Honey, you’re too sweet!

1. Diabetes mellitus is a group of metabolic disorders that cause high blood glucose levels. It happens when the body does not produce adequate insulin or cannot effectively utilize insulin.

2. Insulin is a hormone produced by beta-cells of the pancreas to reduce blood glucose levels.

3. Untreated high blood glucose will damage nerves, eyes, kidneys, and other organs.

Types of diabetes mellitus

  • Type 1 diabetes is an autoimmune disease in which the immune system damage beta cells of the pancreas that secrete insulin causing insulin cannot be produced.
  • Type 2 diabetes happens when body cells become resistant to insulin and sugar cannot get into body cells causing sugar build-up in the blood.
  • Prediabetes occurs when blood glucose is higher than normal but not it is not high enough to be diagnosed as diabetes mellitus.
  • Gestational diabetes mellitus (GDM) is high blood sugar during pregnancy. Insulin-blocking hormones produced by the placenta cause this type of diabetes.

Symptoms

Male Female Type 1 Type 2 GDM
General Symptoms

  • Increased hunger
  • Increased thirst
  • Weight loss
  • Frequent urination
  • Blurry vision
  • Extreme fatigue
  • Sores that don’t heal
  • Decreased sex drive
  • Erectile dysfunction
  • Poor muscle strength
  • Urinary tract infections
  • Yeast infections
  • Dry, itchy skin.
  • Extreme hunger
  • Increased thirst
  • Unintentional weight loss
  • Frequent urination
  • Blurry vision
  • Tiredness
  • Mood change
  • Increased hunger
  • Increased thirst
  • Increased urination
  • Blurry vision
  • Tiredness
  • Sores that are slow to heal
  • Recurring infections
  • Increased thirst
  • Increased urination

 

Cause of Diabetes Mellitus

Types Cause
Type 1 Diabetes The immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas.

Genetic may plays a role in causing this; however, viral infection may also lead to this metabolic disorder.

Type 2 Diabetes It is caused by a combination of genetics and lifestyle factors. Being overweight or obese, especially with increased belly fat making the cells to be more resistant to insulin effect on sugar.
Gestational Diabetes Gestational diabetes is the result of hormonal changes during pregnancy. The placenta produces hormones that make a pregnant woman’s cells less sensitive to the effects of insulin. This can cause high blood sugar during pregnancy.

Women who are overweight when they get pregnant or who gain too much weight during their pregnancy are more likely to get gestational diabetes.

Risk Factors

Types Risk Factors
Type 1 Diabetes
  • Genetic, usually at a young age
Type 2 Diabetes
  • Overweight or obese
  • Age 45 or above
  • Family history of diabetes
  • Physically inactive
  • Had a medical history of gestational diabetes
  • Have prediabetes
  • Have high blood pressure, high cholesterol and high triglyceride
  • Ethnic factors (Indian are more likely)
Gestational Diabetes
  • Overweight or obese
  • Pregnancy over the age of 25 years
  • Had gestational diabetes during a past pregnancy
  • Had given birth to an overweight baby before (>3.5kg)
  • Family history of type 2 diabetes
  • Have polycystic ovary syndrome

Complications

Type 1 and Type 2 Gestational Diabetes
  • Cardiovascular diseases: heart attack and stroke
  • Neuropathy
  • Nephropathy
  • Retinopathy and vision loss
  • Hearing loss
  • Foot damage such as infections and sores that don’t heal
  • Skin conditions such as bacterial and fungal infections
  • Depression
  • Dementia
  • Premature birth
  • Higher-than-normal weight at birth
  • May develop preeclampsia
  • May require a caesarean delivery
  • Increased risk for type 2 diabetes later in life
  • Low blood sugar
  • Jaundice
  • Stillbirth

 

Diagnosis of DM

1.Diagnostic value based on venous plasma glucose

–Fasting blood glucose ≥7.0mmol/L

–Random blood glucose ≥11.1mmol/L

2.Diagnostic value based on HbA1c

–Normal (<5.6%)

–Prediabetes (5.6-6.2%)

–Diabetes (>6.2%)

  • Diagnostic value based on oral glucose tolerance test (OGTT)

 

Diabetes Prevention

1. Type 1 diabetes is not preventable as it is an autoimmune disease.

2. The onset of type 2 diabetes can be delayed or prevented by:

–Engage in exercise for at least 150 minutes per week

–Cut saturated fat and trans fat, along with refined carbohydrates

–Consume lean protein source

–Eat more fruits, vegetables and whole grains

–Have smaller but frequent meals

–Cut down body weight by 10%

 

Treatment for Type 1 Diabetes

1. Insulin is the main treatment for type 1 DM

–Rapid-acting insulin starts to work within 15 minutes and its effects last for 3 to 4 hours.

–Short-acting insulin starts to work within 30 minutes and lasts 6 to 8 hours.

–Intermediate-acting insulin starts to work within 1 to 2 hours and lasts 12 to 18 hours.

–Long-acting insulin starts to work a few hours after injection and lasts 24 hours or longer.

2. Learn how to do carbohydrate counting and discuss meal plans with a dietitian.

 

Treatment for Type 2 Diabetes

1. Diet and lifestyle changes are the first line of treatment; however, if lifestyle changes aren’t enough to lower blood sugar, medication and insulin will be required.

