Hi everyone.
My boss just found out her 16 year old daughter has type 1 diabetes. We were all very sad to hear the news. Apparently she will be taking medication everyday for the rest of her life and she has a strict diet to follow. What’s the difference between type 1 and type 2? Also, do people with diabetes have a tendency to be thin and lose a lot of weight because of their diet? Apparently before she was diagnosed, she lost 10 pounds within a month.
Thanks!
Whats The Difference Between Type 1 Diabetes And Type 2?
February 24th, 2010What Happens When You Get Diabetes Type 1?
February 12th, 2010Is 1 when you just can’t eat to much sugar, or is that 2.
How does diabetes 1 affect your life?
Do Genes Cause Diabetes 1 Or Do You Have To Be Exposed To A Certain Virus?
January 13th, 2010Some people tell me that getting the genes for diabetes 1 isn’t enough, and that you also have to be exposed to a certain virus.
The Truth About Diabetes
December 27th, 2009Like all complicated matters there are certain misunderstandings regarding Diabetes.
Today I want to dispel some myths regarding diabetes.
Here is a list of the questions that I will be discussing: Can get diabetes from someone else? Eating too much sugar causes diabetes Type 2 diabetes is mild diabetes People with diabetes eventually go blind It’s not safe to drive if you have diabetes People with diabetes can’t play sport People with diabetes are more likely to get colds and other illnesses People with diabetes can’t eat sweets or chocolate People with diabetes shouldn’t eat bananas or grapes People with diabetes should eat special diabetic foods
Now for some serious myth bashing. . .
Can get diabetes from someone else? Although we don’t know exactly why some people get diabetes, we know that diabetes is not contagious – You cannot get it from others. There is a chance that a person whose parents or brothers and sisters have diabetes might get diabetes, particularly Type 2 diabetes. But lifestyle factors also play a part.
Eating too much sugar causes diabetes Eating sugar does not cause diabetes. Diabetes is caused by a combination of inherited and lifestyle factors. However, eating a diet high in fat and sugar can cause you to become overweight. Being overweight increases your risk of developing Type 2 diabetes, so if you have a history of diabetes in your family, a healthy diet and regular exercise are recommended to control your weight.
Type 2 diabetes is mild diabetes There is no such thing as mild or borderline diabetes. All diabetes is equally serious, and if not properly controlled can lead to serious complications.
People with diabetes eventually go blind Although diabetes is the leading cause of blindness in people of working age, research has proved you can reduce your chances of developing diabetes complications – such as damage to your eyes – if you: • Control your blood pressure and glucose levels • Keep active • Maintain your ideal body weight • Give up smoking
It’s not safe to drive if you have diabetes Providing you are responsible and have good control of your diabetes, research shows that people with diabetes are no less safe on the roads than anyone else. Nevertheless, the myth that people with diabetes are not safe persists
People with diabetes can’t play sport Pakistan’s famous all-rounder Wasim Akram has diabetes; many other people with diabetes take part in active sports. People with diabetes are encouraged to exercise as part of a healthy lifestyle. Keeping active can help avoid complications associated with diabetes, such as heart disease. There may be some considerations to take into account with your diabetes before taking up a new exercise regime – talk to your doctor for more information.
People with diabetes are more likely to get colds and other illnesses No. You are no more likely to get a cold or another illness if you’ve got diabetes. However, people with diabetes are advised to get flu vaccinations. This is because any infection interferes with your blood glucose control, putting you at risk of high blood glucose levels and, for those with Type 1 diabetes, an increased risk of ketoacidosis.
People with diabetes can’t eat sweets or chocolate Sweets and chocolate can be eaten by people with diabetes just like the rest of us, if eaten as part of a healthy diet. Remember that confectionery foods tend to be higher in fat and calories too so for this reason they should be limited especially if you’re trying to lose weight.
People with diabetes shouldn’t eat bananas or grapes All fruit and vegetables are extremely good for you. Eating more can reduce the risk of coronary heart disease, some cancers and some gut problems. You should aim to eat at least five portions of fruit and vegetables a day. This also helps to improve the overall balance of the diet. Eating a variety of different fruit and vegetables ensure you get the maximum benefit.
People with diabetes should eat special diabetic foods Diabetic versions of foods offer no special benefit. They still raise blood glucose levels, contain just as much fat and calories, are usually more expensive and can also have a laxative effect. The healthy diet for people with diabetes is the same as that recommended for everyone – low in fat, salt and sugar, with meals including starchy foods like bread and pasta and plenty of fruit and vegetables.
