Diabetes Mellitus Treatment

Diabetes Mellitus Treatment

The goal of diabetes control is to keep blood glucose levels as close as possible to normal. Since diabetes can greatly increase the risk of heart disease and peripheral artery disease, measures to control blood pressure and cholesterol levels are an essential part of the treatment of diabetes as well.

People with diabetes should take responsibility for their daily care. This includes controlling blood glucose levels, controlling diet, maintaining physical activity, keeping weight and stress under control, controlling oral medications and, if necessary, using insulin through injections or a pump. To help patients achieve this, the UCSF Diabetes Teaching Center offers self-management educational programs that emphasize individualized diabetes care. The program allows patients to make more consistent and appropriate adjustments in their therapy and lifestyle.

Dietary Management And Physical Activity

Modifying eating habits and increasing physical activity are often the first steps to reduce blood sugar levels. At UCSF Medical Center, all patients work with their doctor and certified dietitian to develop a dietary plan. Our Teaching Center conducts workshops that provide patients with information on the nutrient content of food, healthy cooking and exercise.

Insulin Therapy

People with type 1 diabetes require multiple injections of insulin each day to maintain safe levels of insulin. Insulin is often required to treat type 2 diabetes. Using an insulin pump is an alternative to injections. The pump is about the size of a pager and is usually worn on your belt. Insulin is given through a small tube (catheter) that is placed under the skin (usually in the abdomen).

There are four main types of insulin:

• Fast action
• Short-acting
• Intermediate action
• Long Acting

Your doctor will determine your dose and how often you need to take insulin. There is no standard dose of insulin, since it depends on factors such as body weight, the amount of insulin you consume, how often you exercise and the amount of insulin you produce.

Oral Medications

Sometimes, blood sugar levels are still high in people with type 2 diabetes despite eating healthy and exercising. When this happens, medications taken in pill form may be prescribed. The medicines work in different ways. These include improving the effectiveness of the body's natural insulin, reducing the production of blood sugar, increasing insulin production and inhibiting the absorption of sugar in the blood. Oral medications for diabetes are sometimes taken in combination with insulin.

Read More

Diabetes Mellitus Types

Diabetes Mellitus Types

Diabetes mellitus or diabetes is a health disorder that affects the body's work in using sugar as a source of energy. Diabetes is a disease that can not be cured and is associated with various complications ranging from heart disease, kidney disorders, nervous system disorders, to blindness. The more alarming, the number of diabetics in Indonesia is increasing from year to year. By 2015, the number of diabetics in Indonesia reaches 10 million people or is ranked seventh with the most diabetics in the world.

Before discussing the causes of diabetes mellitus, it is better if you know first 3 types of diabetes mellitus disease. There are 3 types of diabetes mellitus, namely type 1 diabetes, type 2 diabetes and gestational diabetes. Everything has in common, that is the disturbance of the hormone insulin which is an important hormone to manage blood sugar levels. As a result, blood sugar levels become high and can cause complications.

The cause of diabetes mellitus varies according to the type of diabetes. By knowing the causal factors of each type of diabetes mellitus, then you can take precautions to avoid this disease. Here are the causes of diabetes mellitus based on each type:

Causes of Type 1 Diabetes Mellitus

Diabetes mellitus type 1 is known as insulin-dependent diabetes. The failure of the pancreas to produce insulin is a major contributing factor to this type of diabetes mellitus. Type 1 diabetes mellitus is commonly experienced by children. People with type 1 diabetes can not produce insulin because of impaired immune system that causes damage to pancreatic cells. The exact cause of type 1 diabetes is not known clearly, but is suspected to be related to:

1. Genetic factors

Type 1 diabetes mellitus is often decreased. If you have a nuclear family with a history of type 1 diabetes, you also have a higher risk.

2. Environmental factors

Environmental factors suspected to act as the cause of type 1 diabetes is a viral infection. Viral infection is one of the factors suspected to trigger immune system disorders and then interfere with the function of the pancreas in people with type 1 diabetes.

