DIABETES TYPE 2

In Malaysia, diabetes is known as ‘Kencing Manis’ which literally means ‘Sweet Urine’. As the name implies, the most common symptoms that a person has is when the urine has too high sugar levels which result mainly from long term diet.

In fact, it is one of the top 5 killers in Malaysia because as the local name suggests, it has to do with sugar. In Malay, diabetes is known as ‘Penyakit Kencing Manis’ or ‘Sweet Urine Disease’ which is the same name given by the Chinese and other communities as well.

Diabetes is often associated with sugar intake and the consequences are always linked with amputation of legs and such to avoid further complications.
Such a situation would be deterrence enough for any Malaysian to think twice about consuming too much sugar in their daily diet.

Diabetes occurs when a person’s blood sugar is too high. Apart from that, it can happen when the pancreas is not able to produce enough insulin to regulate the sugar levels. In general, diabetes has 2 main types known as Type 1 and Type 2 while there is another type called gestational diabetes that occurs among pregnant women.

Malaysians are known for their love of food and for their sweet tooth. It is often said that food without sugar might not taste as good as they are supposed to. This is found not only in solid food but more significantly in beverages like coffee, Teh and Milo. It is a common practice that Malaysian order their beverages ‘kurang manis’ or less sugar but they still prefer to have their beverages prepared with a certain level of sweetness. On the other hand, food is often prepared with high contents of sugar while a proper and consistent fitness regime must be carried out to lower the risk of diabetes.

Be alert with early signs of Diabetes

Diabetes is a serious health problem. If you do not take note of the signs when you can, it might be too late to get diagnosed. Do you think you have diabetes since it has been found that 40% of adults today either have a minor or major problem with this disease? Diabetes is easy to control and treated in the early stages because it is normally silent. The rule that you should not be going about looking for problems if it is not broken would not apply since diabetes starts from inside your body and its best to figure out if it is actually happening. So instead of allowing diabetes to slowly causing damage in your body, perhaps it is better to find out if you are actually having this problem. Below are some common that you might have diabetes and if you have those symptoms, it would be time to see your doctor and do not prolong any longer.

Common symptoms of diabetes:

• Weight loss—even though you are eating more (type 1)
• Tingling, pain, or numbness in the hands/feet (type 2)
• Urinating often
• Feeling very thirsty
• Feeling very hungry—even though you are eating
• Extreme fatigue
• Blurry vision
• Cuts/bruises that are slow to heal

The common symptoms of diabetes is when you have to urinate too often, often feeling thirsty or hungry, blurred visions, cuts or bruises that are slow to heal and extreme fatigue.
The best method to reduce the risk of contracting diabetes is to watch your food intake. In Malaysia, food with high levels of sugar is very common.

Symptoms from your physical attributes
First, check your own family background. If anyone in your immediate family has had diabetes, then your chances are quite high of getting it. This could be your parents, siblings or grandparents where to a certain extent, it could be hereditary. If you are Asian, the risk is higher as compared to other continents due to the diet styles.

Weight plays an important role. If you are slightly overweight, then it is time to keep it in watch. If you are above 40 years old, then your risk of getting Type 2 Diabetes would be higher than those in other age groups.

The longer diabetes progresses inside your body, the more obvious the signs would become. If you suddenly get excessive thirst and increased appetite, then chances are you are in the early stages of Diabetes.
Other signs include fatigue, blurred vision, too frequent urination, a tingling feeling in your hands and feet, sexual dysfunction and frequent infections in your skins.

PrevalenceThis chronic illness if not controlled will result in much pain for the individual. It is accumulated throughout the years and is usually resulted from food intake. Malaysians love their ‘Teh Tarik’ and ‘Nescafe Kau’ and they are usually prepared using sugar and milk. If not controlled, it could lead to heart failure and stroke while the men could face erectile dysfunction problems too.

Like it or not, everyone in Malaysia is exposed to the risk of contracting diabetes because we love our food to be tasty and sweet. This happens when the levels of sugar in the blood is too high. Make no mistake about it, our body needs glucose, a type of sugar to function efficiently. Glucose is absorbed into the bloodstream because it is one of the main sources of energy. The pancreas creates insulin which is needed to move glucose from the bloodstream to other parts of the body that requires energy like the muscles and most importantly, the liver cells.

A person with diabetes has too much sugar in their blood which will cause the pancreas to fail in making enough insulin. Another reason is that the cells do not respond to the insulin while it could be due to both the problems too. There are 2 major types of diabetes which are Type 1 and Type 2 respectively. The former are more common among the younger age group where the body is unable to produce insulin and daily injections of this is required. The latter is the most common and is often found among adults due to lifestyle, food intake and other reasons.