Supplements Supporting Diabetes
December 21st, 2009Diabetes is a disease in which the body does not produce or properly use insulin. Diabetes mellitus, often referred to simply as diabetes is a syndrome of disordered metabolism, usually due to a combination of hereditary and environmental causes, resulting in abnormally high blood sugar levels (hyperglycemia). The disease and its treatments can cause many complications as it is often detected when a person suffers a problem that is frequently caused by diabetes, such as a heart attack, stroke, neuropathy, poor wound healing or a foot ulcer, certain eye problems, certain fungal infections, or delivering a baby with macrosomia or hypoglycemia. Diabetes mellitus, commonly referred to as diabetes was first identified as a disease associated with “sweet urine,” and excessive muscle loss in the ancient world. Diabetes mellitus is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime. Type 1 diabetes can affect children or adults but was traditionally termed “juvenile” diabetes because it represents a majority of the diabetes cases in children. This type appears to be triggered by some (mainly viral) infections, or less commonly, by stress or environmental exposure (such as exposure to certain chemicals or drugs). Type 1 diabetics have a genetic predisposition to the disease. Type 1 diabetes occurs equally among males and females but is more common in whites than in non-whites. Additionally, this type of diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States. Type 1 diabetes develops most often in children but can occur at any age. Type 1 diabetes may also cause a rapid yet significant weight loss (despite normal or even increased eating) and irreducible fatigue. Type 2 diabetes is far more common than type 1. Type 2 diabetes risk can be reduced in many cases by making changes in diet and increasing physical activity. However, Type 1 and Type 2 diabetes impede a person’s carefree life. Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanics/Latinos. Type 2 diabetes is becoming more common due to increasing obesity and failure to exercise. This type may go unnoticed for years because visible symptoms are typically mild, non-existent or sporadic, and usually there are no ketoacidotic episodes. Diabetes insipidus, a rare disorder, is not related to diabetes mellitus (sugar diabetes). Diabetes symptoms may include increased thirst and urination, blurred vision, and fatigue. This type also appears to affect the speed of our thought processes as well. Diabetes is a costly disease associated with severe morbidity and premature death that affects millions of Americans. Diabetes insipidus includes any of several types of polyuria in which the volume of urine exceeds 3 liters per day, causing dehydration and great thirst, as well as sometimes emaciation and great hunger. Diabetes affects approximately 17 million people (about 8% of the population) in the United States. It is the third leading cause of death in the United States after heart disease and cancer. It is further the primary reason for adult blindness, end-stage renal disease (ESRD), gangrene and amputations. Diabetes is a condition characterized by the inability of the pancreas to produce sufficient levels of insulin to prevent hyperglycemia. Diabetes is a disease in which your blood glucose, or sugar levels are too high. Diabetes can also create the need to remove a limb. Diabetes can be caused by too little insulin, resistance to insulin, or both. The disease can damage blood vessels and nerves and decrease the body’s ability to fight infection. It is the most common condition leading to amputations. Although this disease cannot be cured, it often can be managed with proper medical care, diet, and regular exercise. Diabetes was the sixth leading cause of death in the US. It is a serious disease, but it is controllable. The good news is that diabetes prevention is proven, possible, and powerful. Treatment need not significantly impair normal activities if sufficient patient training, awareness, appropriate care, discipline in testing and dosing of insulin is taken. Treatment for the disease also includes checking blood sugar levels to make sure that the disease is under control. Treatment usually includes eating healthy foods and spreading carbohydrates throughout the day, exercising regularly, checking your blood sugar levels often, and possibly taking medicine. And most of all this disease shouldn’t take all the fun out of shopping, cooking and dining. Diabetes treatment plans consist of a healthy diet, exercise, medications and sleep. Diabetes supplements can help you fight the effects of diabetes and help you to keep your blood sugar levels stabilized. Many people find natural diabetic supplements a valuable aid in improving their control of Type 2 Diabetes.
Type Of Diabetes
December 17th, 2009Different Type of Diabetes
There are many types of diabetes, but the three most common are:
1. Type 1
2. Type 2
3. Gestational
These three types of Diabetes are same with some differences, everyone with diabetes has one thing in common and that is little or no ability to move glucose out of the blood into the cells, where it is converted into body’s primary fuel. We all have glucose in our blood, whether or not we have diabetes. Main source for glucose is food which we eat. When we eat, the digestive system breaks down food into glucose, which is absorbed into the blood in the small intestine. People who don’t suffer from diabetes depend on insulin, a hormone made in the pancreas, to move glucose from the blood into the body’s billions of cells. But people who suffer from diabetes either don’t produce insulin or can’t efficiently use the insulin produced in their body. Without insulin, glucose can’t move into blood cells. Scientists don’t know the exact reason behind cause’s diabetes, but it seems to be a result from a combination of genetics and environmental factors, including viral infections, poor diet, and sedentary lifestyle. Till now, diabetes has no solution, but the good news is that the disease can be managed and treated. People with diabetes can live fulfilling, healthy lives.
Type 1
Diabetics with type 1 diabetes, also known as insulin-dependent diabetes mellitus or IDDM don’t produce insulin and require regular supply of insulin to keep their blood glucose levels normal. Type 1 diabetes was known as juvenile-onset diabetes, but that name has been changed because type 1 diabetes also strikes young and older adults alike.
Risk factors
What causes it?
Most of the children, whose parents are diabetics, do not suffer from this disease, but scientists still believe that heredity plays a big role in Type 1 diabetes because it tends to run in families. Researchers have researched on several genes that appear to increase risk of type 1 diabetes. But they haven’t got a single gene that causes diabetes. Type 1 diabetes has many hallmarks of an auto-immune condition. In auto-immune diseases, the immune system, this protects from disease by killing invading germs. In the case of type 1 diabetes, the immune system kills the cells in the pancreas that produces insulin. Type 1 diabetes often occurs shortly after a viral infection, and doctors sometimes notice a sharp jump in type 1 diabetes diagnoses after viral epidemics.