Causes of Type 2 Diabetes Mellitus

Diabetes mellitus type 2 is the type of diabetes most commonly experienced by most diabetics. This type of diabetes is also known as non-insulin-dependent diabetes, in which the body can still produce homo insulin but insulin hormone work is disrupted because the body can not respond to insulin well.

1. Obesity

Obesity is thought to be the cause of type 2 diabetes. In fact, obesity is believed to be the cause of type 2 diabetes especially. How can obesity cause diabetes? Fats that accumulate in the body can lead to insulin resistance, a condition in which insulin is less sensitive so it can not function properly in regulating blood sugar levels. Especially the fat deposits in the abdomen characterized by waist circumference beyond the normal limit, ie, ≥80 cm for women or ≥90 cm for men, are important factors of diabetes.

2. Lifestyle

Unhealthy lifestyle can also trigger the risk of type 2 diabetes. Unhealthy eating patterns such as consumption of sugar, fat, and high calories can lead to obesity and type 2 diabetes. Research shows that those who regularly consume sugar-sweetened sweet drinks was at risk higher diabetes. Moreover, if an unhealthy diet is supported by smoking habits, alcohol consumption, or never exercise.

3. Age factor

Believe it or not, the risk of type 2 diabetes will increase with age. The older a person's age, his weight will tend to increase and exercise habits are reduced. This factor triggers the higher risk of type 2 diabetes mellitus disease as you get older. Type 2 diabetes is commonly experienced by people aged 40 and older.

4. Certain ethnicity

Asians have a higher risk of developing type 2 diabetes. It is thought to be associated with higher body fat levels in Asians. Plus, Asians have a habit of always eating white rice. Research shows that high consumption of white rice was also a factor that causes diabetes. A research review published in the British Medical Journal showed that increased consumption of white rice was associated with an increased risk of diabetes. As a healthier alternative, whole grains can be an option, such as brown rice or oats.

5. Genetic factors

If you think that type 1 diabetes can be derived by the family, in fact type 2 diabetes can also be caused by genetic factors. Yes, a person who has a parent or sibling who has had type 2 diabetes has a higher risk of developing the same disease. However, this one factor can be prevented by having a healthier lifestyle and exercise routine.

6. Less physical activity

If you lack exercise, your risk of type 2 diabetes will increase. Exercise is very important to help maintain weight, use glucose as energy, and increase insulin sensitivity.

Causes of Gestational Diabetes

Gestational diabetes is experienced by very pregnant women. What exactly causes gestational diabetes? Are there any risk factors associated with gestational diabetes?

1. Pregnancy

Hormonal changes during pregnancy can lead to insulin resistance. The hormone produced by the placenta is known to inhibit the working of the hormone insulin in the body of the mother. High sugar levels of diabetes in pregnant women can cause health problems in the mother and baby so it must be controlled properly.

2. History of gestational diabetes

Women who have had gestational diabetes in previous pregnancies are also at risk of re-experiencing the disease in pregnancy at this time. So also with the mother who gave birth to a baby weighing more than 4.1 kg.

3. Obesity

Weight is also a risk factor for gestational diabetes. A woman who is already overweight or obese is known to have a higher risk of gestational diabetes. Therefore, it is important to keep the weight within normal limits before pregnancy.

Not only diabetes mellitus can cause various complications in other organs. You also have to live with this disease throughout your age. So, you better prevent this disease since now also because people with diabetes melitus can not be cured.

By knowing the cause of diabetes mellitus, you are expected to be more careful in living the everyday lifestyle. Diabetes mellitus is a chronic disease that can cause various complications until death. Therefore, prevent diabetes mellitus from now on with a healthy lifestyle and routine physical activity. Perform weight management, nutritional monitoring and regular exercise to avoid the risk of diabetes mellitus.