Medical checkups and tests
Do not feel overly assured that if your first medical check-up shows that you are free from diabetes. Always obtain a second reading and opinion to confirm the results. It is very important that you carry out this examination each year depending on your ethnic background and food intake. The most important factor is to ensure that you are not at risk for diabetes at all times.

Diagnosis

Diabetes can occur to anyone and at any age. As such, anyone who has a BMI (Body Mass Index) of more than 25 would be at risk of developing this disease. If you have a BMI above 25, then you should watch your weight and reduce to below that level or you should consult your doctor to find out if you might be having high blood pressure which could lead to diabetes. Apart from that, those who are above 45 years old would be recommended to go for blood sugar screening as people in this age group are usually the one in the high risk category. In most cases, a glycated hemoglobin test will be carried out while other known methods include a random blood sugar test and fasting blood sugar test to determine if the person has diabetes and if it is positive, to ascertain the next course of action or treatment required.

Glycated hemoglobin Test

The Glycated Hemoglobin or A1C Test is carried out to determine the average blood sugar level in your body. The information collected can date back to the last 2 to 3 months to determine which level it is in. It would be ideal if your blood level sugar is below 5.7% which is normal. Anything above that would mean you are at risk. In fact, any level between 5.7 and 6.4% is where you are in the pre-diabetes stage. Anything above 6.5% means you have diabetes, it is as simple as that. However, it is not always that you can use an A1C test as there are situations when the test might not work. As such, doctors will advise you with a string other options.

Random Blood Sugar Test

This is the test that will produce a result in mg/dL or milligrams per decilitre or mmol/L (millimoles per litre). If the level is above 200 mg/dL which is equivalent to 11.1 mmol/L, then you are diabetic. This test can be carried out at any time and is immaterial if you fasted before taking the test.

Fasting Blood Sugar Test

As the name implies, you will need to fast the night before taking this test. It involves taking a blood sample after that. The measurement is the same as the Random Blood Sugar Test where you are prediabetic if the level is between 5.6 and 6.9 mmol/L (equivalent with 100 to 125 mg/dL). Anything below 100 mg/dL is considered as normal and anything above 7 mmol/L or 126 mg/dL is considered as diabetic.

Oral glucose tolerance test

This test is not very common but is used nonetheless. Like the Fasting Blood Sugar Test, you are required to fast the night before where your blood sugar levels will be tested after you drink a sugary liquid during the session. The testing is done over 2 hours where the blood sugar levels are taken periodically to check if it is above 200 mg/dL or 11.1 mmol/L of which it means you are diabetic. Anything below 140mg/dL or 7.8 mmol/L is normal.

When do you take the test?

When would then be a good time to take a diabetes test so as to discover any problems before its too late? This is highly dependent on the following:

• Age: It is highly recommended that anyone passing the age of 45 to take a routine screening for type 2 diabetes. This is most significant if you are overweight (above the normal BMI) or obese. If the results return normal in the screening, then a similar test should be carried out once every 3 years to check for any developments.
• Weight: If you are not above 45 years of age but is overweight or obese, then you should take the type 2 diabetes test as soon as possible. This is because diabetes is most prevalent among those who are above their respective BMI level.
• Medical Condition: A diabetes test would be required for anyone who has medical conditions such as a heart disease (high risk). Another factor that you must consider going for screening is if you have high blood pressure or any family member has this condition.
• Hereditary: If any member of your family has a history of Type 2 Diabetes or gestational diabetes, then you should have your blood sugar levels checked regularly.

Take note: Being diagnosed with diabetes is just the first step with which the doctor will need to ascertain whether you have Type 1 or Type 2 Diabetes. This is because the treatment for both the types are very different. Once that is determined, then you need to change your lifestyle and have the condition treated. Here are some things to consider:

• • Ch eck your A1C levels a few time every year. Ideally, it should be 3-4 times.
• Consult your doctor to determine which A1C goal you want to achieve. The recommended level should be less than 7% but it really depends on your age, weight and several others.
• Plan your diet plan. It is imperative that you make major changes to your diet and also your medication.
• Check your blood pressure. Your doctor will surely be checking your blood pressure on top of taken samples of your blood and urine to determine how well your liver is functioning, kidney’s conditions, cholesterol levels and thyroid.
• Take 60 minute routine exercises. This is one routine which might resonate well among diabetic patients (especially those who are not overweight). It is after all, a good practice (and healthy one) among non-diabetic patients as well.

Dietary Guide for Diabetes Mellitus

What should your blood sugar levels be?
The normal range of blood sugar level for someone who is fasting should be between 4.4 and 6.1 mmol/l while for those who are not fasting (normal adults), it should be between 4.4 and 8.0 mmol/l.

