A diabetes consultation is an appointment with a medical professional specializing in the diagnosis, treatment, and management of diabetes who could be your primary care doctor or a specialist called diabetologist /endocrinologist. The purpose of the consultation is to either diagnose diabetes or assess the extent of the condition and discuss the different aspects of diabetic care (for those patients who were already diagnosed with the condition.) Primary doctors and Diabetologist typically work with a dietitian/Nutritionist/Diabetes educator who creates individualized nutritional plans to help diabetics get the right nutrition to maintain optimal health despite their condition.
Diabetes care teams can be vitally important in helping young people understand more about their diabetes and how it needs to be treated. The team includes your Doctor, Asst Doctors, Nutritionist, Dietitian, Diabetes educators, Podiatrist, Health Educators, Fitness trainers etc Diabetes care teams try to do more than just prescribe treatment – they also guide and advise young people about living their lives as fully as any other young person. Some young people said they’d had fantastic care and support from their diabetes care teams and felt they had worked really well together.
After the consultation, the patient is expected to have a clear diagnosis or to undergo lab tests to confirm a diagnosis, or to have a treatment plan in place. As the management of diabetes involves several factors, diabetics can also undergo special consultations focused on their nutrition or self-care plan. These specialized appointments are intended to help them improve various aspects of their life.
Along with healthy eating and physical activity, diabetes medications also play an important role in management of diabetes. Each drug acts in a unique way in glycemic control, however some act by common mechanism and are grouped in same class of drugs.
Hyperglycemia and uncontrolled diabetes for a longer period of time can cause and lead to many complications which includes heart diseases, stroke, amputation, nerve damage, kidney disease etc. These complications can be avoided by proper glucose control. If you cant reach your blood glucose target levels with physical activity and healthy eating there is a need to take diabetes medications. The kind of medicines advised to you depends on variety of factors like type of diabetes, age, daily schedule, physical activity, eating patterns, other health problems etc.
Classification of Oral Diabetic Medicines
(Metformin 500mg -1000mg Metformin Extended release 2500mg max dose)
How to Take : Metformin usually taken twice a day with breakfast and dinner. Metformin Extended Release usually taken once a day in the morning
How it works : It decreases the amount of glucose produced by the liver and also helps in decreasing insulin resistance and body weight
(Glimepiride 1-8mg Glyburide, Glipizide 5 – 20 mg, Glicazide 40 – 320 mg)
How to Take : it is usually taken after meals once or twice a day
How it works : it stimulates the pancreas to release more insulin
3. Thiazolidinediones (TZD’s)
(Pioglitazone 7.5 – 45mg )
How to Take : Usually taken once a day after meals
How it works : It makes the body more sensitive to the effects of insulin and thus decreases insulin resistance. It should not be used for patients who had congestive heart failure.
(Repaglinide 0.5 -4mg Nateglinide 60- 240 mg)
How to Take : These medicines have to be taken with meals and in case if you skip the meals you should also skip the dose.
How it works : It stimulates the pancreas to release more amount of insulin after meals.
5. DPP4 Inhibitors
(Sitagliptin 100mg, Saxagliptin 5mg, Linagliptin 5 mg, Vildagliptin 50 mg, Teneligliptin 20mg )
How to Take : They have to be taken once or twice a day at the same time each day
How it works : It helps in improvement of insulin levels of the body after meals and also lowers the amount of glucagon produced in the body. It mainly helps in controlling post prandial glucose levels.
6. Alpha- Glucosidase Inhibitors
(Acarbose 50 – 100mg, Miglitol, Voglibose 0.2 – 0.3 mg)
How to Take : It is taken along with meals, with the first bite of the food. If you are skipping the meal do not take the dose. It is taken once, twice or thrice in a day with meals.
How it works : It slows the absorption of glucose (carbohydrates) into bloodstream after meals.
7. SGLT2 Inhibitors
(Canagliflozin 100mg, Dapagliflozin 10mg, Emphagliflozin 10 mg)
How to Take : It has to be taken before meals once in a day. Once you are on this medication you have to keep your body hydrated.
How it works : It increases the glucose excretion via kidneys
8. GLP-1 Agonists
(Exenatide, Liraglutide, Dulaglutide)
How to Take : They are injectable therapies and have to be taken once a day/ once a week
How it works : It stimulates insulin secretion, suppresses glucagon secretion, slows gastric emptying time, decreases apetite and improves insulin sesnsitivity.
Many different types of medications are available to help lower blood sugar levels in type 2 diabetes. Be sure that you talk to your doctor about the right time to take the prescribed medications. If your doctor has recommended you Insulin for your diabetes management, following information would help you with some helpful information. The aim of insulin therapy is to maintain the blood sugar within the range recommended by your doctor.
What is Insulin ?
Everyone needs insulin to help move sugar from the blood into the cell where it can be used for energy. In type 1 diabetes the pancreas make little or no insulin. While Type 2 diabetes is a progressive condition in which the beta cells which makes insulin gradually decrease and no longer function properly. Eventually these cells may not produce enough amount of insulin. Most people with type 2 diabetes may need to take insulin to control their blood sugar levels. Remember controlling your blood sugar is far more important than the treatment you use, whether it’s pills, insulin shots or both. Each person with diabetes is different. So their needs will also be different.
Some facts about insulin:
It is important to understand that when is prescribed by the doctor, the type 2 diabetic patient goes through an array of emotions. It is necessary to understand the facts and benefits about insulin and its therapy.
- Insulin helps to achieve glycemic targets in an individual
- It helps to avoid diabetic complications
- Taking insulin shots doesn’t mean you are in the last stage of disease
- Increasing the number of times you take insulin everyday doesn’t mean your diabetes is more severe
- Insulin never cause complications like blindness and skin diseases
- Once you are on insulin therapy you would be never lifelong on insulin unless and until your body is not able to produce sufficient amount of insulin required for you.
- Insulin comes with added responsibility
- Sometimes though your pancreas is still producing insulin you need to start on insulin treatment to have a better sugar control
- Insulin helps in improving the overall quality of life.
How you can take Insulin:
There are different ways how you can take insulin –
1.Insulin Syringes: the syringe helps to draw insulin from a vial (Bottle). The syringe has the units marked along the side. These syringes are available in 40 IU and 100 IU
40IU syringe is with red colour cap and 100IU syringe is with orange cap.
2.Insulin Pens: These devices can be preloaded with insulin (Disposable Pens) or catridges loaded with insulin (Reusable pen). They are more convenient than traditional vial and syringe with better dosing accuracy and administration.
- Disposable Insulin Pen : They come as pre-filled insulin devices and have to be thrown away when they are empty. They are more convenient than reusable devices as they come as pre loaded devices, however they are costly than reusable pens and cartridges.
- Reusable Pens : The pen consist of a cartridge which holds 300 units of insulin. When the cartridge is empty, it is thrown away and is replaces with a new cartridge. No need to replace the insulin pen every time. With proper care, a reusable pen can be used for several years.
3.Insulin Pumps : An insulin pump is about the size of pager, which delivers a flow of insulin around the clock via the canula under the skin. The pump user controls the amount of insulin by presetting the amount of insulin to be given throughout the 24 hour period.