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diabeties doctor in Patna

Diabetes mellitus (DM), commonly known as diabetes, is a group of metabolic disorders characterized by a high blood sugar level over a prolonged period of time. Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many complications. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, damage to the nerves, and damage to the eyes

Three major diabetes types can develop: Type 1, type 2, and gestational diabetes.

Type I diabetes: Also known as juvenile diabetes, this type occurs when the body fails to produce insulin. People with type I diabetes are insulin-dependent, which means they must take artificial insulin daily to stay alive.

Type 2 diabetes:  affects the way the body uses insulin. While the body still makes insulin, unlike in type I, the cells in the body do not respond to it as effectively as they once did. This is the most common type of diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases, and it has strong links with obesity.

Gestational diabetes: This type occurs in women during pregnancy when the body can become less sensitive to insulin. Gestational diabetes does not occur in all women and usually resolves after giving birth.

TREATMENT Of DIABETES

Diabetes medications and insulin therapy

Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might combine drugs from different classes to help you control your blood sugar in several different ways.

Examples of possible treatments for type 2 diabetes include:

  • Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes. It works by lowering glucose production in the liver and improving your body’s sensitivity to insulin so that your body uses insulin more effectively.

  • Sulfonylureas. These medications help your body secrete more insulin. Examples include glyburide (DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride (Amaryl). Possible side effects include low blood sugar and weight gain.
  • Meglitinides. These medications — such as repaglinide (Prandin) and nateglinide (Starlix) — work like sulfonylureas by stimulating the pancreas to secrete more insulin, but they’re faster acting, and the duration of their effect in the body is shorter. They also have a risk of causing low blood sugar and weight gain.
  • Thiazolidinediones. Like metformin, these medications — including rosiglitazone (Avandia) and pioglitazone (Actos) — make the body’s tissues more sensitive to insulin. These drugs have been linked to weight gain and other more-serious side effects, such as an increased risk of heart failure and anemia. Because of these risks, these medications generally aren’t first-choice treatments.
  • DPP-4 inhibitors. These medications — sitagliptin (Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta) — help reduce blood sugar levels, but tend to have a very modest effect. They don’t cause weight gain, but may cause joint pain and increase your risk of pancreatitis.
  • GLP-1 receptor agonists. These injectable medications slow digestion and help lower blood sugar levels. Their use is often associated with weight loss. Possible side effects include nausea and an increased risk of pancreatitis.

    Exenatide (Byetta, Bydureon), liraglutide (Victoza) and semaglutide (Ozempic) are examples of GLP-1 receptor agonists. Recent research has shown that liraglutide and semaglutide may reduce the risk of heart attack and stroke in people at high risk of those conditions.

  • SGLT2 inhibitors. These drugs prevent the kidneys from reabsorbing sugar into the blood. Instead, the sugar is excreted in the urine. Examples include canagliflozin (Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance).

    Medications in this drug class may reduce the risk of heart attack and stroke in people with a high risk of those conditions. Side effects may include vaginal yeast infections, urinary tract infections, low blood pressure, and a higher risk of diabetic ketoacidosis. Canagliflozin, but not the other drugs in the class, has been associated with increased risk of lower limb amputation.

  • Insulin. Some people who have type 2 diabetes need insulin therapy. In the past, insulin therapy was used as a last resort, but today it’s often prescribed sooner because of its benefits. Low blood sugar (hypoglycemia) is a possible side effect of insulin.

    Normal digestion interferes with insulin taken by mouth, so insulin must be injected. Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night. There are many types of insulin, and they each work in a different way.

    Often, people with type 2 diabetes start using insulin with one long-acting shot at night, such as insulin glargine (Lantus) or insulin detemir (Levemir). Discuss the pros and cons of different drugs with your doctor. Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health

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