Lifestyle changes
Achieving a healthy lifestyle is critical for keeping diabetes under control. A good diet and weight reduction. If needed, are this first goals--and definitely the most chalenging. After all, anyone can swallow pills, but it takes real will power to change long-established patterns of poor eating. A dietitian with training in diabetic meal planning can help you formulate a program well suited to your needs. Sadly, more than half of all people with diabetes abandon their diet therapy, relying on luck and medications--and in the process risk serious problems down the line.
The basics of a diabetes diet are simply those of healthy eating, with kilojoule restrictouryyions, if needed. When you start getting 50 percent of your kilojoule from carbohydrates, 30 percent from fats and 20 percent from protein, it will drawn on you that if everyone are like this, there would be less obesity as well as less diabetes in the world. Such an eating plan also reduces your chances of developing heart disease and cancer. For most people, the real challenge is usually portion control. Gone are the days of piling your plate to overflowing, or going back for second helpings, followed by a rich desert, and maybe even an evening snack.
If you're overweight, shedding a few kilos will improve your blood glucose levels; losing just 10 percent of your body weight can slow the progression of diabetes. If weight is an issue for you, consider a support group such as weight watchers, and ask your doctor about one of the new drugs for weight control, such as Reductil or Xenical (See on later). Regular exercise, when combined with kilojoule restriction, will difinitely speed your weight loss. And when you have diabetes, exercise has an added benefit: It increases your cell's sensitivity to insulin and enables them to use glucose more efficiently. Exercising as little as 30 minutes three times a week can help, but engaging in something vigorous every day is best. Choose activities that are aerobic: cycling, swimming, or walking, as opposed to resistance exercise such as weight lifting. And kick the smoking habit. The double damage inflicted on your circulation by diabetes and smoking could eventually result in the amputation of your toes or feet.
PROMISING DEVELOPMENTS
The six main classes of oral diabetes drugs act on different sites in the body and employ different mechanisms, but they all have one goal: to control blood sugar levels. They'll work only if your pancreas still produces some insulin. The drugs can be used alone, in combination or with insulin. The drugs can be used alone, in combination or with insulin. The drugs can be used alone, in combination or with insulin. Your doctor is likely to recommend insulin injections only when the oral medications are losing their effect.
For over 30 years, sulfonylureas (Danoil, Diamicron, Amaryland others) have been the first-line drugs for diabetes, lowering blood sugar by prompting the body to increase its insulin production. Low blood sugar (hypoglycaemia) is a common and serious side effect of these medications. Overtime, a sulfonylurea drug may stop lowering your blood sugar sufficiently, and you'll need to go on something else.
To increase your body's sensitivity to insulin (your own or injected forms), the oral medications metformin (Diabex, Diaformin) is very valuable. It reduces the liver's production and release of glucose and increases the uptake of glucose-lowering effect. With Diabex or Diaformin, hypoglycaemia isn't a problem and some people even lose weight due to diminished appetite. Consequently it is commonly prescribed for obese patients. Diarrhoea can occur but may disappear overtime.'
Like the sulfonylureas, a group of drugs called meglitinides, such as NovoNorm, stimulate the pancreas to produce insulin. They work quickly and act for only a short time, so you need to take them before every meal. Because meglitinides definitely lower blood sugar, their main effect is hypoglycaemia. Another group of drugs taken with meals, the alpha-glucosidase inhibitors (Glucobay), will delay the digestion of complex carbohdyrates and table sugar. Their purpose is to blunt the increase in blood sugar that normally occurs after eating. Because these drugs interfere with digestion, some people experience mild flatulence and bloating, but this often subsides with long-term use.
DIABETES COMPLICATIONS
Diabetes affects various body systems.
Eyes: jeopardises blood vessels in the eyes causing diabetic retinopathy, which leads to blindness. It can be treated with laser surgery. Glucose control lessens risk.
Kidneys: damage to the small vessels within the kidneys, termed nephropathy, is a leading cause of kidney failure. Glucose control can often prevent problems, but sometimes dialysis or a kidney transplant will be needed.
Nerves: diabetic neuropathy occur when nerves, usually in the legs and the feet, have been damaged by diabetes. People with neuropathy usually have either thumbness and inability to sense pain in the feet, or symptoms of burning or pins and needles. Occasionally patients can have both. Medications such as Neurontin can help with pain.
Feet. infections, injuries and gangrene can develop in the feet as a result of poor circulation. Always see a podiatrist. People with diabetes often don't detect sores developing on their feet because of imparied vision and nerve endings that mask pain.
Relatively new and quite pricey, thiazolidinediones (TZDs), or glitazones, decrease muscle-cell resistance to insulin by activating certain genes involved in fat synthesis and metabolism. Obese people resistant to insulin often take TZDs. Some of these can cause liver problems, so your doctor will probably want to check your liver enzymes. One of the drugs, troglitazone, has been withdrawn from the market for this reason. Avandia and Actos do not appear to cause liver problems, but they are currently not listed on the PBS. Side effects of TZDs include fluid retention, raised lipid levels and anaemia.
A new drug, Starlix, a phenylalanine derivative, is on the horizon in Austrialia. This lowers glucose levels by stimulating the pancreas to release insulin. It works quickly and acts to prevent the increase in blood glucose that occurs after eating.