Meanwhile, the blood lipid and cholesterol level is considered normal when the Triglycerides are less or equals to 1.7 mmol/L while the HDL cholesterol should be at least 1.1 mmol/L and the LDL cholesterol being at most ≤ 2.6 mmol/L.
The blood pressure should not be more than 130/80mmHg to be in the healthy bracket while the BMI or body mass index should be between 18.5 and 24.9 kg/m².

Basic dietary guide
To reduce the risk of diabetes, obtaining glucose from food would be the best method. This is mostly found through foods that are high on carbohydrate. Most plants have carbohydrates which are usually broken down into glucose to produce energy for the body. This simply means that one should take sufficient amount of carbohydrates.

There are in general simple and complex carbohydrates where the former should be avoided while the latter to be taken in moderation.
Simple carbohydrate foods include all types of sugar, spreads, sweetened foods and confectionary while complex carbohydrates include cereals and grain products, starchy vegetables, mee and meehoon, flour and such.

Besides that, protein that are low in fat are highly advised while fiber should be taken to slows down the glucose absorption into the blood stream which helps in digestion.

Other foods that are in the high risk category of diabetes include artificial sweeteners which makes food sweeter although they are low on calorie.

Dietary guide for diabetic patients during fasting(for muslim)

During the holy month of Ramadan, Muslims refrain from food intake for more than 12 hours which is an important practice before Eid Mubarak. While fasting is a healthy practice in many ways which could be a viable option for the physically able, it might not be the same for those who are facing certain types of health problems.

For patients with diabetes, the situation is a lot harder. While the Muslim wants to fulfill the religious obligation, it could mean depriving the body from certain nutrition which could be damaging. As such, it would be best to ensure that the body continues to get enough supply of minerals without compromising the fasting process.

For diabetics, eating sahur would be a good practice. In the morning, ensure that the meal is complete with all the needed minerals and nutrients. There should be enough protein which does not increase sugar in the body. Many types of food have high levels of sugar which must be avoided if possible.

Always include a snack for supper after tarawih and when breaking fast, avoid food which is high in cholesterol. Water and fluid might not come easy during the day so for the diabetic patient, going for at least 8 glasses of water would only be possible during and after fasting.

Salt intake should be minimized at all costs. This will help to reduce the risk of dehydration while ensuring that there are specific times for medication. Apples and dates would be good for sahur, sweetened kuih should be taken in moderation with low fat milk.

At breakfast, eat a piece of chicken or fish with lots of vegetables while taking a1 whole orange with plain water. For the post-tarawih supper, a piece of unsweetened kuih might help or take some cream crackers or low-sugar biscuits with a glass of low fat milk.

Statistics of Diabetic Disease in Malaysia

In Malaysia, diabetes is one of the highest causes of health-related problems like kidney failure that required dialysis, irreversible blindness and leg amputation. Despite the growing research and positive results to cure diabetes, there has not much change around as people are still consuming sugar at an uncontrollable rate. The National Health and Morbidity Survey 2011 showed that there has been an increase of 20.8% rate of diabetes from 5 years earlier. 10 years ago, it was 8.3% among adults above the age of 30 years old and 15 years before that was only 6.3%.

It has been reported that diabetes is the seventh highest cause of deaths in Malaysia in 2011 while it continues to be the in top 10 around the world. Diabetes is a common problem which is faced by people above 30 years of age which is largely due to the accumulation of blood sugar over many years of unhealthy diet and health practices. However, there have been reports in recent years where children suffered from diabetes which were contributed by hereditary reasons as well as unhealthy living conditions which required expensive and long-term medical treatment.

Prevention

The most obvious way to prevent diabetes is by watching your diet. In fact, when it comes to diseases, preventing diabetes is perhaps the easiest although practicing it might be very challenging. To avoid developing diabetes, you must watch your weight so that you do not become obese. You need to lower your blood sugar level using every method possible. This is where you need to watch what you are eating and to ensure that you reduce the consumption of sugar whether as an ingredient or during cooking.

You need to exercise regularly in order to regulate and facilitate better blood circulation while ensuring that the minerals in your blood are evenly distributed. Exercising will boost your sensitivity to insulin and as such, helps in maintaining your blood sugar within a range which is regarded as ‘normal’. In your diet, ensure that you have plenty of fiber through vegetables and fruits while whole grains make a lot of difference too.

How to Monitor and Regulate your Blood Sugar?

You will only be diabetic if your blood sugar level is alarmingly high. This means that you can actually prevent this from happening by some drastic measures. What you really need to do is to monitor your blood sugar (like how we monitor our body weight). Below are some steps that you can take to ensure that your blood sugar level is kept in check.