Read More

Sport Tips for Diabetics

Sport Tips for Diabetics

The recommended physical activity for diabetes mellitus control and prevention is a 30 minute minimum 3-4x weekly (or ideally daily) session for adults and 60 minutes for children and adolescents.

Activities can be divided into sessions, each session 10-15 minutes. Recommended activities are activities that increase breathing and heart rate and cause less sweating, such as walking, gardening, swimming, or cleaning the house. Perform increasing intensity and length of exercise gradually.

Alternatively, you can also choose sports sessions 3 times a week each for 20 minutes with more demanding activities, such as jogging, running, aerobics classes, and so on. Do not forget to keep the dipasanan and cooling to prevent muscle injury.

WARNING

Do not do physical activity is too heavy or too long. If you do, the body will produce the hormone adrenaline and other hormones that will fight the function of insulin. That way, your blood sugar will increase.

TIPS Exercise For Diabetes Patients

• Before starting the exercise, the diabetic patient should first consult his physician, to ensure that his chosen exercise activity is safe and appropriate to his physical state, for example if the patient has had problems with the nerves of the foot or the veins of his eyes. In addition, doctors can adjust the drug or insulin levels as well as the portion of food provided so as to prevent the occurrence of hypoglycemic conditions.
• Practice with someone who knows that you are a diabetic and know what to do if you are suddenly hypoglycemic.
• Bring snacks while exercising, such as a box of raisins or sweets, to use if you are hypoglycemic.
• If not accompanied, use a bracelet or attribute indicating that you are a diabetic.
• Use comfortable shoes and cotton socks. Replace socks that have been wet.
• After exercising, check your feet for any redness, blisters, cuts or blisters.
• Drink enough water before, during and after exercise to prevent dehydration.
• Do not ignore the pain you feel. Immediately stop the exercise if suddenly you feel the pain.
• Choose the activity you love so you can go about it happily on a regular basis. Activities to choose from are walking, hiking, aerobics, dancing, biking, playing basketball, tennis, volleyball, and so on.

Read More

Diabetes Mellitus Prevention

Diabetes Mellitus Prevention

Prevention of type 2 diabetes mellitus is primarily aimed at people at risk of developing type 2 diabetes. The goal is to slow the onset of type 2 diabetes, maintain the function of insulin-producing cells in the pancreas, and prevent or slow the appearance of disorders of the heart and blood vessels. The risk factor for type 2 DM is differentiated into a modifiable and unmodifiable factor. Prevention efforts are done by reducing the risks that can be modified.

Risk factors that can not be modified for example racial and ethnic, family history of DM, age> 45 years, birth history of infants with BB born infants> 4000 grams or history of gestational DM (DMG), and low birth weight history, less than 2.5 kg.

Modifiable risk factors such as excess body weight, lack of physical activity, hypertension (> 140/90 mmHg), impaired lipid profile (HDL <35 mg / dL and or triglyceride> 250 mg / dL, and unhealthy diet high sugar and low fiber.The prevention of DM should also be done by prediabetes patients ie those who have glucose intolerance (GDPP and TGT) and high-risk type 2 diabetes mellitus.

Prevention of type 2 DM in people at risk in principle is to change lifestyle that includes exercise, weight loss, and dietary regulation. Based on the analysis of a group of people with intensive lifestyle changes, diabetes prevention is most associated with weight loss. According to the study, weight loss of 5-10% can prevent or slow the emergence of type 2 diabetes. It is also recommended to eat a healthy diet, which consists of complex carbohydrates, containing less saturated fat and high soluble fiber. Caloric intake is intended to achieve ideal body weight.

Physical activity should be enhanced by regular exercise, at least 150 minutes per week, divided 3-4 times a week. Exercise can improve insulin resistance that occurs in prediabetes patients, increase levels of HDL (good cholesterol), and help achieve ideal body weight. In addition to sports, it is also recommended to be more active during daily activities, for example by choosing a ladder from an elevator, walking to the market rather than using a car, etc.

