By Olivia Turansky, Pharmacy Resident, BHMC-North Little Rock
Someone is diagnosed with diabetes every 23 seconds. One in 11 people in the U.S. have diabetes, and 86 million more are at risk for developing diabetes. Diabetes is the seventh-leading cause of death with more deaths a year than breast cancer and AIDS combined.
A diabetes diagnosis almost doubles your chance of having a heart attack, but good diabetes control can reduce your risk for complications from diabetes. Common risk factors for diabetes include family history, ethnicity, high blood pressure, being overweight, and being physically inactive.
Diabetes is a problem with your body that causes blood sugar (glucose) levels to rise higher than normal. When you eat, your body breaks down food into glucose and sends it into the blood. Insulin helps move the glucose from the blood into your cells to be used as fuel for energy right away or stored to be used later. In a person with diabetes, the body either does not make enough insulin, cannot use insulin it does make, or both.
Common warning signs include urinating often, feeling very thirsty or hungry, fatigue, blurry vision, and cuts or bruises that are slow to heal.
To manage diabetes, it is important to manage your A1C level, blood pressure, and cholesterol to reduce your risk of heart attack or stroke. It is important to check your blood sugar before meals and to keep a record of your blood sugars to help your physician adjust your insulin regimen. If you have diabetes, it is important for you to get your yearly flu shot, have an annual eye exam, and do regular foot exams.
There are different types of diabetes: Type 1, Type 2, and a condition called gestational diabetes.
In Type 1 diabetes, your immune system destroys the beta cells in your pancreas that makes insulin. The destruction of the beta cells can happen over a few weeks, months, or years. When enough beta cells are destroyed, your pancreas either stops making insulin or makes very little insulin so that you need to take insulin to live.
In Type 2 diabetes, your body has something called insulin resistance, which is when the insulin in your body is not being used properly. Some people with Type 2 diabetes are able to manage their diabetes with healthy eating and exercise, but your doctor may also prescribe an oral medication or insulin to meet your target blood glucose levels.
Gestational diabetes develops during pregnancy, and for most women their blood glucose levels will return to normal after giving birth. If you have had gestational diabetes, then you will need to be tested regularly since you are at risk for developing Type 2 diabetes later in life.
Diabetes is a progressive disease so even if you do not need medication to treat your diabetes at the beginning, you may need to over time.
Insulin is a hormone secreted by the pancreas and many people with diabetes are prescribed insulin because their bodies do not produce insulin (Type 1 diabetes) or do not use insulin properly (Type 2 diabetes).
Rapid-acting insulin (Apidra, Humalog, Novolog) begins to work about 15 minutes after injection and continues to work for two to four hours. Regular or short-acting insulin (Humulin, Novolin) reaches the bloodstream within 30 minutes and is effective for three to six hours.
Intermediate-acting insulin (NPH) reaches the bloodstream two to four hours after injection and is effective for 12 to 18 hours. Long-acting insulin (Lantus, Levemir, Tresiba) reaches the bloodstream several hours after injections and will lower glucose levels over a 24-hour period.
Only people with Type 2 diabetes can use pills to manage their condition. Diabetes pills (metformin, glipizide, sitagliptin) work best when used with meal planning and exercise to help combat lowering blood-glucose levels in three different ways.
If you have recently been diagnosed with diabetes, then the chances are good that diabetes pills will work well for you to keep your blood glucose levels near normal. Diabetes pills have been known to stop working after a few months or years, but that does not mean your diabetes is worse, only that an additional medication may be needed. There is no “best” pill or treatment for Type 2 diabetes, and you may need to try one type of pill, combination of pills, or pills plus insulin.
There is no cure for diabetes, but it can be managed. Balancing the food you eat with exercise and medicine will help you control your weight and can keep your blood glucose in the healthy range.