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Diabetes

Diabetes is a disease that affects the amount of insulin and
sugar in a person's body. There are two major types of
diabetes--type 1 and type 2. People with type 1 diabetes
produce virtually no insulin. In type 2, the most common form
of the disease, the body does not produce enough insulin or
effectively use insulin. If people with diabetes do not properly
control their blood sugar levels, serious complications
including heart disease, kidney failure, blindness, and nerve
damage may develop.

Onset, Causes, Signs and Symptoms

Type 1 Diabetes
This type of diabetes is mostly found in children and young
adults. If you have type 1 diabetes, your body does not make
insulin and you must inject insulin daily. You May: urinate
often, be very thirsty, be very hungry, lose a lot of weight, be
very tired, be irritable, have blurred vision and have trouble
seeing.

Type 2 Diabetes
Most people with diabetes have this form of the disease. Type
2 is usually found in people over 45, who have diabetes in
their family, who are overweight, who don’t exercise, and who
have cholesterol problems. It is also common in certain racial
and ethnic groups (blacks, American Indians, and Hispanics)
and in women who had diabetes when they were pregnant. If
you have type 2 diabetes, your body cannot make enough
insulin or correctly use it.

You May Have: any of the symptoms of type 1 diabetes, a lot
of infections, cuts or bruises that heal slowly, tingling or
numbness in the hands or feet and skin, gum, or bladder
infections that keep coming back.

Taking Care of Your Diabetes

The best way to take care of your diabetes is to make sure
the levels or amount of sugar in your blood are near the
normal range. This will make you feel better and help you stay
healthy.

Your doctor will tell you how often to check your blood sugar
level. To do this, you will need to take a drop of your blood
and place it on a special test strip. Then a device, called a
blood glucose meter, reads the strip. This device measures
the amount of sugar in your blood.

Writing down this level, along with the time and date, will help
you see how well your treatment plan is working.
Remember:

A person’s blood sugar level rises after eating any meal that
contains carbohydrates or protein. Table sugar (also called ?
sucrose) counts as a carbohydrate. Artificial sweeteners, such
as saccharin, aspartame (NutraSweet), and sucralose
(Splenda), do not count as carbohydrates or fats. They make
food taste sweet. But they do not raise blood sugar levels
and have little or no calories.

What Else Can You Do?

Eat well-balanced meals. The right amount of healthy food will
keep your weight under control and help manage your
diabetes. Your body needs food from the four main food
groups every day:

* Fruits and vegetables
* Whole grains, cereals, and bread
* Dairy products (milk, cheese, and yogurt)
* Meats, fish, poultry, eggs, dried beans, and nuts.

Too much fat and cholesterol in your diet can be very harmful
to people with diabetes. Food that is high in fat includes red
meat, dairy products (whole milk, cream, cheese, and ice
cream), egg yolks, butter, salad dressings, vegetable oils, and
many desserts.

Treatment
Treatment is diabetes pills and sometimes insulin injections,
as well as diet and exercise.

Diabetes pills work in one of three ways. They either stimulate
the pancreas to release more insulin, increase the body's
sensitivity to the insulin that is already present, or slow the
breakdown of foods (especially starches) into glucose.

In type 1 diabetes, inhaled insulin may be added to longer-
acting insulins as a replacement for short-acting insulin taken
with meals. In type 2 diabetes, inhaled insulin may be used
alone, along with oral medications that control blood sugar, or
with longer-acting insulins. There are six categories of
diabetes pills: sulfonylureas, meglitinides, nateglinides,
biguanides, thiazolidinediones, and alpha-glucose inhibitors.

Exubera, an inhaled powder form of recombinant human
insulin (rDNA) for the treatment of adult patients with type 1
and type 2 diabetes, is the first new insulin delivery option
introduced since the discovery of insulin in the 1920s.

Like any insulin product, low blood sugar is a side effect of
Exubera, and patients should carefully monitor their blood
sugars regularly. Other side effects associated with Exubera
therapy seen in clinical trials included cough, shortness of
breath, sore throat, and dry mouth.

Content Source First Inhaled Insulin Product Approved, FDA Consumer
Magazine, 2006 Diabetes FDA

MEDICAL NOTES

Oral Antidiabetes Medications

Sulfonylurea - stimulates beta
cells to release more insulin,
e.g. Diabinese
(Chlorpropamide), Glucotrol
(Glipizide),
DiaBeta/Micronase/Glynase
(Glyburide), Amaryl (Glimepiride)

Meglitinide - stimulates beta
cells to release more insulin e.g.
Prandin (Repaglinide),

Nateglinide -stimulates beta
cells to release more insulin e.g.
Starlix (Nateglinide).

Biguanide - sensitizes the body
to the insulin already present,
e.g. Glucophage (metformin),
Glucophage XR (metformin
(long lasting), Glucovance
(metformin with glyburide).

Glitazone (Thiazolidinedione) -
helps insulin work better in
muscle and fat; lowers insulin
resistance, e.g. Avandia
(rosiglitazone), Actos
(pioglitazone).

Alpha-Glucose Inhibitor - slows
or blocks the breakdown of
starches and certain sugars;
action slows the rise in blood
sugar levels following a meal.
Precose (acarbose) and Glyset
(miglitol).