Based on the world health organization (WHO), diabetes is a chronic disease that occurs under two circumstances. First, experts explain that diabetes occurs when the human pancreas fails to generate enough insulin. Secondly, it can also happen when the human body cannot efficiently use insulin. Biologically, insulin is a hormone in the human body responsible for regulating blood sugar. Therefore, when the body fails to use it or ineffectively uses it, individuals develop hyperglycemia, or high blood sugar, a common effect of untreated diabetes that eventually results in severe complications to the body systems, blood vessels, and nerves. In addition, healthcare professionals have warned that having excessive glucose in the body is likely to lead to comorbidity; therefore, since diabetes has no cure, it is recommended to follow the steps outlined by healthcare professionals to stay out of the dangers of this disease.
Also, based on the report from WHO, 8.5% of people aged 18 years and above exhibited cases of diabetes in 2014. Exceedingly, in 2019, the disease resulted in the death of nearly 1.5 million. Between 2002 and 2016, the United States recorded a 5% increase in premature deaths from diabetes. However, in many other high-income global countries like the United States, the early mortality rates from diabetes recorded a tremendous decrease between 2002 and 2010. The situation recorded a slight shift from 2010 to 2016, when increased diabetes-related deaths were witnessed. But in developing nations, premature deaths from diabetes increased throughout the periods.
Diabetes is a highly predominant disease in the United States today. Based on the National Institute of Diabetes and Digestive and Kidney Diseases statistics, 30.3 million people in the US were recorded to have diabetes as of 2015. The number represents 9.4% of the total population. The institution also reported that more than 1 in every four people who reported having this disease never knew they had it. Furthermore, among people aged 65 and older, every 1 in 4 are affected or likely to be affected by diabetes. And lastly, the institution records that nearly 95% of diabetes cases among adults are type 2 diabetes.
Types of Diabetes
The predominant types of diabetes people suffer from daily are type 1, 2, and gestational diabetes. In addition, various subtypes of diabetes, such as monogenic diabetes and cystic fibrosis-related diabetes, exist.
Type 1 Diabetes
Also known as juvenile diabetes, type 1 diabetes is a chronic disorder where the pancreas generates minimal insulin. Insulin allows sugar to move to the body cells, generating energy; thus, with little or no insulin, body cells find it difficult to produce the required energy. When the body cannot make insulin, especially when the immune system attacks and terminates the pancreas’ cells. Type 1 diabetes is commonly diagnosed in youths and adults but can also be experienced in any age group. Doctors recommend that individuals diagnosed with type 1 diabetes take insulin daily to lead a healthy and normal everyday life.
Despite the extensive research on this type of diabetes, it still has no cure; therefore, treatment only dwells on good blood sugar levels with lifestyle, diet, and insulin to avoid further complications. Unfortunately, since there is no insulin in the body to let glucose to the body cells, sugar levels build up in the bloodstream, leading to hyperglycemia, high blood sugar, or glycosuria (excess sugar in the urine). The main risk factors for this type of diabetes include family history, environment, age, and genetics.
Type 2 Diabetes
Type 2 diabetes occurs when the human body fails to make or use the produced insulin effectively. It can develop at any age, both young and adult; however, recent studies confirm that it primarily occurs in the middle-aged and elderly. This type of diabetes can be acute or chronic since it hinders how the human body manages and uses glucose as energy. Type 2 diabetes is a condition that leads to excess sugar moving into the bloodstream.
People with type 2 diabetes exhibit two interrelated problems; their pancreas produces insufficient insulin. As a result, the hormone regulating the movement of sugar into the body’s cells responds poorly to insulin (insulin resistance). Type 2 diabetes, best known as adult-onset, is also predominant in children with obesity. Like many other types of diabetes, this condition can be managed through therapeutic lifestyle changes (TLC) such as a balanced diet and regular exercise. However, if measures such as a balanced diet and regular exercise are insufficient, patients are encouraged to use oral medications or insulin therapy.