• Lose Weight: You definitely need to lose weight (if you have over BMI). Start from a small number. 5-10% of weight loss has very significant results and makes a lot of difference. After that, you can continue to do more. The ideal weight loss ratio is actually 7% and above of your initial weight. If you can do that, it would be perfect and would surely affect your blood sugar level.
• Control your diet: Start eating healthy food and try to eat less. One of the worst eating habits that Malaysians have is biting more than they can chew (literally). </li.
• Check your food intake: There is no specific diet that can be catered to diabetic patients. However, you can start counting your calories whenever you eat (keeping it as low as possible) and reduce food intake with saturated fats. Take more food which is high in fiber while reducing sweet stuff.

Malaysian Sweet Tooth Lifestyle

In Malaysia, a lot of our food is cooked with sugar. We drink coffee and tea each day which are made with sugar. All our different types of cuisine are prepared with one type of sugar-related material or another. The biggest problem is that we enjoy our food so much; we become too ignorant that we might be in the pre-diabetic levels without knowing it.

In actual fact, diabetes can be avoided if you take preventive action instead of remedial ones.

Check your BMI and watch your weight

The top preventive measure you should take is to watch your weight. If you are about 100kgs, then you should start shedding your weight. Check your BMI (Body Mass Index) and work towards achieving about 10kgs lesser than your BMI and work to stay at that level.

Eat lots of greens

This goes around in ALL healthy regimes. Eat lots of vegetables and fruits. In doing this, you will reduce meat intake. You need not go on a vegetarian diet but reducing meat will help you to keep your weight down which will reduce your risk of developing diabetes.

Kurang Manis

This should be the ‘key word’ when ordering food. Like it or not, food from the Mamak stalls are extremely delicious, but you should try and reduce having your meals there. When ordering your Teh Tarik or Nescafe Tarik, always request for ‘kurang manis’. If the drink is still sweet, request to change.

Coffee

Coffee has certain elements that help to keep diabetes down. However, drinking coffee could have other effects. Ensure that your coffee is not overly sweet and to go with a 1 mug – 1 spoonful of sugar model.

Other types of food known to keep your sugar levels low include cinnamon, which you can take through supplementary products. Meanwhile, lead a healthy life which includes taking walks, yoga, and exercise while minimizing on unhealthy activities like alcohol and smoking. At the end of the day, ensure that you have a good night rest so that your body can rejuvenate and replenish itself. Remember, diabetes is a silent killer and can cause a lot of harm if not curbed.

The Types of Diabetes

Did you know that there are actually a few main types of diabetes? Knowing what they are will give you more knowledge on what to expect and how you might be able to go around it. Here is the drill down to the few major types of diabetes.

Type 1 Diabetes

Type 1 diabetes is very common among people in the younger age group. While statistics show that Type 1 diabetes is most prevalent among young people, it does not mean that older people do not get it. Formerly known as IDDM or insulin-dependent diabetes mellitus or juvenile-onset diabetes, this is the medical condition that is most worrying for parents as they will need to constantly monitor their child from an early age including providing proper medication and treatment. What actually happens is that the pancreas fails to produce enough insulin for the body. The biggest setback about this is that:

• There is NO cure for Type 1 diabetes and you could only possibly be done by moderating the blood sugar level of the patient. This can be done through managing the level of blood sugar by changing the lifestyle and using insulin so that complications can be prevented

To date, there is no definite cause of Type 1 diabetes which could be hereditary where some children are born with it. However, a lot of findings have shown that the immune system of the body is destroying the cells in the pancreas that produces insulin. Symptoms of Type 1 diabetes include sudden increased thirst or hunger, irregular or increased frequency of urination and fatigue. One of the hardest things that parents would need to do is to inject insulin into the child and this need to be done quite frequently (depending on the situation).

Type 2 Diabetes

Type 2 diabetes meanwhile is the most common and prevalent among adults. It is known also as NIDDM or non-insulin dependent diabetes mellitus. It also goes by the name of adult-onset diabetes. One of the most devastating figures about Type 2 diabetes is that this condition is most common among people over the age of 40 and it contributes to more than 90% of the total diabetic patients. Like Type 1 diabetes, it has something to do with insulin. While the pancreas is able to produce insulin, the glucose is unable to get into the cells because they are resisting such an action. What makes this scarier though is that diabetes is hereditary which means that a person who has a relative with Type 1 diabetes is at risk.
On top of that, people who are overweight or obese would be at high risk as well. This is because overweight people have cells that are insulin resistant where they do not function properly as required. Meanwhile, it is the same situation for those with hypertension and hyperlipidemia.

