Diabetes Mellitus Type 2

Diabetes Mellitus is an endocrine disorder:

Diabetes Mellitus type 2 is an endocrine disorder characterized by insulin insufficiency (type 1 diabetes)

                                                                             OR

Insulin resistance (type 2 diabetes)and chronically raised blood sugar levels. Vascular diseases (diabetic angiopathies) play a deciding role in the course of the disease.

 

Symptoms for Diabetes Mellitus Type 2:

Damage to nerves and causes problems with sensation.

  • Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. …
  • Increased hunger. …
  • Weight loss. …
  • Fatigue. …
  • Blurred vision. …
  • Slow-healing sores or frequent infections.
  • Areas of darkened skin.

Normal values:

RBS 140-159mg/dl(Normal)200 mg/dl (Diabetes Mellitus)
FBS80-100 mg/dl (Normal)126 mg/dl (Diabetes Mellitus)
PPBS<120 mg/dl  (Normal)>160 mg/dl (Diabetes Mellitus)
HBA1C<5.8% (Normal)  >7% (Diabetes Mellitus)

Prescription for Diabetes Mellitus Type 2:

Sulfonylureas:

  • Glipizide Regular release 2.5 mg once/day-20 mg twice a day
  • Glipizide extended-release 2.5-20 mg once/day
  • Glimepiride 1-8 mg once/day
  • Glibenclamide 1-2 mg once daily

Biguanides:

  • Metformin Regular release 500 mg once/day-250 mg twice/day
  • Metformin extended release 500 mg-2 mg once/day

Thiazolidinediones:

  • Pioglitazone 15-45 mg once/day
  • Rosiglitazone 2-8 mg once/day

Alpha-glucosidase inhibitors:

  • Acarbose 25-100 mg 3 times a day with meals
  • Miglitol 25-100 mg 3 times a day with meals
  • Voglibose

Dipeptidyl peptidase-4 inhibitors:

  • Sitagliptin 100 mg once/day

Insulin:

  • Rapid-acting insulins: Lispro(Humalog),Aspart(Novolog),Glulisine(Apidra)
  • Short-acting: Regular (Humulin R or Novolin R)
  • Intermediate-acting: NPH (Humulin N and Novolin N)
  • Long-acting: Glargine(Lantus)
  • Premixed-Humulin 70/30, Novolin 70/30, Novolog 70/30, Humulin 50/50, Humalog mix 75/25

Counseling on side effects:

  • Glipizide: Hypoglycemia, Weight gain-check for sugar levels After exercise or a missed meal.
  • Glimepiride: Hypoglycemia, Weight gain-check for sugar levels After exercise or a missed meal
  • Glibenclamide: Dizziness so doesn’t drive a car or don’t operate machinery. Dehydration during the hot season so drinks plenty of fluids. Monitor kidney, liver functions.
  • Metformin: Diarrhoea,Nausea,Stomach upset,metallic taste,lactic acidosis
  • Pioglitazone: Anemia,fluid retention,edema,weight gain,Bone loss in women,Bladder cancer, monitor liver function before and during treatment.
  • Rosiglitazone: Heart failure, Angina.Stroke
  • Acarbose, Miglitol: Flatulence
  • Sitagliptin: Runny nose, Headache, Upper respiratory tract infection-Discontinue treatment if there are signs of hypersensitivity. Caution when used with sulfonylureas and/or other antidiabetic medications; monitor blood glucose regularly.

 

General counseling points for Diabetics:

  • Eat food at fixed hours
  • Do not overeat
  • Do not eat immediately after a workout

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