Diabetes caused by an inability of the pancreas that is unable to produce enough insulin or known as insulin malfunction a condition of not being able to transform sugar into energy that supports the body sugar level therefore raises extremely. Consequently, regarding long time of sugar accumulated in the body organs may start to lose their functions and cause some complications especially to the eyes, kidneys, perpheral nerve, heart and blood vessels.
Diabetes divided into 4 types based on its causes as follows:
- Type 1 caused by insulin deficiency that require insulin injection mostly occur to people in young age who found having skinny body shape by 5-10 percent.
- Type 2, caused by insulin deficiency (insulin resistance) mostly occur in adults and those who are overweight however in present there are children with high body weight suffer from a disease as well; treatments include proper diet, exercise and antihyperglycemic agents.
- Other types of diabetes such as caused by use of certain drugs, pancreatitis or infection from certain virus.
- gestational diabetes
Principles of treating diabetic patients depend on the type of diabetes consisting of
- Lifestyle adjustment is a key of diabetes treatment such as having foods based on goal of weight loss avoiding foods that contain high fat therefore is very important including fast food together with at least half an hour or one hour exercise per day.
- Using drug to control blood sugar levels which divided into 2 types regarding medical approach.
- Diabetes medicine that used before meal and bed
- Medicine before meals
- Medicine taken after meal
Acts to stimulate the body by making it ready for using an energy from flour and sugar; the stimulation is done by activating the pancreas to release insulin hormone at the time when blood sugar levels increase after eating; generally, it is usually recommended to be taken about 30 minutes before meals. Please note that after taking this type of medicine you require to have a meal immediately that is because the secreted insulin hormone lowers sugar in blood which may lead to severe side effect.
If I forget to take a medicine, what should I do?
You should not take a medicine after meal as it is active when the sugar in blood is at low level therefore it makes the level even lower which result in hypoglycemia; so, if you forget we recommend you to skip it and do not take it twice for a next meal.
Medicine is categorized into different groups and may require more than 1 type of medicine to increase more efficiency; in case of forgetting to take it after meal you can take it right after you remember however if it is close to a time for next meal we recommend you to keep it for that next dish instead.
Currently, there are many drugs used for injection such as insulin categorized in GLP-1 analogue ; the injection has to be done through thigh and abdomen 1- 4 times before meal which takes about 30 minutes or before bedtime; a spot for injection should be changed however you have to avoid doing the injection on the same spot but a skin area has to remain; for example, the injecting on thigh could switch to another spot but remain on the thigh the unused insulin should be kept in normal temperature inside a refrigerator not a freezer. Whenever it has to be used, roll it by two hands to make a temperature equal to your body temperature before injecting it if you go to a hospital and receive insulin injections, therefore, it is necessary to fill in ice after having the insulin for to go while commuting from a hospital to a house because heat can degenerate a quality of it and no longer to be used.
For insulin that used can be placed outside the refrigerator if temperature is not too high . Moreover, it is vital to be used within 30 days, which advantages of the use is that it can apply to patients despite having certain conditions for example high blood sugar; some indications may be showing such as having diabetic ketoacidosis, pregnancy, liver disease, kidney disease, surgery, severe infections, severe hyperglycemia as well as patients who are unable to control blood sugar levels from diet and pills which side effects from drug use include extreme low sugar and weight gain.
The key thing for treating diabetes ... is constant supervision care
Diabetes is a chronic disease in which the patient significantly controls blood sugar levels to remain it at normal level using medication and injectable medical substance constantly optimally and reasonable; curbing the sugar level can reduce chance for complication as well as preventing mental health. As a result, what could definitely used to control the diabete in patients must be given to those having sugar level at 90-130 mg/dL before having meal regarding fasting (Fasting plasma glucose FPG) or having the level lower than 180 ml/ dL or HbA1c is lesser than 7.
Dr. Rattaphong jiwarangsinee
Internist specializes in Endocrinology and Metabolism
Weena Wongakeaunksorn B.Sc.(in Pharm.)
Phyathai 3 Hospital