Prediabetes Symptoms

One of the biggest problems faced by Type 2 diabetic patients is that the symptoms sometimes do not justify the outcome. In other words, many patients are unaware of their condition because of the lack of symptoms. Frequent urination and constant thirst could well be signs of dehydration or malnutrition. It is only when one goes through a routine (or non-routine) blood sugar check that Type 2 diabetes can be determined.

Gestational Diabetes

When the level of glucose level in your body is abnormal, then you might be experiencing a condition known as Gestational Diabetes Mellitus. Glucose intolerance is mostly faced by pregnant mothers and this is one situation which can be very negative not only for the mother but for the baby as well. In most cases, a routine practiced by doctors is to carry out an Oral Glucose Tolerant Test by the doctor. It is extremely important that the blood glucose level in the body is maintained properly so that there is sufficient levels within. In order to regulate the blood glucose level, an insulin injection might be required. While Gestational Diabetes is not formally a type of diabetes, it could lead to Type 2 diabetes (for the mother) at a later stage while the baby might be at risk as well.

Getting help for Diabetic Patients

Being diagnosed with diabetes can be a devastating blow to a person. While it might be a medical condition that can be treated, the entire process can be very grueling and heart-wrenching. There have been many reports where diabetic patients have to amputate a foot because of this medical problem. Malaysia has been in 2014 been claimed to be the most obese country in Asia and that in itself is a scary taught. Obesity is by near or by far the closest cause to diabetes. The truth is, the National Diabetes Institute (NADI) had declared in 2018 that in Asia, Malaysia has the highest rate of diabetes cases. This was further expounded by the International Diabetes Federation which reported that in Malaysia, there were close to 3.5 million cases of diabetes in 2017. That is more than 10% of the total Malaysian population!! If a person is diagnosed with diabetes, what are the options available?

Changing lifestyle and seeking support

The most possible way is to change lifestyle. Whether as a pre-emptive measure or to react to the problem, something needs to change. Unhealthy diets must go and exercising must take place. It must be noted that Type 2 Diabetes is no longer prevalent only among those above 40 and it is reported that more people in their 30s have already been diagnosed. The government of Malaysia has increased tax on sugar and other foods that are known to have a direct impact on diabetes.

The first level of support must come from family and friends. In fact, the family members must come together to carry out family health screenings and be honest about it. If a member of the family has diabetes, there is a high risk that it might be ‘passed down’ to the later generations. This is crucial as a form of early detection. If anyone of the family members is diagnosed with diabetes (even pre-diabetes), then the whole group must work cohesively. Diet must be changed and it helps that everyone is committed to this transition.

Being prepared for diabetic patients

When the body reacts, it is sometimes difficult to be entirely ready to respond. However, diabetic patients can be prepared by taking a few precautions. This can be possibly predicted and then reacted if the patient is at home or in a controlled environment but then what if it is in an unforeseen circumstance? Below are some preparatory options.

• When behind the wheel – If hypoglycaemia strikes when the patient is driving, the consequences can be deadly. As such, it is imperative that the blood sugar level is checked regularly while driving so that such occurrences do not happen. An interval of 15 minutes would be ideal and if it is less than 70 mg/dL or 3.9 mmol/L, taking a chocolate bar containing about 15 gm of carbohydrates should do the trick.
• While at work – At an office environment, taking breaks would be quite easy and accessible. But what if the patient moves around a lot? That would be inconvenient. The employer should be aware of the situation and condition and allow additional breaks so that the patient can test the blood sugar levels and to have it treated when needed.
• Pregnant – For pregnant women, there is a high risk of pregnancy complications with Type 1 Diabetes. The ideal level for A1C readings for pregnant women should be below 6.5%. This should be done before conceiving. If the mother is at high risk, then it becomes necessary (mandatory even) to have it regulated to reduce the risk of birth defects.
• At an older age – The acceptable A1C level for older people with Type 1 Diabetes should be below 8%. This can be quite challenging because the older ones might be more difficult to treat especially among those who have other medical conditions like hypertension and heart diseases.
• Children – That which makes it really difficult is when you have a child who is diabetic at home. In most cases, the child would have Type 1 Diabetes which means there is a need for injections every day. Getting a child to have a standard injection is difficult enough, what more if you have to do it several times a day. There is a lot of preparatory work that needs to be put in place if you need to treat a child with diabetes.

Seek Help from Organisations

There are several organizations that offer support in various ways for diabetic patients.