Smoking, while not directly causing glucose intolerance, can exacerbate cardiovascular complications of glucose intolerance and type 2 DM. Therefore, patients are also advised to stop smoking.

Read More

Diabetes Mellitus Complications

Diabetes Mellitus Complications

Uncontrolled blood glucose levels in patients with diabetes mellitus will cause various complications, both acute and chronic. Therefore, it is important for patients to monitor their blood glucose levels regularly.

Acute complications

The conditions included in acute DM complications are diabetic ketoacidosis (KAD) and Hyperosmolar Hyperglycemic Status (SHH). In these two situations the blood glucose levels are very high (at KAD 300-600 mg / dL, at SHH 600-1200 mg / dL), and the patient is usually unconscious. Because of the high mortality rate, patients should be immediately taken to the hospital for adequate treatment.

The state of hypoglycemia is also included in acute DM complications, where there is a decrease in blood glucose levels up to <60 mg / dL. Patients with unconscious DM should be considered to have a state of hypoglycemia. Things that can cause hypoglycemia such as patients taking too much medicine (most often sulphonylureas) or injecting too much insulin, or patients not eating after taking the drug or injecting insulin.

Symptoms of hypoglycemia include sweating, pounding, trembling, hunger, dizziness, anxiety and, if severe, loss of consciousness to coma. If the patient is aware, can be immediately given sweet drinks containing glucose. If the patient's condition does not improve or the patient is unconscious should be taken to the hospital for further treatment and monitoring.

Chronic complications

Uncontrolled diabetes mellitus in the long term will cause damage to blood vessels and nerves. Blood vessels that can be damaged divided into two types, namely large and small blood vessels.

Included in large blood vessels include:

• Heart blood vessels, which if damaged will cause coronary heart disease and sudden cardiac arrest
• The peripheral veins, especially on the limbs, which if damaged will cause ischemic injuries to the feet
• The blood vessels of the brain, which if damaged will be able to cause a stroke

Small blood vessel damage (microangiopathy), for example, concerns the retinal blood vessels and can cause blindness. In addition, there may be damage to the renal blood vessels that will cause diabetic nephropathy.

The most commonly damaged nerves are peripheral nerves, which cause numbness or numbness in the fingertips. Because of their numbness, especially on their feet, DM patients are often unaware of any foot injuries, increasing the risk of deeper wounds (foot ulcers) and the need for amputation. In addition to numbness, patients may also experience burning and vibrating legs themselves, more pain in the night and weakness in the hands and feet. In patients with peripheral nerve damage, it should be taught about adequate foot care thereby reducing the risk of injury and amputation.

Read More

Diabetes Mellitus Symptoms

 Diabetes Mellitus Symptoms

In the beginning, patients often do not realize that he has diabetes mellitus, even years later. However, suspicion of DM should occur if a person has a classic DM complaint in the form of:

• polyuria (many urine)
• polydipsia (thirst so much to drink)
• polifagia (much to eat due to feelings of continuous hunger)
• weight loss that can not be explained why

If the above complaints are experienced by a person, to confirm the diagnosis can be checked additional DM complaints in the form:

• weak, tired, tingling, itching
• blurred vision
• poor wound healing
• erectile dysfunction in male patients
• itching in the genitals of female patients

Diagnosis of DM should not be based on the discovery of glucose in the urine alone. Diagnosis is confirmed by examination of blood glucose levels of the veins. While to see and control the results of therapy can be done by checking the blood glucose capillaries with glucometer.

A person is diagnosed with DM if he or she has one or more of the following criteria:

• Experiencing classic symptoms of DM and plasma glucose levels at ≥200 mg / dL
• Experiencing the classic symptoms of DM and fasting plasma glucose ≥126 mg / dL
• Plasma glucose 2 hours after Oral Glucose Tolerant Tests (TTGO) ≥200 mg / dL
• HbA1C Examination ≥ 6.5%

Information:

• Plasma glucose as a result of a momentary examination one day regardless of the patient's last feeding time.
• Fasting means the patient does not get additional calories for at least 8 hours.
• TTGO is an examination performed by giving a specific glucose solution to be drunk. Before drinking the solution will be examined blood glucose levels, then will be checked again 1 hour and 2 hours after drinking the solution. This examination is rarely practiced.

