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FEATURE — Whereas attending pharmacy faculty, I developed a sudden and intense curiosity in diabetes when my spouse was recognized with Kind 1 diabetes, a analysis that modified our lives and was a catalyst for focusing my research.
Each Kind 1 and Kind 2 diabetes have the identical last end result: an elevated quantity of sugar within the blood. This enhance in sugar is dangerous to the physique. If left untreated, it may result in critical well being issues, corresponding to coronary heart illness, imaginative and prescient loss, and irreversible kidney illness.
Kind 1 diabetes is brought on by an autoimmune dysfunction that causes the physique’s immune system to mistakenly assault the cells within the pancreas that make insulin. That is the molecule that alerts to the cells within the physique that sugar is offered. Kind 1 diabetics can now not make their very own insulin.
Alternatively, Kind 2 diabetes happens when the cells within the physique change into proof against the messenger (insulin) telling them that sugar is offered within the blood. Which means that a Kind 2 diabetic can nonetheless produce insulin however typically has elevated ranges of insulin as a result of the cells within the physique simply aren’t listening. Due to this distinct distinction, Kind 2 diabetics have extra therapy choices.
When treating Kind 2 diabetes, the purpose is the next:
- Improve the quantity of insulin within the physique.
- Improve the sensitivity of the physique’s cells to insulin.
- Lower the quantity of sugar within the blood.
Whereas we’ve many new and thrilling drugs within the therapy of diabetes, one of many first drugs discovered to extend sensitivity to insulin was metformin.
Metformin was used as a medicine in France beginning in 1957, so we’ve 40 years of information on it. To today, Metformin continues to be thought of a primary line remedy. First line drugs are the primary line of therapy. Different drugs which have nice observe data are glipizide, which focuses on signaling the physique to create extra insulin. The downside with these drugs is that they sign the physique to make insulin whether or not it wants insulin or not.
Newer drugs enhance insulin however have a a lot decrease likelihood of inflicting low blood sugar or of serving to the physique eliminate sugar that’s already within the blood. New drugs that enhance insulin embrace injectable drugs corresponding to bydureon, victoza, and trulicity and oral remedy corresponding to januvia, onglyza, and tradjenta.
The opposite primary class of remedy prevents the reuptake of sugar from the kidneys. This permits the sugar to be excreted within the urine and due to this fact lowers the quantity of sugar within the blood. These drugs embrace farxiga, invokana, and jardiance, to call a couple of.
Whereas there are lots of new and thrilling drugs for the therapy of Kind 2 diabetes, the simplest therapy in combating the consequences of diabetes continues to be weight loss program and train. In reality, Type 2 diabetes is a kind of persistent illnesses that typically will be cured with weight loss program and train alone. Every pound that we will lose has a profound impact on our physique’s management of its sugar degree.
As a pharmacist, I at all times inform my sufferers that we must always use drugs after we’ve explored all different choices. One of the best half is that we don’t have to decide on between remedy or weight loss program and train. I truthfully can’t consider one diabetic remedy that interacts negatively with weight loss program and train.
Kind 1 diabetes differs from Kind 2 in that the physique can now not make any insulin. Which means that the one choice we’ve is to switch the insulin by injection. Kind 1 diabetics should rely each carbohydrate they eat in order that they will inject the correct quantity of insulin to be able to maintain their sugar degree regular. Many Kind 1 diabetics are not-so-patiently ready for his or her “synthetic pancreas.”
This can be a mixture of a steady glucose (sugar) monitor – often called CGM – and an insulin pump. When the sugar in a Kind 1’s physique goes up or down, the CGM alerts the insulin pump. The insulin pump then both will increase or decreases the quantity of insulin that’s being delivered to the affected person to be able to maintain their sugar degree inside regular ranges.
This expertise has the potential not solely to enhance the well being of those sufferers but additionally to drastically enhance their high quality of life.
Via advances in medication and expertise, each Kind 1 and Kind 2 diabetics are experiencing an improved high quality of life. Please don’t hesitate to contact your pharmacist about your diabetic well being issues, and keep in mind, your pharmacist is your most accessible medical skilled.
Written by BRETT PETERSON, PharmD., Stapley Pharmacy
Contributing creator: KELLI CHARLTON, Director of Schooling and Group Engagement.
This text was first revealed within the September/October 2019 situation of St. George Health and Wellness magazine.
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