Achieving a healthy lifestyle is critical for keeping diabetes under control. A good diet and weight reduction. If needed, are this first goals--and definitely the most chalenging. After all, anyone can swallow pills, but it takes real will power to change long-established patterns of poor eating. A dietitian with training in diabetic meal planning can help you formulate a program well suited to your needs. Sadly, more than half of all people with diabetes abandon their diet therapy, relying on luck and medications--and in the process risk serious problems down the line.
The basics of a diabetes diet are simply those of healthy eating, with kilojoule restrictouryyions, if needed. When you start getting 50 percent of your kilojoule from carbohydrates, 30 percent from fats and 20 percent from protein, it will drawn on you that if everyone are like this, there would be less obesity as well as less diabetes in the world. Such an eating plan also reduces your chances of developing heart disease and cancer. For most people, the real challenge is usually portion control. Gone are the days of piling your plate to overflowing, or going back for second helpings, followed by a rich desert, and maybe even an evening snack.
If you're overweight, shedding a few kilos will improve your blood glucose levels; losing just 10 percent of your body weight can slow the progression of diabetes. If weight is an issue for you, consider a support group such as weight watchers, and ask your doctor about one of the new drugs for weight control, such as Reductil or Xenical (See on later). Regular exercise, when combined with kilojoule restriction, will difinitely speed your weight loss. And when you have diabetes, exercise has an added benefit: It increases your cell's sensitivity to insulin and enables them to use glucose more efficiently. Exercising as little as 30 minutes three times a week can help, but engaging in something vigorous every day is best. Choose activities that are aerobic: cycling, swimming, or walking, as opposed to resistance exercise such as weight lifting. And kick the smoking habit. The double damage inflicted on your circulation by diabetes and smoking could eventually result in the amputation of your toes or feet.
PROMISING DEVELOPMENTS
- A rice bran formulation was able to lower blood glucose by up to 30% in people with type 2 (and type 1) diabetes in one small study, reducing the need for insulin or oral medications.
- Look to the news for more on an experiment treatment (protein GLP-1) for type 2 disease. It not only helps with glucose control, but also helps make you slimmer.
The six main classes of oral diabetes drugs act on different sites in the body and employ different mechanisms, but they all have one goal: to control blood sugar levels. They'll work only if your pancreas still produces some insulin. The drugs can be used alone, in combination or with insulin. The drugs can be used alone, in combination or with insulin. The drugs can be used alone, in combination or with insulin. Your doctor is likely to recommend insulin injections only when the oral medications are losing their effect.
For over 30 years, sulfonylureas (Danoil, Diamicron, Amaryland others) have been the first-line drugs for diabetes, lowering blood sugar by prompting the body to increase its insulin production. Low blood sugar (hypoglycaemia) is a common and serious side effect of these medications. Overtime, a sulfonylurea drug may stop lowering your blood sugar sufficiently, and you'll need to go on something else.
To increase your body's sensitivity to insulin (your own or injected forms), the oral medications metformin (Diabex, Diaformin) is very valuable. It reduces the liver's production and release of glucose and increases the uptake of glucose-lowering effect. With Diabex or Diaformin, hypoglycaemia isn't a problem and some people even lose weight due to diminished appetite. Consequently it is commonly prescribed for obese patients. Diarrhoea can occur but may disappear overtime.'
Like the sulfonylureas, a group of drugs called meglitinides, such as NovoNorm, stimulate the pancreas to produce insulin. They work quickly and act for only a short time, so you need to take them before every meal. Because meglitinides definitely lower blood sugar, their main effect is hypoglycaemia. Another group of drugs taken with meals, the alpha-glucosidase inhibitors (Glucobay), will delay the digestion of complex carbohdyrates and table sugar. Their purpose is to blunt the increase in blood sugar that normally occurs after eating. Because these drugs interfere with digestion, some people experience mild flatulence and bloating, but this often subsides with long-term use.
DIABETES COMPLICATIONS
Diabetes affects various body systems.
Eyes: jeopardises blood vessels in the eyes causing diabetic retinopathy, which leads to blindness. It can be treated with laser surgery. Glucose control lessens risk.
Kidneys: damage to the small vessels within the kidneys, termed nephropathy, is a leading cause of kidney failure. Glucose control can often prevent problems, but sometimes dialysis or a kidney transplant will be needed.
Nerves: diabetic neuropathy occur when nerves, usually in the legs and the feet, have been damaged by diabetes. People with neuropathy usually have either thumbness and inability to sense pain in the feet, or symptoms of burning or pins and needles. Occasionally patients can have both. Medications such as Neurontin can help with pain.
Feet. infections, injuries and gangrene can develop in the feet as a result of poor circulation. Always see a podiatrist. People with diabetes often don't detect sores developing on their feet because of imparied vision and nerve endings that mask pain.
Relatively new and quite pricey, thiazolidinediones (TZDs), or glitazones, decrease muscle-cell resistance to insulin by activating certain genes involved in fat synthesis and metabolism. Obese people resistant to insulin often take TZDs. Some of these can cause liver problems, so your doctor will probably want to check your liver enzymes. One of the drugs, troglitazone, has been withdrawn from the market for this reason. Avandia and Actos do not appear to cause liver problems, but they are currently not listed on the PBS. Side effects of TZDs include fluid retention, raised lipid levels and anaemia.
A new drug, Starlix, a phenylalanine derivative, is on the horizon in Austrialia. This lowers glucose levels by stimulating the pancreas to release insulin. It works quickly and acts to prevent the increase in blood glucose that occurs after eating.
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