• Diabetes Malaysia – A member of the International Diabetes Federation, the aim of this organization is to help serve people with diabetes and to create more awareness among the general public of this killer disease. Besides that, it helps to raise fund to help the poor with this condition in helping them treat diabetes. This is because modern medication for diabetes (that has a lesser strain on the liver) is very costly and not everyone has the luxury of a medical insurance policy). Furthermore, a public donation to Diabetes Malaysia is not sufficient.
• National Diabetes Institute – Known in short as NADI, the objective of this organization is to be the main Diabetes Education Resource Centre in Malaysia. It operates the National Diabetes Hospital which is a health facility that helps with combatting this problem. The National Diabetes Registry ins under its purview as well while being the nation’s main voice in the education, research and other related efforts in diabetes.
• Malaysian Diabetes Educators Society – The Malaysian Diabetes Educators Society or MDES was formed by a group of panel trainers from the ASEAN Diabetes Educators together with Johnson & Johnson. It is a National Non-Governmental Organization in the country which is aimed at providing education and management on diabetes for the people in Malaysia as well as to create more awareness among the general public.

Treatments and medication for Type 2 Diabetes

If you are diagnosed with Type 2 Diabetes, then you will need to find medical help as soon as possible. While a drastic change in your lifestyle can actually help, professional help will help to expedite the process. In fact, there has been a lot of cases where Type 2 Diabetic patients have achieved their target blood sugar levels after changing their diet and by exercising and losing weight. But this is easier said than done where you might then need to consider certain medications or to go through insulin therapy. The treatments that are common for helping those with Type 2 Diabetes are:

• Metformin – This is one of the most (and perhaps earliest) form of treatment given to patients with Type 2 Diabetes. Metformin is used to lower the liver’s production of glucose. On top of that, it helps to enhance the body’s reception of insulin. This will then enable your body to absorb and effectively use the insulin produced. Take note that metformin could have side effects such as diarrhoea and nausea especially in the initial stages. Once your body get used to this medication, the effects will dissipate.
• Thiazolidinediones – This medication functions very much like metformin where it stimulates the tissues in the body so that they are more sensitive in absorbing insulin. Among the types of Thiazolidinediones include pioglitazone and rosiglitazone, to name a few. Among the many types of medication, this is one which might have major side effects including heart failure and weight gain.
• Sulfonylureas – When your body needs to secrete more insulin, then you will need to take drugs with sulfonylureas like glipizide and glyburide. However, there are some side effects here that include minor (not every time) blood gain and low blood sugar.
• Meglitinides – Repaglinide and Nateglinide are among the popular types of Meglitinides. This medicine is used to stimulate the pancreas to secrete more insulin and works faster than Sulfonylureas. Both have the same effects that include weight gain.
• DPP-4 inhibitors – Sitagliptin and Linatgliptin are 2 major types of DPP-4 Inhibitors. This is one medication which has very low side effects as compared to the others where it does not cause much weight gain. However, it must be noted that there is a high risk of pancreatitis.
• Exenatide – the types of Exenatide available in the market are Byetta and Bydureon, liraglutide and semaglutide. Both liraglutide and semaglutide have been found to reduce stroke risk among the patient.
• Insulin – Insulin therapy might be required for certain Type 2 diabetic patients although it is more common among Type 1 patients. This medication was traditionally used and applied when other medications failed. However, it is now being used in the early stages because it has been found to be extremely effective. Going through insulin therapy could cause low blood sugar. One of the problems with this is that insulin can only be injected into the body and is not practical to be taken orally.

Medication and treatment for Type 1 Diabetic Patients

Insulin remains as the one most important medication needed for the treatment of patients diagnosed with Type 1 Diabetes. However, there are other medications that are used as well. This includes the following:

• High Blood Pressure drugs – This includes the ACE (angiotensin-converting enzyme) inhibitors are used for kidney health. Besides that, there are the ARB or angiotensin II receptor blockers. Such drugs are used for diabetic patients with blood pressure considered to be high.
• Medication to control high cholesterol
• Monitoring of blood sugar level – A natural option that must be carried out for Type 1 Diabetic Patients, the doctor would advise recording blood sugar levels up to 5 times daily to ensure it is moderated and controlled. This should be done before meals, before going to sleep and before any rigorous activities. </li.
• Monitoring of continuous glucose – One of the recent additions to treat Type 1 Diabetic patients, this is extremely important to avoid hypoglycaemia. This is done by attaching a fine needle under the skin so that the blood glucose level can be checked periodically (several minutes).