Type 2
Approximately 95 % of diabetics suffer with type 2 diabetes which is also known as non-insulin-dependent diabetes mellitus or NIDDM. Type 2 Diabetics produces insulin, but the cells in their bodies are “insulin resistant” they can’t respond properly to the hormone, so glucose is accumulated in their blood. Some people with type 2 diabetes inject insulin, but mostly can control the disease through a combination of weight loss, exercise, a prescription oral diabetes medication, and tight control. Risk factors
What causes it?
Scientists are not sure, but type 2 diabetes, like type 1 diabetes, flows from families to families, which shows some genetic connection. In fact, a genetic link in Type2 diabetes seems even stronger in comparison with type 1. Scientists have not yet found a single gene that causes the disease, but they are still in search for errors in several that may contribute to the disease. Researchers also have a doubt on genetic susceptibility to obesity.
Obesity is the only single most important cause of type 2 diabetes. There are different definitions for obesity, but in general, Obesity occurs if a person’s weight is at least 20 percent more than what’s recommended according to their height and build. 75% of people with type 2 diabetes have problem of being overweight. That’s why type 2 diabetes is usually linked with diet and exercise.
Less weight and good muscles helps the body use insulin more effectively. This is very important to know how much weight we should carry. People whose weight is above their hips have a greater risk of developing type 2 diabetes than those who carry it on their hips.
Age also plays an important role in type 2 diabetes. Most of the newly diagnosed are of age 55 and above, and around 11 percent of Americans ages 65 to 74 suffers from type 2 diabetes. However, it is not sure if age is a cause of type 2 diabetes or it is simply a reflection of the fact that people tend to gain weight and become less physically active as they grow older.
Gestational
Gestational diabetes affects only to pregnant ladies without any previous history of diabetes. Nearly 137,000 U. S. females develop gestational diabetes each year. Typically, gestational diabetes is cleared up on its own after female’s delivery. But research shows that about 40% of females with gestational diabetes face type 2 diabetes within 15 years. All pregnant ladies should be tested for gestational diabetes between their 24th and 28th weeks of pregnancy. Gestational diabetes and insulin resistance can be prevented by keeping a healthy weight, having healthy food and with the help of regular exercise. Risk factors
What causes it? Hormones may play an important role. Pregnant ladies produce various hormones important for their baby’s growth. However, these hormones may interfere with the mother’s body’s ability to properly use insulin, causing insulin resistance. Every pregnant lady has some degree of insulin resistance. But if this resistance becomes full-blown gestational diabetes, it usually appears around the 24th week of pregnancy. That’s why all pregnant ladies should be screened for gestational diabetes at that time.
Diabetes a Health Hazard
December 14th, 2009DIABETES
Definition as stated by Dr Miriam Stoppard
Types of diabetes
1- Type 1
2- Type 2
Causes
1- Lifestyle
2- Disorders
3- Gestational diabetes
DIABETES MELLITUS
Long term complication
1-Heart problem
2-Eye
Treatment
1-Insulin Prevention
2- Good lifestyle 1-healthy diet
3- Monitoring blood glucose 2-blood pressure measurement
3- healthy lifestyle
Symptoms
1-excessive urination
2- weakness
3- weight loss
Notes from readings
- pancreas either produces insufficient amounts of insulin or body cells become resistant to the hormone’s effects.
- Type 1 diabetes and type 2 diabetes.
- Although dietary measures are also important, it must be treated with insulin injections. About 60,000 people in the UK have this type of diabetes.
- The pancreas continues to secrete insulin but cells in the body become resistant to its effects.
- Diabetes mainly affects people over the age of 40 and is more common in overweight people.
- Condition may be treated with dietary measures only.
- Diabetes mellitus can sometimes develop during pregnancy. This is called gestational diabetes and is usually treated with insulin to maintain the health of the mother and baby.
- Type 1 diabetes is usually caused by an abnormal reaction in which the immune system destroys insulin-secreting cells in the pancreas.
- Type 2 diabetes are less well understood, but the genetics and obesity are important factors.
- The symptoms of type 2 may not be obvious or may go unnoticed until a routine medical check-up. The main symptoms of both forms may include:
- Excessive urination
- Thirst and a dry mouth
- Insufficient sleep because of the need to urinate at night.
- Lack of energy
- Blurry vision
- Weight loss
Symptoms of type 2 may go unnoticed until routine medical check up.
The main symptoms of both forms may include:
- excessive urination
- thirst and a dry mouth
- insufficient sleep because of the need to urinate at night.
- Lack of energy
- Blurry vision
- Weight loss
The main symptoms of ketoacidosis include:
- nausea and vomiting, sometimes with abdominal pain.
- Deep breathing.
- Acetone smell to the breath (like pear drops or nail polish remover)
- Confusion.
Living with diabetes:
- A healthy diet
- Drinking and smoking
- Special care for your feet.
- Exercise and sports.
- Strenuous exercise
- Moderate exercise
- Medical check up
- Eye examination
- Blood pressure measurement.
Treatment for:
Type 1
Insulin can be injected into any fatty area, such as upper arm.
Source: Dr Miriam Stoppard , Doling Kindersley Ltd 2002 ‘Family Health Guide’, pages 504 to 507.
“Department of Diabetes, University of Newcastle upon Tyne, UK.
Address correspondence and reprint requests to:
P Home. Department of Diabetes, The Medical School, University of Newcastle
upon Tyne, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
philip. home@newcastle. ac. uk
Received: ; revised: December 10, 2002
Diabetes Metab 2003,29,101-9 • © 2003 Masson, all rights reserved 101”
- Diabetes is a growing healthcare challenge worldwide.