If a person's blood glucose levels are higher than normal values ​​but do not fit into the DM criteria, then they fall into the prediabetes category. Included in it is:

• Impaired Fasting Blood Glucose (GDPT), which is established when fasting plasma glucose is obtained between 100 - 125 mg / dL and plasma glucose levels 2 hours after taking TTGO glucose solution <140 mg / dL
• Impaired Glucose Tolerance (TGT), which is established when plasma glucose levels are 2 h after taking TTGO glucose solution between 140 - 199 mg / dL

Normal blood glucose numbers

Fasting

Normal for person without diabetes: 70–99 mg/dl (3.9–5.5 mmol/L)

Official ADA recommendation for someone with diabetes: 80–130 mg/dl (4.4–7.2 mmol/L)

2 hours after meals

Normal for person without diabetes: Less than 140 mg/dl (7.8 mmol/L)

Official ADA recommendation for someone with diabetes: Less than 180 mg/dl (10.0 mmol/L)

HbA1c

Normal for person without diabetes: Less than 5.7%

Official ADA recommendation for someone with diabetes: 7.0% or less

 

Read More

Diabetes Mellitus Causes

Diabetes Mellitus Causes

Type 1 diabetes is believed to be an autoimmune disease, in which the body's own immune system specifically attacks and damages the insulin-producing cells present in the pancreas. Not yet known what triggers the occurrence of this autoimmune event, but the evidence suggests that genetic factors and environmental factors such as certain viral infections play a role in the process. Although type 1 diabetes is associated with genetic factors, genetic factors play a role in the incidence of type 2 diabetes.

Type 2 diabetes is thought to be caused by a combination of genetic and environmental factors. Many type 2 diabetic patients have family members who also suffer from type 2 diabetes or other diabetes-related health problems, such as high blood cholesterol, high blood pressure (hypertension) or obesity. The descendants of Hispanic, African and Asian races have a higher tendency to have type 2 diabetes. While environmental factors that affect the risk of developing Type 2 diabetes are our daily diet and physical activity.

Here are the major risk factors for a person suffering from type 2 diabetes.

• The family history of the core suffered from type 2 diabetes (parent or brother or sister)
• High blood pressure (> 140/90 mm Hg)
• Dyslipidemia: high blood triglyceride (fat) (> 150mg / dl) or HDL cholesterol <40mg / dl
• History of Impaired Glucose Tolerance (TGT) or Blood Glucose Disturbed (GDPT)
• History of gestational diabetes or a history of having a baby with a birth weight of more than 4,500 grams
• Foods high in fat, high in calories
• Lifestyle is not active (sedentary)
• Obesity or excess weight (weight 120% of ideal body weight)
• Old age, where the risk began to increase significantly at age 45 years
• History suffers from polycystic ovarian syndrome, where insulin resistance occurs

Gestational diabetes is caused by hormonal changes that occur during pregnancy. Increased levels of some hormones produced by the placenta make the body's cells become less responsive to insulin (insulin resistance). As the placenta continues to develop during pregnancy, hormone production is also increasing and exacerbating the insulin resistance that has occurred.

Usually, the pancreas in pregnant women can produce more insulin (up to 3x the normal amount) to overcome the insulin resistance that occurs. However, if the amount of insulin produced remains insufficient, blood glucose levels will increase and cause gestational diabetes. Most women with gestational diabetes will have normal blood sugar levels after giving birth to their baby. However, they have a higher risk for gestational diabetes during subsequent pregnancies and to develop type 2 diabetes later in life.

Read More