The role of Insulin

Insulin therapy is a necessary treatment for diabetic patients most notably those with Type 1 Diabetes. The biggest challenge is that it can be very disheartening because this might be required for an entire lifetime until something more convenient comes about. There are a few types of insulin which are:

• Short-acting insulin – Otherwise known as regular insulin and is among the most common.
• Rapid-acting insulin – Used for those in urgent need and would be in the bloodstream usually within 15 minutes or so.
• Intermediate-acting (NPH) insulin – NPH is short for Neutral Protamine Hagedorn used to lower the glucose in the blood after injection. This is also known as the N insulin.
• Long-acting insulin – Generally, there are a few types of long-acting insulin namely Lantus or insulin glargine, Levemir or insulin detemir and Toujeo. It usually takes at least 4 hours before they get into the blood.
• Short-acting insulin – This type of insulin takes about half to an hour to take effect.
• Pre-mixed insulin – This is the type that combines 2 different insulin types of which one is used to controlling your blood sugar levels in between your meals and the other used to control during the meal consumption.

How is insulin administered?

One of the most significant factors about insulin is that it cannot be taken as an oral medication. This is because the stomach enzymes are unable to break down the insulin. When that happens, it is as good as not taking any. Hence, insulin can only be administered either through a pump or an injection for it to take effect.

• Injecting insulin – like any other form of injection, a syringe is used with a fine needle. In most cases, you can use the disposable ones which are available in injection pen forms too. Take note that insulin injections for day and night might differ. The recommended dosage is to have 3 or more insulin injections per day.
• Insulin pumps – This is a wearable device attached to the body. It is about the size of your palm where a tube is connected to the repository and then under the skin of the abdomen. There are specially designed belts for this while they also come in shapes of a waistband or just a device to be kept in the pocket. More modern pumps now come as wireless devices. This is a very convenient option where they are programmed to pump insulin into the body in steady doses.

Dealing with a diabetic patient at home

There are many facets and phases that you need to go through if any member of your family (or friend) is diagnosed with diabetes. There is the emotional, psychological and mental stress that everyone needs to go through which could be very draining. While those can be very consuming, there are certain items that you need to have around the house in preparation to help the patient when needed. Here are some of the very essential items.

Insulin Equipment

This includes in most cases, insulin syringes, pumps and pens. The whole idea is that you need to keep your blood sugar levels low (not too low). You might need any of the few types of insulins (rapid-acting, regular or short-acting, intermediate-acting, long-acting or such). There is a need to inject insulin into the body for Type 1 Diabetes patients which is more prevalent among children. A syringe is most common where the insulin can be drawn out from a glass bottle. An insulin pen uses a removable cartridge or a pre-filled tube.

Home Remedies for Diabetes
While modern medicine remains as the most reliable source to treat diabetes, there are several home remedies and practices that can help in reducing your blood sugar level. In most cases, this will involve some form of herbs and supplements that can be added into the daily diet or food consumption.
A disclaimer though that such herbs and supplements might not be the cure for diabetes but they have already been found to be able to help in moderating the sugar levels. In fact, these remedies MUST NOT be regarded as a form of treatment for diabetes. While some might work cohesively to improve the condition, others are used to offer relief from the experience.

Aloe Vera

One of the best properties of the aloe vera is that a person who consumes this fruit can improve pancreas health. The aloe vera has often been regarded to be one of the best foods with a lot of medicinal properties which is very good for the skin. However, recent studies have shown that aloe vera actually helps to reduce the speed of type 2 diabetes’ growth. The study used rats and found that aloe vera actually helped to repair the beta cells in the pancreas which is instrumental in producing insulin for the body. To consume aloe vera, you can use either one of the following methods:

• Make a smoothing and add aloe vera juice pulp
• Buy and take capsules from the pharmacy

Consuming Cinnamon

This very fragrant spice which is derived from a tree’s bark is a popular ingredient used for baking and confectionaries. It is also a common ingredient in many types of Asian cooking. Because of its natural sweetness, the cinnamon offers a perfect choice for cooking without having to use any form of processed sugar. People with Type 2 Diabetes usually prefer to use cinnamon because they can continue to enjoy the sweetness in their foods. One of the major studies showed that cinnamon, when consumed by a human had improvements in their insulin, glucose, and blood pressure. In fact, it even helped with digestion. When the blood pressure is reduced, it directly reduced the risk of diabetes as well. In most cases, cinnamon is taken as an ingredient for cooking and for making drinks such as tea.

Bitter melon

The bitter melon has been known for its medicinal properties for generations. It has been used in traditional Indian and Chinese medicine and is also known as the Momordica charantia. This fruit can be cooked and used in the preparation of many types of dishes too. Because of its medicinal properties, it has been a strong subject of research among scientists. In a recent study, it was found that blood sugar level can be reduced when the bitter melon is taken in the following ways:

• The seeds are consumed
• Bitter melon juice
• The fruit is blended with vegetable pulp

Milk thistle

Known for its anti-inflammatory properties, milk thistle has been used to treat people with diabetes as a supplementary food. This food can be easily found which is known for silymarin, the extract known for its anti-inflammatory properties and antioxidant agents. This food has been taken by people for many generations now where it has been traditionally known to treat people with liver problems.

