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Understanding Diabetes and Its Management

Diabetes is a metabolic disease where the body does not produce enough insulin or effectively use the insulin it does produce, resulting in high blood sugar. There are three main types of diabetes: type 1 caused by an autoimmune destruction of insulin-producing cells; type 2 where the body becomes resistant to insulin; and gestational diabetes during pregnancy. Prediabetes occurs when blood sugar levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. Symptoms of diabetes include increased hunger, thirst, weight loss, frequent urination, and fatigue. Insulin is the main treatment for type 1 diabetes, while type 2 diabetes can be managed through lifestyle changes, oral medications, and insulin injections.

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Rohit Thanage
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94 views10 pages

Understanding Diabetes and Its Management

Diabetes is a metabolic disease where the body does not produce enough insulin or effectively use the insulin it does produce, resulting in high blood sugar. There are three main types of diabetes: type 1 caused by an autoimmune destruction of insulin-producing cells; type 2 where the body becomes resistant to insulin; and gestational diabetes during pregnancy. Prediabetes occurs when blood sugar levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. Symptoms of diabetes include increased hunger, thirst, weight loss, frequent urination, and fatigue. Insulin is the main treatment for type 1 diabetes, while type 2 diabetes can be managed through lifestyle changes, oral medications, and insulin injections.

Uploaded by

Rohit Thanage
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Diabetes and its management

Rohit thanage
What is diabetes

What is diabetes?
Diabetes mellitus, commonly referred to simply as diabetes, is a metabolic disease that causes high
blood sugar.

The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. With
diabetes, your body either doesn’t make enough insulin or can’t effectively use the insulin it does
make.

Types of diabetes
There are a few different types of diabetes:
•Type 1: Type 1 diabetes is an autoimmune disease. The immune system attacks and destroys cells in the 
pancreas, where insulin is made. It’s unclear what causes this attack.
•Type 2: Type 2 diabetes occurs when your body becomes resistant to insulin, and sugar builds up in your
blood. It’s the most common type—about 90% to 95%Trusted Source of people living with diabetes have type
2.
•Gestational: Gestational diabetes is high blood sugar during pregnancy. Insulin-blocking hormones produced
by the placenta cause this type of diabetes.
Prediabetes
Prediabetes is the term that’s used when your blood sugar is
higher than expected, but it’s not high enough for a diagnosis of
type 2 diabetes. It occurs when the cells in your body don’t
respond to insulin the way they should. This can lead to type 2
diabetes down the road.

General symptoms
The general symptoms of diabetes include:
•increased hunger
•increased thirst
•weight loss
•frequent urination
•blurry vision
•extreme fatigue
•sores that don’t heal
Diabetes Pathophysiology
Triad to Ominous Octet

Hepatic  Peripheral
Glucose Production
 Insulin Secretion (-cell)
Glucose Utilization
(liver)
(muscle)

Traditional Triad Ominous octet


Metabolic-Cardio-Renal Continuum*

*Adapted from original CV Risk Continuum: Dzau VJ, Braunwald E. Am Heart J. 1991 Apr;121(4 Pt 1):1244-63
Insulin is the main treatment for type 1 diabetes. It replaces the
hormone your body isn’t able to produce.
Various types of insulin are commonly used by people with type
1 diabetes. They differ in how quickly they start to work and
how long their effects last:
•Rapid-acting insulin: starts to work within 15 minutes and its
effects last for 2 to 4 hours
•Short-acting insulin: starts to work within 30 minutes and
lasts 3 to 6 hours
•Intermediate-acting insulin: starts to work within 2 to 4 hours
and lasts 12 to 18 hours
•Long-acting insulin: starts to work 2 hours after injection and
lasts up to 24 hours
•Ultra-long acting insulin: starts to work 6 hours after
injection and lasts 36 hours or more
•Premixed insulin: starts working within 5 to 60 minutes and
lasts 10 to 16 hours
Drug How it works Examples

alpha-glucosidase inhibitors slow your body’s breakdown of acarbose (Precose) and miglitol


sugars and starchy foods

biguanides reduce the amount of glucose your metformin (Glucophage, Riomet)


liver makes
alogliptin (Nesina), linagliptin
DPP-4 inhibitors improve your blood sugar without (Tradjenta), saxagliptin (Onglyza),
making it drop too low and sitagliptin (Januvia)
stimulate your pancreas to produce semaglutide (Ozempic), dulaglutide
glucagon-like peptides more insulin; slow stomach (Trulicity), exenatide (Byetta), and
emptying liraglutide (Victoza)

meglitinides stimulate your pancreas to release nateglinide and repaglinide


more insulin
canagliflozin (Invokana),
SGLT2 inhibitors release more glucose into the urine dapagliflozin (Farxiga), and
empagliflozin (Jardiance)

stimulate your pancreas to release glyburide (Glynase), glipizide


sulfonylureas more insulin  (Glucotrol), and glimepiride
 (Amaryl)

thiazolidinediones help insulin work better pioglitazone (Actos) and


rosiglitazone
What are the comparisons between the available T2D
treatment options?
Metformin SU TZD DPP-4i SGLT2i GLP-1 RA Insulin

Efficacy High High High Intermediate Intermediate High Highest

Risk of Low Moderate Low Low Low Low High


hypoglycaemia

Weight Loss Gain Gain Neutral Loss Loss Gain

Oedema, HF, Genital


Side effects GI Hypo fractures Rare Infections GI Hypo

DPP-4i, dipeptidyl peptidase-4 inhibitor; GLP-1 RA, glucagon-like peptide-1 receptor agonist; HF, heart failure; SGLT2i, sodium-glucose co-transpoter-2 inhibitor; SU, sulphonylurea; T2D, type 2 diabetes; TZD, thiazolidinedione
ADA. Diabetes Care 2020;43:S1

8
lippincott
Thank you

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