-A considerable proportion
of people either have impaired glucose tolerance with a significant
risk of development of diabetes, or have undiagnosed Type 2
diabetes.
-Pivotal to reducing the risk of morbidity and the development
of complications and mortality is the normalisation of both fasting
and postprandial blood glucose levels.
-diabetes is reaching epidemic proportions
worldwide, with between 5 and 10% of the world population
affected.
- People with diabetes have approximately twice
the prevalence of hypertension compared with non-diabetic
patients
-40% of subjects were defined as hypertensive on entry
(receiving antihypertensive treatment or with a mean systolic
blood pressure ? 160 mmHg and/or a mean diastolic blood
pressure ? 90 mmHg)
-People with diabetes are 17 times more prone to kidney disease,
with diabetic nephropathy being the most common
complication [11]. Diabetic nephropathy may eventually
lead to end-stage renal disease and thus significant mortality.
-Approximately 30-40% of people with diabetes develop
retinopathy, and diabetes is the most common cause of blindness
in the working years of life in developed countries
-According to a 1997 estimate [12], 120 million people
have Type 2 diabetes (approximately 2% of the world population)
and an additional 4 million have Type 1 diabetes.
Type 2 diabetes accounts for more than 85% of all cases of
diabetes in developed countries and almost all cases in developing
countries. It appears to be epidemic (affecting a high
and increasing proportion of the population) in many parts
of the world, and represents a serious and growing global
health challenge primarily as a result of increased obesity,
ageing populations, increasing urbanisation and a more sedentary
lifestyle [34, 35]. However, data from many parts of
the world with high and increasing prevalence (Asia, Latin
America, China) are not broadly based, and so this estimate
is likely to be markedly low.
-Type 1 diabetes
is one of the most common childhood diseases in developed
European countries and the incidence has increased dramatically
in some newly prosperous countries
-The incidence of Type 2 diabetes in particular is expected
to increase considerably as developing countries become
more Westernised in terms of availability of healthcare and
modernisation of existing resources, as well as a result of
substantial improvements in diabetes surveillance and
screening. Growth is projected to be greatest in Asia and
Africa, where diabetes could become 2-3 times more common
than it is today [12]. By 2025, more than 75% of people
with diabetes will be from developing countries, compared
with 62% in 1995
-Type 2 diabetes suggests a need for continuing
attention to control of blood glucose, blood pressure
and blood lipids through medication, diet and exercise.
People with Type 1 diabetes, and increasingly those with
Type 2 diabetes, have the additional burden of subcutaneous
insulin injections, self-monitoring and care of their insulin
supplies and equipment.
Direct Quote
Dr Miriam’s definition of diabetes is:
“the inability of the body to use glucose for energy due to inadequate amounts of or loss of sensitivity to, the hormone insulin. ”
Dr Miriam Stoppard. 2002, Family Health Guide, Dorling Kindersley Ltd, England, Page 504
Paraphrase
The body uses glucose as energy in order to perform work and if it fails because of insufficient amount of insulin (which is essential for the absorption of glucose) or because the body cells become more resistant to the hormone’s effect then we end up with the non-healthy state called diabetes.
Summary
Dr Stoppard states that “Glucose from the blood stream is the main source of energy for the body’s cells. Its absorption is enabled by the pancreas, which produces insulin. Among people suffering from diabetes mellitus, a build up of toxic by- products, like acetone with a pear drop smell, in the body occurs. This is caused by the use of other sources of energy than glucose. Hence the unused glucose accumulates in the blood and urine, causing high blood sugar levels. 1 in 10 diabetes depends on self administered injections of insulin and the rest take oral drug and are careful about their diet. These treatments are vital in preventing the symptoms of high blood sugar level like frequent passing of urine, thirst and loss of weight as well as complications leading to peripheral nerve disorders which may affect the eyes, kidneys, the cardiovascular system. The weakening of the immune system may also cause infections like cystitis. ”
Dr Miriam Stoppard. 2002, Family Health Guide, Dorling Kindersley Ltd, England, Page 504
Plan
1- Introduction
a- Definition
b- Types of diabetes
c- Brief description of each diabetes
2- Causes
a- Causes of Type 1 diabetes more frequent in children
b- Causes of Type 2 diabetes more frequent in adults
3- Symptoms
a- Both short term and long term consequences in case of non treatment for both Type 1 and Type 2 diabetes.
4- Treatment
a- The use of insulin to control diabetes in both Type 1 and Type 2
5- Short Term and Long Term complications.
a- Short term and long term effect in Type 1 diabetes
b- Short term and long term effect in Type 2 diabetes
6- Conclusion
a-healthy diet
b- healthy lifestyle
7- Bibliography
Introduction
Diabetes mellitus is developing in epidemic proportions in today’s world with 5 to 10% of the worldwide population affected. This disease is defined by Dr Stoppard, “as the inability of the body to use glucose for energy due to inadequate amounts of or loss of sensitivity to, the hormone insulin”. Which means that the body uses glucose in order to perform work and if it fails because of insufficient amount of insulin or because the body cells become more resistant to the hormone’s effect then we end up with the non-healthy state called diabetes.
There are two types of diabetes:
1- Type 1 which is caused by the abnormal reaction in which the immune system destroys insulin secreting cells in the pancreas. It is more common in childhood.
2- Type 2 which causes are less understood. However, genetics and overweight are important factors.
Causes
Diabetes of Type 1 is usually caused by some viral diseases which affect the immune system of the child, though the genetic factor of one parent suffering from type 1 diabetes may have some effect, however most children who develop type 1 diabetes do not have parents with diabetes. As for Type 2 diabetes it is the increase in food intake which leads to overweight and obesity as well as the living of a sedentary lifestyle and it mostly affects adults.
Symptoms
Both types of diabetes have the same symptoms where there is excessive urination which account for the thirst and dry mouth but also for the insufficient sleep at night because of the need to go to the toilet. This state is paralleled by the lack of energy; blur vision and quick weight loss, abdominal pain, deep breathing and acetone smell breath may also consist of symptoms of diabetes.
Treatment
While the Type 1 diabetes have to submit themselves to the burden of insulin injection, self monitoring and the care of their insulin supplies and equipments, though the Type 2 diabetes have the need to control their blood glucose, their blood pressure and their blood lipids these may be done through medication, diet and exercise but sometimes in addition the Type 2 diabetes have to make insulin injections as the Type 1’s diabetes with all the inconvenience attached to it. As for treatment by insulin Dr Stoppard states that “Glucose from the blood stream is the main source of energy for the body’s cells. Its absorption is enabled by the pancreas, which produces insulin. Among people suffering from diabetes mellitus, a build up of toxic by-products, like acetone with a pear drop smell, in the body occurs. This is caused by the use of other sources of energy than glucose. Hence the unused glucose accumulates in the blood and urine, causing high blood sugar levels. 1 in 10 diabetes depends on self administered injections of insulin and the rest take oral drug and are careful about their diet. These treatments are vital in preventing the symptoms of high blood sugar level like frequent passing of urine, thirst and loss of weight as well as complications leading to peripheral nerve disorders which may affect the eyes, kidneys, the cardiovascular system. The weakening of the immune system may also cause infections like cystitis. ”
Hence, no complete cure of diabetes exist, for it is a chronic disease but it can be controlled so as not to cause more severe damage to the body which is affected by it. For that a healthy diet with special attention to avoid excessive drinking of alcoholic beverages and smoking. Special care should also be taken with the feet and the eyes. Medical check up as well as blood pressure measurement should be regular. While sports should be practiced excessive strenuous exercise should be avoided.
Short Term and Long Term effect
If left unattended the diabetes mellitus may give rise to both short-term and long term complications. In case of Type 1 neglect of treatment may lead to nausea and vomiting accompanied by abdominal pain and deep breathing, while an acetone smell breath is noted. If left untreated the subject quickly enter in a confusion state where dehydration may lead to coma and death. As for the Type 2 diabetes if left untreated as is often the cause long term diseases like cardiovascular diseases occurs which may end up in a stroke. These are consequences of high blood pressure and elevated cholesterol in the blood. There is an increase risk of cataracts in the eyes and symptoms of dizziness upon standing and poor circulation because of nerve damage may lead to ulcers and gangrene.
Conclusion
In conclusion it can be said that the Diabetes mellitus is a disease that compel the one suffering from it to adopt a healthier lifestyle so as to control the devastation that the disease may cause to the body and to avoid the shortening of one’s life.
(810 words)
BIBLIOGRAPHY
1- http://www. e2med. com/dm
“Department of Diabetes, University of Newcastle upon Tyne, UK.
Address correspondence and reprint requests to:
P Home. Department of Diabetes, The Medical School, University of Newcastle
upon Tyne, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK.
philip. home@newcastle. ac. uk
Received: ; revised: December 10, 2002
Diabetes Metab 2003,29,101-9 • © 2003 Masson, all rights reserved 101”
2- Dr Miriam Stoppard, 2002, Family Health Guide, Doling Kindersley Ltd, England
To Compare the Role of Glibenclamide and Pioglitazone Drugs in Type 11 Non- Insulin Dependent Diabetes Mellitus Patients
December 9th, 2009To compare the role of glibenclamide and pioglitazone drugs in type 11 non- insulin dependent diabetes mellitus patients. Authors:Raj kumar chohan,Mashori Ghulam Rasool,Bhurgri Ghulam Rasool,Shamim-u-Rehman,DahriGhulam mustafa,Anis-u-rehman. Introduction:-
To compare the role of glibenclamide and pioglitazone drugs in type 11 non- insulin dependent diabetes mellitus patients.
Authors:Raj kumar chohan,Mashori Ghulam Rasool,Bhurgri Ghulam Rasool,Shamim-u-Rehman,DahriGhulam mustafa,Anis-u-rehman.
Introduction:-
Diabetes comes from the greek word for ‘SIPHON” which one is the first term and implies for a lot of urine is made . The trm “mellitus” comes from a laton word, “met” which means “honey” and was used because the urine was sweet (Wheeler,2004)
Diabetic ketaocidosis is one of life threatening condition requiring some data hospitalization and treatment. Recognition of this condition is of almost importance, because even small delays can have an impact on survival (Nattrass, 2006). Hypoglycaemia are involved in insulin induced episodes in individuals with diabetes. Probably the major factor prescribing, insulin treated patient from achieving the glucose targets needed to prevent diabetic complications. The incidence of hypoglycaemia reflects the inadequancy of current mathods of insulin delievery which lead ot inappropriately high insulin concentration, particularly some persons after eating more foods at night onset of blindness and also a major risk factor heart disease and stroke
(Heller, 2003).
TYPES OF DIABETE MELLITUSTYPE 1 DIABETES MELLITUS (IDDM): Type I diabetes affect children of all ages, both sexes and all athenic groups. type 1 diabetes usually occurs by mechanisms. It is most common metabolic condition in children and adolescents (Bui, 2004). Type1diabetes is characterized by immune mediated destruction of pancreatic b -cells resulting in insulin deficiency. This results in a common biochemical end point of hyperglycaemia and risk of ketoacidosis, but the clinical presentaion varies, widely depending on the rate and degree of b -cells failure (Lambert & Bingley. 2005). Type II diabetes mellitus (NIDDM):
TYPES OF DIABETE MELLITUS
TYPE 1 DIABETES MELLITUS (IDDM):
Type II diabetes mellitus (NIDDM):
Type II diabetes is a complex metabolic disorder associated with, b -cells dysfunction and with varying degree of insulin resistance primary pathogenic factors leading insulin resistance leading to type 2 diabetes and decreased insulin, secretion which arise from abnormalities with in liver, skeletal muscle and pancreatic b -cells (charles & clark, 1996).
GESTATIONAL DIABETUS MELLITUS : Women who develop glucose intolerance in late pregnancy and womens who with previously undiagnosed diabetes.
GESTATIONAL DIABETUS MELLITUS
Women who develop glucose intolerance in late pregnancy and womens who with previously undiagnosed diabetes.
SECONDARY DIABETUS MELLITUS:
SECONDARY DIABETUS MELLITUS:
Secondary diabetes is due to disease of the pancreatic and endocrime system, genetic disorders, or exposure to chemical agents.
Type – I diabetes formerly known as insluin dependent diabetes mellitus (IDDM), is characterized by the destruction of the pancreatic beta cells that produces inslulin
Type – I diabetes formerly known as insulin dependent diabetes(IDDM),is characterized by the destruction of pancreatic beta cells that produces insulin. Type-1 diabetes occures most often in children and young adults but it can occures at any age. (Anderson et al 2007).
Type-11 diabetes is not straight uprward. A pancreas that does not produce enough insulin. Liver that release too much glucose,muscle cells that do not readily take in glucose. (Carren 2008)
Many genetic factors are involved in the development of diabetes. Because of new genetic methodology researchers are closers to identifying all of the cadidate gene for both non –insulin dependent and insulin dependent diabetes(Bernhard,1995).
Woman who had gestation diabetes are more likely to develop Type-11diabetes themselves. Pergnant women with diabetes are another disadvantaged group. They need much more intensive antenatal care and close monitoring of blood sugar,blood pressure and weight. (jawed2006)
Over weight children the progression of child obesity into adulthood is associated with early develop of complications, including IgpG2 diabetes and cardiovascular disease. Type diabetes is the most common clinical form of diabetes accountingforabout 90% of all cases,it is currently undergoing world wide epidemic. Type 11diabetes mellitus is caused by body’s infective use of insulin, it is often results from excess body weight and physical inactivity(WHO 2007).
PREVALACES& IINCIDENCE :
PREVALACES& IINCIDENCE
Diabetes mellitus increases with aging, in 200 the prevalance of diabetes,it was estimated to be 0. 19% people20 years old. There is considered geographic variation in the incidence of both type-1 and type-11 diabetes mellitus. Scavandinvian has the highest incidence of type-1 diabetes mellitus e. g in Finland, the incidence is 35/100,000 per year the pacific rim has a much lower rate in japan and china the incidence is 1 to 3/100,00 per year of type-1 diabetes mellitus, Northern Europe and the United States share an intermediate rate (8to17/100,000 per year). The prevalence of type 11 diabeties mellitus is highest in certain pacific island, intermediate in countries such as India and the United States, and relatively low in Russia and China. This variability is likely due to genetic, beharioral and enviromental factors(Power 2005). Diabettes mellitus prevalance also arises among different ethic population within a given countries it is common inall ethnic groups its prevalance increased with age and more than 5% of individuals of more than 65 years of age have diabetes mellitus (David Owerback 1988). The World wide prevalence of diabetes mellitus has risen dramatically over past two decades. The prevalence of type11 diabettes mellitus is expected, type 11 diabetes mellitus is more prevalent among Hispanies Native Americas,African,American,and Asians, pacific Islanders than in non- Hispanic whites,the incidence is essentially equal in woman and men in all populations. Type 11 diabetes is becoming increasingly common because people are living longer,and the prevalence of diabetes increases with age it is also seen more frequently now than before in young people, in association with the rising prevalenceof childhood obesity although type11 diabetes still countries with the estimated nubers of cases of diabetes in 2000and 2030.
Rank Country
2000 Individuals country with diabetes (milloins)
Country
2030 Individuals with diabtes (Million)
India
31. 7
India
79. 47
China
20. 8
China
42. 3
USA
17. 7
USA
30. 3
Indonesia
8. 4
Indonesia
21. 3
Japan
6. 8
Pakistan
13. 9
Pakistan
5. 2
Brazil
11. 3
Russian federation
4. 6
Bangladesh
11. 1
Brazil
4. 6
Japan
8. 9
Italy
4. 3
Philippines
7. 8
Bangladesh
3. 2
Egypt
6. 7
(Wareham& FOROUHI 2OO6)
DRUG TREATMENT OF DIABETIES MELLITUS :
DRUG TREATMENT OF DIABETIES MELLITUS
Biguanides lower blood glucose, they increase glucose uptake and utilize in skeletal muscle there by reducing insulin resistance, and reduce hepatic glucose production (gluconeogenesis). Lower blood glucose, addionally reduces low denisity and very low denisity lipoproteins (LDL and VLDL) respectively. Metformin has a half life of about 3 hours and is excreted unchanged in the urine. Clinically metformin used in type 2 diabetic who are obese and who fail treatment with diet alone. Adverse effects are produced dose related gastrointestinal disturbances e. g anorexia,diarrhoea,nausea,lactic acidosis rare but potentially fatal toxic effect. (Dale,2003).
Improving insulin sensitivity by activating certain genes involved in fat synthesis and carbohydrate metabolism Rosigilitazone and Piogiltazone are currently approved. Thiazolidinediones. Thiazolidinediones do not cause hypoglycemia when used alone,although they are usually taken in combination with sulfonylurease.
In some incouraging studies, thaiazolidiniones have produced very favorable effects on the heart, including reducing blood pressure and improving triglycerides and cholestrol levels including increasing HDL level,the good cholestrol. They may also block a molecule called 11 Best HSK that may play a significant role in metabolic syndrome,as well as diabetes type11. One study also sugessted that Rosiglitazone may even improve beta cells functions and so help prevent progression of diabetes. Anemia, weight gain, increased risk of fluid buildup, may worson heart failure. Troglitazone,was withdrawn after a few reports of heart failure. Liver failure abd death. Current Thiazoldinediones don not appear to pose the same effects on the liver although there have been a few reports of liver injury.
In patients with dietry failur the choice of a sulfonylurea agent or insulin therapy has been controversial and empric in favour of insulin therapy are the studies, who reported marked improvement post receptor diagnostic after intensive short term therapy in untreated type 2 diabetes mellitus (Scarlett et al,1984) Sulfonylureas further classified into two groups or generations based on their potency,duration,drug interaction,side effects profiles. Sulfonylureas enhance insulin action in cells in culture and stimulate the synthesis of glucose transporters (Jacobes et al 1998). A sulfonylurea drug should normally be the insulin secretagogue of choice, NICE (National Institute for Clinical Excellence) also recommends that a generic ,drug should be perscribed (Scsade et al1998).
RESEARCH DESIGN AND MATERIAL AND METHODS:
RESEARCH DESIGN AND MATERIAL AND METHODS:
This study was conducted in the deprtment of Pharmacololgy and Therapeutics,Basic Medical Science Institute,Jinnah,Postgraduate Medical Centre,karachi under kind supervision od DRr:GhulamRsool Mashori,Associate Professoer and Head OF Department Of Pharmacology and Therapeutics in colloboration with Medical Outpatient Department Unit111 and Filter Clinic, Medical Department, JPMC,Karachi.
Seventy NIDDM (type-II)diabetic patients were initially enrolled in the study from the filter clinic/ out patient department Medical Unit III ,and diabetic clinic. Out of this 60 diabetic patients were associated in whole period of study, remaining 10 patients were dropped due to poor comlpiance or change in residential place. All the patients were divided in two main groups,groupI and in group II these patients were selected in this study according of inclusion and exclusion criteria.
INCLUSION CRITERIA :
INCLUSION CRITERIA
EXCLUSION CRIRERIA :
EXCLUSION CRIRERIA
MATERIAL:
MATERIAL:
DRUGS
DRUGS
Tab:Daonil 5 mg (Aventis Pharma)
Drug category:Sulphonylurea.
Generic Name: Glibenclamide.
MFGLIC:No. 000007 RegistrationNO. 000220
MFG Date:0-06
EXP Date:7-10
Lot NO:B230
Tab:piozer (Hilton Pharm) PvtLTd.
Tab:Poizer 15mg
Drug category:Thaiazolinedione.
Generic Name:Pioglitazone Hydrochloride.
MFG LIC: O. 000136 Registration No. 03270
MFG Date:3-06
EXP Date:3-o9
Lot No:6287
Tab: Poizer (Hilton Pharma)pvt ltd.
PARAMETERS:
Fasting Blood Sugar (FBS).
Random Blood Sugar (RBS).
Weight.
Key words:Diabetes mellitus,Non-insulin diabetes mellitus,Insulin depedent diabetes mellitus, Daonil,poizer,Insulin.
RESULTS:
RESULTS:
Table 1
Table 1
Weight and Blood Sugar level observed on baseline day 0
In group1 and group11
Group 1
Group 11
Pioglitazone n=27
Glibenclamide n=33
Weight
63. 37
+ 2. 25
¯
62. 7
+ 15. 56
¯
Fasting Blood Sugar
172. 7
+ 13. 32
¯
188. 42
+ 12. o5
¯
Random Blood Sugar
285. 11
+ 15 . 532
¯
284. 18
+ 17. 07
¯
All Values are expressed in Means± SEM.
FIGURE-1 weight and blood sugar levels observed on baseline (day-o)
In table No shpwing the weight (KG’S) and blood sugar (msg/dl0 levels which is observed on baseline (day-0) in both groups 9group: 1 & group11)
Group: 1 Weight in (Kg’s) mean + SEM) IS 63. 37±2. 25 Fasting blood sugar 172. 7±13. 32,and Random
blood sugar 285. 11±15. 32
Group:11 Weight (KG’s0 (mean +SEM)62. 7±1. 56 Fasting blood sugar (mg/dl0 188. 42±12. 05, Random blood sugar is 284. 18±17. 03.
Group:11
Figure 2: showing the weight and blood sugar levels observed in base line (day-0) in group: 1 and group 11 weight in 9kg’s) its mean values are 63. 37,62. 7, Fasting blood sugar in (mg/dl) is 172. 71, 188. 42 Random blood sugar (mg/dl) is 285. 11 &284. 18.
TABLE: 2
Peroidic Observation In All Parameters Group1
Goup1(Pioglitazon) n=27
P-value
Day-0
Day-45
Day-90
Day-0to45
Day-45-90
Weight
63. 37
±2. 25
63. 63
±2. 26
63. 63
±2. 23
>0. 05
(NS)
>0. 05
(NS)
Fasting blood sugar
172. 7
±13. 32
165. 04
±8. 98
153. 37
±7. 59
>0. 05
(NS)
0. 05
(NS)
Randomblood sugar
285. 11
±15. 32
279. 78
±13. 63
255. 56
±12. 65
>0. 05
(NS)
>0. 05
(NS)
All values are expressed in Mean±SEM . (NS) Non significant.
TABLE NO:2
TABLE NO:2
Showing the periodic observations in all parameters in group 1 (piogiltazone) (n+27) weight P. value (day 0 to day 45)>0. 05 (NS). Fasting blood sugar >0. 05 (NS) Random blood sugar >0. 05 (NS) P. values day 90 weight >0. 05 (N. S), FBS>0. 05 (N. S) 7RBS >0. 05(N. S) NON SIGNIFICANT
FIGURE:2 Showing the periodic observation in all parameters in group 1 on day0 day 45& day-90. Mean values in weight (Kg) is 63. 37,63. 26,63. 63, fbs (mg/dl) 172. 7,165. 04,153. 37,RBS(mg/dl) 285. 11,279. 78,255. 56.
TABLE NO3
Peroidic Observation in All Parameters Group11
Group 11 (Glibenclamide)
N=33
P-value
Day-0
Day-45
Day-90
Day-0 to 45
Day-45 to 90
Weight
62. 7
±1. 56
65. 64
±2. 10
64. 55
±1. 92
>0. 05(NS)
0. 05(NS0
Fasting blood sugar
188. 42
±12. 05
168. 45
±10. 99
140. 06
±5. 68
>0. 05(NS)
>0. 05(S)
Random blood sugar
284. 18
±17. 03
220. 12
±13. 39
170. 94
±5. 80
0. 002(MS0
(s) significant, (MS) moderate significant
All values are expressed in Mean±SEM.
Table No3:
Table No3:
Showing the periodic observation in all parameter in goup:11, Group:11 containing drug (Glibenclamide),no of patients (n=33). It’s P-value on day 0 to day 45 on weight >0. 05(NS),FBS>0. 05(N. S) RBS
Figure 3:Shwing the periodic observations in all parameters in Group 11 weight 62. 7,65. 64,64. 55,FBS (MG/DL) 188. 42,168. 45 140. 06,RBS(mg/dl) 284. 18 220. 12, 170. 94 (on day-0-day 45 to 90).
DISCUSSION:
DISCUSSION:
In Denmark Beck-Nielsenet al,skillman TG (1981) published studies demonstation that glyburide increased he number of receptors on the monocytes of patients with type 11 diabetes mellitus. Some patients were treated with diet and in cobination of second generation sulfonyureas agents Wie. The numbers of insulin receptors all patients were measured before and after the treatment. Intrvenous glucose test shows the persistent impairent of insulin secretion afterthe starting of drug therapy. However those patient who were on drug Pioglitazone some results were obtained of insulin secretion in the impairment in early drug drug therapy. Clinical observations have suggested that the second generation sulfonylureas may exert their effects by potentiating insulin released by other primary stimulators Insulin secreting drug.
According to the study of WilliamC Dukworth et al(1972), aftr the chronic treatment with sulfonylureas it is well documented that plasma insulin levels were decreased in response to oral glucose load. This apparently occures even though glucose tolerance is improved over pre-treatment, levels,present study clearly support that study.
The result og group 11 correlates with the research conducted by Bonnie &Kimmel (2005) produces the same results as FBS reduces from baseline, and at the end of study,with an overall 23. 44%,reduction,while with the results showed at the end of study peroid p-value were (p
Similarly Michael Alvarsson et al (2003) conducted a similar type of study and the found and overall changes of change of 22. 11% in Fbs and 40. 88% in Rbs at the end of trial p-value were (p
However a study conducted by (Stone &Brown in (2003) didnot match to our results in the parameter of FBS and observer a reduction of 26. 22%.
CONCLUSION:
CONCLUSION:
In the light of study discussion it is obiovus the glibenclamide was more effective,tolerable and safer than pioglitzone in a short duration. Diabetes Mellitus is chronic prolong disease for whole life. Poor community can afford it easily,on base of marketing of this drug in pakistan diabetes patients easily go and purchase economically,in fact ,mostly people buy it from pharmacy without dr’s perscription,because pharmacist and patient both of know about this disease. Just like dispirin as analgesic,it is famous anti-diabetic drug in our states as compared of other anti-diabetic drugs.
REFERNCES:
REFERNCES: