diabetes : A team of researchers in Chandigarh has found that a substance found abundantly in tomatoes can help ward off the memory loss and learning disabilities that are associated with advanced stages of diabetes.    Lycopene, a bright red carotenoid found in tomatoes and red fruits, is known to be beneficial to health in many ways, but it is for the first time that scientists have found it plays a major role in delaying - if not outright controlling  - cerebral complications linked to what doctors call diabetic encephalopathy. Diabetic encephalopathy, as the name suggests, is a complication suffered by a large number of diabetics when blood sugar levels have not been kept under control for long, resulting in the damage of neurons in the brain. This damage causes cognitive impairment.

ALOE VERA for Diabetes    Several studies have shown efficacy of Aloe Vera  to lower the glucose level of a person with diabetes. However, Aloe Vera is yet to be proven as an treatment for the disease though it is to some extent administered for type2 diabetes. Despite many research findings prove the efficiency of Aloe Vera for hypoglycemia treatment; it is still necessary to perform more experiments to establish the plant’s effectiveness. It may help to lower down the glucose level which is the main cause associated with the disease. Sometimes administration of Aloe Vera may result in sudden hypoglycemic condition in patients and more so if taken along with allopathic treatment.

ALOE VERA

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