Gestational Diabetes
Gestational diabetes was first witnessed in some women during their pregnancy period. In many cases, this disease tends to disappear after delivery. However, experts have revealed that women who show signs of gestational diabetes or have ever had this disease have higher chances of experiencing type 2 diabetes in the future. Although gestational diabetes is a common disease during birth, some diabetes recorded during pregnancy were mostly type 2 diabetes.
Treatment of Diabetes
Healthcare professionals use various medications and treatments to prevent individuals from the complications of diabetes, such as renal disease and loss of vision. The typical treatment methods involve regular exercise, lifestyle changes, and a balanced diet. Others use medications given by mouth, while others are offered through injection.
Type 1 Diabetes
The primary treatment criteria for this type of diabetes is insulin. Insulin helps replace the hormone that the body cannot produce. Different doctors use different insulin depending on how fast they start to function and the period their effects may take. The varying types of insulin used involve:
- Rapid-acting insulin; starts to function within the first 15 minutes of administration and becomes effective for nearly 4 hours.
- Short-acting insulin is the second type that starts to work within the first 30 minutes of use and goes for up to 8 hours.
- Intermediate-acting insulin begins to work within the first 1 to 2 hours of administration and remains effective for 18 hours.
- Long-acting insulin becomes active a few hours after administration and remains effective for one day (24 hours).
Type 2 Diabetes
As healthcare professionals recommend, a balanced diet and regular exercise is the primary treatment for type 2 diabetes. In addition, individuals with this disease need therapeutic lifestyle changes to manage and control this disease adequately. However, if therapeutic lifestyle changes aren’t enough to lower the blood sugar level, the following drugs are recommended under the supervision of a clinician.
Gestational Diabetes
During pregnancy, women are advised to monitor their blood sugar levels closely. If they realize it’s high, they are advised to embark on dietary changes and exercise as the first steps to regulate it. However, research studies indicate that approximately 10 to 20% of women with gestational diabetes will require insulin to regulate their blood sugar levels; however, Insulin is considered safe for pregnant women and their unborn babies.
Drugs for Treating Diabetes
Metformin
They are primarily prescribed for individuals with type 2 diabetes since it works by inhibiting glucose production by the liver, thereby decreasing blood sugar and improving weight loss.
Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors and Glucagon-Like-Peptide-1 (GLP-1) Receptor Agonists
SGLT2 inhibitors such as Canagliflozin (Invokana), Dapagliflozin (Farxiga), and Empagliflozin (Jardiance) are newly introduced drugs that lower glucose levels in the human bloodstream. Their mechanism of action is reducing the quantity of glucose reabsorbed by the kidneys, thereby reducing sugar in the bloodstream, and are best prescribed for individuals unwilling to use insulin. GLP-1 receptor agonists such as Dulaglutide (Trulicity), Exenatide (Byetta), Semaglutide (Ozempic), and Liraglutide (Victoza, Saxenda); their mechanism of action is stimulating the release of glucose-dependent insulin from the pancreas; in addition, gastric emptying is slowed down, and unnecessary after-meal production of glucagon is inhibited. Also, satiety is increased, appetite is lowered, blood sugar is controlled, and weight loss is improved.
Insulin
There are various types of insulin used in the treatment of diabetes mellitus. Insulin is classified based on its onset, peak time, action, and duration. There are various types of insulin; rapid-acting insulin, such as the insulin Lispro (Humalog) and insulin aspart (Novolog), can control blood glucose for up to 4 hours; regular (short-acting) insulin, such as the Human Regular (Humulin R and Novolin R) can control blood glucose up to 6 hours; intermediate-acting insulin such as the Neutral Protamine Hagedorn (NPH): (Humulin N and Novolin N) can control blood glucose up to 18 hours; long-acting insulin like glargine (Lantus), Degludec (Tresiba), and Detemir (Levemir) can control blood glucose up to 24 hours. In addition, ultra-long-acting glargine-type insulin (Toujeo) is used for type 1 and type 2 diabetes; it is more concentrated than regular glargine and can control blood glucose for up to 36 hours.