Types of Medications How do they act? Examples
Alpha-glucosidase inhibitors Slow down the break down of carbohydrates Acarbose (Precose) and miglitol (Glyset)
Biguanides Reduce glucose production by the liver Metformin (Glucophage)
DPP-4 inhibitors Maintain optimal level of blood glucose Linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia)
Glucagon-like peptides Reduce hepatic glucose output Dulaglutide (Trulicity), exenatide (Byetta), and liraglutide (Victoza)
Meglitinides Stimulate pancreas to produce more insulin Nateglinide (Starlix) and repaglinide (Prandin)
SGLT2 inhibitors Increase excretion of glucose through urination Canagliflozin (Invokana) and dapagliflozin (Farxiga)
Sulfonylureas Increase secretion of insulin by the pancreas Glyburide (DiaBeta, Glynase), glipizide (Glucotrol), and glimepiride (Amaryl)
Thiazolidinediones Increase sensitive of insulin Pioglitazone (Actos) and rosiglitazone (Avandia)

 

Dietary changes…

1.Limit calorie intake to 30kcal/kg (ideal body weight)

2.Distribute calorie accordingly (50% carbohydrates, 20% protein and 30% fat)

3.Includes leafy vegetables and whole grain in every meal

4.Consume 2 servings of fruits per day

5. Choose lean meat, low-fat dairy

6.Learn how to count carbohydrates

7.Limit refined sugar and saturated fat

 

Alternative Medicines

1.Bio-Bay Gym Cumin

  • A supplement including cinnamon extract 75mg, curcumin 95% from 200mg turmeric extract, bitter melon extract 125mg & Gymnema extract 30mg
  • Cinnamon extractable to increase insulin sensitivity on bodily cells, this will improve the uptake of glucose into body cells to be used as an energy source; hence, reducing blood glucose level. The recommended dose of cinnamon extract is 250 mg twice a day before meals.
  • Turmeric curcumin is believed able to treat & prevent type 2 diabetes by promoting insulin sensitivity. Other than this, curcumin is a potent antioxidant to protect body cells (blood vessels & nerve) from the inflammatory damage caused by increased blood glucose levels. This is because uncontrolled blood glucose will lead to several complications such as neuropathy, retinopathy and nephropathy.
  • The bitter melon extract is able to stimulate insulin secretion from beta-pancreatic cells as well as to improve insulin sensitivity on the body cells. A 3-month study in 24 adults with diabetes showed that taking 2,000 mg of bitter melon daily decreased blood sugar and hemoglobin A1c, a test used to measure blood sugar control over three months (Marisol et al 2018). Besides HbA1c, it can reduce fructosamine, another marker of blood sugar level.
  • Gymnema extract is the main supplement is this product as it has many pathways to reduce blood glucose levels.
  • Gymnemic acid in Gymnema helps to decrease the ability to taste sweetness by blocking sweet receptors on the tongue; which makes sweet food less appealing.
  • Gymnemic acid also blocks receptors in the intestines and thus sugar absorption, lowering post-meal blood sugar levels. Studies suggest that consuming 200–400 mg of gymnemic acid reduces the intestinal absorption of sugar glucose.
  • Gymnema extract helps to promote much-needed insulin secretion by helping beta-pancreatic cells regeneration. This increases insulin levels in the blood to reduce blood sugar levels even faster.
  • Gymnema is rich in saponin and tannin that can help to protect the body from oxidative damage caused by increased blood glucose levels.
  • The suggested dosage for Gymnema is 200mg extract twice daily.

 

2.Probiotics

  • In a review of seven studies in people with type 2 diabetes, those who took probiotics for at least two months had a 16-mg/dl decrease in fasting blood sugar and a 0.53% decrease in A1C compared to those on a placebo.
  • Studies suggest that probiotics may decrease blood sugar by reducing inflammation and preventing the destruction of pancreatic cells that make insulin.

3.Coenzyme Q10

  • Both oxidative stress and mitochondrial dysfunction have been linked to the onset and progression of diabetes and diabetes-related complications. Those with diabetes may have lower levels of CoQ10, and certain anti-diabetic drugs may further deplete body stores of coenzyme Q10.
  • Supplementation of CoQ10 can help to protect body cells against oxidative damage caused by high blood sugar.
  • CoQ10 also helps improve insulin resistance and regulate blood sugar levels in people with diabetes.
  • The recommended CoQ10 per day to have a beneficial effect on blood glucose is between 100 to 300mg; Bio-bay Q10 4Plex is having 150mg CoQ10
  • 200iu vitamin D is beneficial in managing blood glucose levels as it improves the function of pancreatic cells that make insulin and increase your body’s responsiveness to insulin. Vitamin D deficiency is a potential risk factor for type 2 diabetes.

 

4.Alpha-lipoic acid

–ALA is a powerful antioxidant produced by the liver & can be found in spinach, broccoli & red meat.

–ALA improves insulin sensitivity and your cells’ uptake of sugar from your blood, though it may take a few months to experience these effects.

–It also protects body cells against oxidative damage caused by high blood sugar.

–Doses are generally 600–1,200 mg daily, taken in divided doses before meals.

5.Chromium

–Chromium may enhance the effects of insulin or support the activity of pancreatic cells that produce insulin.

–Chromium deficiency reduces your body’s ability to use carbs — converted into sugar — for energy and raises your insulin needs

–A recommended dose of 200mcg will be effective in regulating elevated blood glucose levels. The daily dosage of 1000mcg recorded to be most effective somehow.