Fenugreek Seeds

The fenugreek is very rich with nutrients and fibers that are known to reduce the speed of carbohydrates and sugar digestion in the body. This is one way that helps to moderate the blood sugar level. In a recent study (2015), it was found that prediabetic patients who took powdered fenugreek seed were less likely to get Type 2 Diabetes. In fact, it could be deduced that fenugreek seeds helped to increase the levels of insulin in the body and lower the cholesterol levels too. Fenugreek can be taken in various ways including grinding it into powder form or just added to warm water.

Gymnema Sylvestre

The Gymnema Sylvestre actually means ‘sugar destroyer’ which originated from India. A study was carried out that compared Type 1 diabetic patients who took the Gymnema leaf extract against those with insulin injections. It was found that the blood sugar levels of the former fell more significantly than those in the latter group.

Ginger foods

Ginger is known as a superfood for a lot of reasons. It is actually one of the best foods which are instrumental in the treating of many types of diseases. It has been found that ginger actually helps to lower the blood sugar levels among diabetic patients. Ginger has already been used for its medicinal properties for many centuries where it has been used to counter inflammatory diseases. It was also traditionally used to treat people with digestive problems but was only a few years ago that research found that ginger could actually help to reduce blood sugar levels. Ginger can be taken in many ways. In most cases, they are used for cooking or to make certain types of juice. However, most theorists will always suggest that ginger to be taken as raw as possible to preserve its medicinal value and properties. Besides that, ginger is available in capsule form which can be purchased from the pharmacy as a food supplement.

Test and Measuring Equipment

There are several items you can have around the house which can be purchased from a local pharmacy which includes:

• Blood sugar meter – this is sometimes referred to as the glucometer. It is a digital device that can measure the blood sugar level.
• Blood Lancet – This item will prick through the skin to take out a drop of your blood that will be placed on a disposable test strip. The strip is then inserted into the monitor before the sugar level is displayed.
• Ketone Test Strips – You can now take a ketone test at home by using the strips to check your urine. People with high ketone level is at a dangerous diabetes level. The strip, once placed on the urine will change its colors. It is essential to take another test in the next few hours. This will give you a clearer indication of where the level is.
• Glucose Tablets and Glucagon – It must be noted that while diabetic patients would do all they can do reduce their blood sugar levels, having them too low would have an adverse effect. In fact, it would create complications that can be dangerous too. If your blood sugar is too low, you could go into seizures. Glucose tablets should be available in the home in case your blood level sugar goes below the acceptable level. In a situation when the patient loses consciousness, a family member would need to give a glucagon shot.
• Diabetes Medical Alert Bracelet – This is a wearable bracelet that communicates to anyone when the patient is unable to speak. The bracelet is most useful in times of emergency especially for doctors or paramedics to know what to do and what they are dealing with. Patients who use insulin would most likely be wearing one of these bracelets.

Artificial pancreas implants

Since the root cause for Type 1 Diabetes is the pancreas, there is now a recent option for an artificial pancreas implant. This has been quite a popular option since 2016. Type 1 Diabetic patients who are 14 years and above could consider this which otherwise is known as the closed-loop insulin delivery which checks the body’s sugar levels once every 5 minutes. The device is connected to an insulin pump that can send the right level of insulin as and when it is needed. The main purpose here is to ensure that the body gets its consistent supply of insulin in order to function at its optimal.

Recent Developments for Treating Diabetes

The medical sector has always been active in inventing new procedures, drugs and processes in the treatment of diseases and other conditions. The same has been going on with Diabetes since this is one of the oldest known diseases. While a lot of such options are still in their research or testing stages, many are drawing nearer to reality. Among those that have been successful include:

• Islet Cell Transplantation – this has been an ongoing research area among medical practitioners. What happens is that islet cell transplantation occurs in such a way that new insulin-producing cells are used from a pancreas donated. The starting stages have been quite challenging in that it met with a lot of restrictions and failures. However, this is changing fast with new technologies and breakthroughs. It would not be long before this materializes.
• Pancreas Transplant – Like heart transplants which were once deemed impossible, pancreas transplant is now possible. If that is done, then there is no longer the need to have insulin injections or pumps. It must be noted though that the procedure is very high risk which means that there is a possible chance of failure or if the body rejects the donor’s pancreas. The main problem here is that the risk is a lot higher for the patient than experiencing diabetes. As such, it would only be administered in conditions where diabetes is very difficult to manage or control.