Raising Diabetes Awareness
By: Amanda Hodges, PharmD Candidate 2012
University of Illinois at Chicago College of Pharmacy
November is American Diabetes Month. Currently in the U.S., 23.6 million, or 7.8% of the population have diabetes and approximately 5.7 million people do not know they have the disease. Diabetes has become the seventh leading cause of death in the U.S. There are 2 forms of diabetes, Type 1, previously known as juvenile diabetes, and Type 2, which is more common. Patients with Type 2 diabetes either do not produce enough insulin or the cells ignore the insulin. Insulin is a hormone that is released from the pancreas and its release is necessary for the body to be able to use glucose or energy. When food is ingested, the body breaks down sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can lead to a numerous symptoms and diabetic complications. Some symptoms include increased thirst, frequent urination, increased hunger, weight loss, fatigue, and blurred vision. Some long-term complications include heart disease, stroke, kidney disease, nerve damage, eye problems, and amputations.
A variety of risk factors increase the likelihood that a patient will develop Type 2 diabetes. Some of these risk factors include:
- Age - people over 45 years are at higher risk
- People with a family history of diabetes
- People who are overweight
- People who do not exercise regularly
- Certain ethnic groups such as Non-Hispanic Blacks, Hispanic/Latino Americans, Asian Americans, and American Indians
- Women who had gestational diabetes while pregnant or women who had a baby weighing 9 pounds or more at birth
The goal of diabetes treatment is to control blood glucose levels, reduce long-term complications, and maintain a good quality of life. The first step in managing diabetes is for patients to modify their lifestyle by adjusting and maintaining a proper diet and exercising regularly. A nutrition plan that involves monitoring carbohydrate intake by carbohydrate counting or exchanges is recommended. In addition, patients should consume a diet high in dietary fiber/whole grains, fruit and vegetables, and low in saturated fats. For physical activity, 150 minutes per week of moderate-intensity aerobic exercise and resistance exercise 3 times per week to target all muscle groups is recommended; however, patients who have not exercised in the past should receive clearance from their physician and start slow with their exercise routine.
If a patient’s diabetes is not controlled by diet and exercise, he/she may be started on medications; however, it is important to continue to follow an exercise and diet plan to maximize the effect of prescribed treatments. A variety of oral and injectable treatments for diabetes are available including: metformin, sulfonylureas (e.g., glyburide, glipizide), thiazolidinediones (e.g., pioglitazone), alpha-glucosidase inhibitors (e.g., acarbose), insulin secretagogues (e.g, repaglinide), dipeptidyl peptidase-4 (DPP-4) inhibitors (e.g., sitagliptin), and insulin. The healthcare provider will decide what the best medication or combination of medications is needed. He or she should discuss proper dosing, administration, and common adverse reactions with the patient. One serious reaction to be aware of is low blood glucose, known as hypoglycemia, which can occur with some prescribed therapies. Symptoms of hypoglycemia include sweating, shakiness, weakness, hunger, dizziness, heart palpitations, blurred vision, and confusion.
Depending on the treatment plan the healthcare provider initiates, patients will most likely be monitoring blood glucose levels at home. It is important to know how often blood glucose levels should be checked at home, the range of acceptable values, and the specific factors that may impact blood glucose levels. For example, blood glucose readings may change in response to food intake, physical activity, medication administration times, acute illnesses, alcohol intake, and stress.
Careful monitoring of blood glucose is necessary to prevent long-term complications. In addition, other monitoring such as routine physical examinations, eye and foot examinations, blood tests to assess long-term markers of glucose control, cholesterol levels, and kidney function, and dental care can help minimize complications.
Amanda Hodges, PharmD Candidate 2012
Additional information about diabetes can be accessed at:
