Treatment For Type 2 Diabetes
It is possible for a person to initially control the symptoms of type 2 diabetes by following a healthy diet, taking regular exercise and keeping their blood glucose levels within an agreed target range. Type 2 diabetes is a progressive condition so they may eventually need to take diabetes medication which will usually be in tablet form. A treatment programme will be tailored to suit the person’s needs by the diabetes team and will typically include one or a combination of the following:
- changing to a healthier diet
- medication such as metformin
- injectable GLP-1
- insulin therapies.
Keeping blood glucose levels under control is vital in reducing the risk of diabetes complications. If a person is overweight, weight loss can often help to reduce the extent of diabetes symptoms. Type 2 diabetes is effectively controlled when a person is involved in the management of their own programme of treatment. Effective ‘self-management’ is essential to successfully achieving their healthy targets for HbA1c, blood pressure and cholesterol levels. A person with type 2 diabetes may need medication that reduces high levels of blood glucose. In the first instance this will usually be glucose-lowering tablets and it may also include injectable insulin. Some oral medications for lowering blood glucose levels can cause hypoglycaemia for example, Gliclazide, Glipizide and Glimpiride.
Further resources
Can I Take Insulin Orally
In a word, no.
At this time, insulin cannot be taken as a pill. There are no pills on the market that are safe to take according to Joslin Diabetes Center, Insulin currently cannot be taken by mouth because the digestive juices in your stomach and intestine will break down the insulin before it has a chance to get into your bloodstream to do its job.
However, there may be a future for oral insulin.
The Research
In September 2017, Biocon and JDRF, a global organization that researchers and advocates for type 1 diabetes, partnered to research a global study the oral insulin, Tregopil. According to The Hindu, The fast-acting oral insulin could improve post-prandial glucose control with reduced side effects and greater adherence, thus holding a promise to transform T1D management.
Tregopil has already had positive clinical data in 2016 in a Phase I study in the United States, and will also be studied in type 2 diabetes participants.
Inhaled Insulin, What Is It?
If youre prescribed insulin but a bit leery, you could try inhaled insulin. In June 2014, the FDA approved Afrezza, which is an inhaler with pre-measured, rapid-acting insulin, so it is used before meals. At this time, there is only a rapid-acting insulin that is in the inhaled form so if you have type 1 diabetes, you would still require an injection for a basal insulin .
Understanding Insulin And Diabetes
- The pancreas maintains the bodys blood glucose balance.
- Primary hormones of the pancreas include insulin and glucagon, and both regulate blood glucose.
- Diabetes is the most common disorder associated with the pancreas.
Anatomy of the Pancreasspineislets of LangerhansHormones of the Pancreas
- Gastrin: This hormone aids digestion by stimulating certain cells in the stomach to produce acid.
- Glucagon: Glucagon helps insulin maintain normal blood glucose by working in the opposite way of insulin. It stimulates your cells to release glucose, and this raises your blood glucose levels.
- Insulin: This hormone regulates blood glucose by allowing many of your bodys cells to absorb and use glucose. In turn, this drops blood glucose levels.
- Somatostatin: When levels of other pancreatic hormones, such as insulin and glucagon, get too high, somatostatin is secreted to maintain a balance of glucose and/or salt in the blood.
- Vasoactive intestinal peptide : This hormone helps control water secretion and absorption from the intestines by stimulating the intestinal cells to release water and salts into the intestines.
Diseases and Disorders of the Pancreas
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What Is Diabetes What Are The Types Of Diabetes
Diabetes is a number of diseases that involve problems with the hormone insulin. Normally, the pancreas releases insulin to help your body store and use the sugar and fat from the food you eat. Diabetes occurs when one of the following occurs:
- When the pancreas does not produce any insulin
- When the pancreas produces very little insulin
- When the body does not respond appropriately to insulin, a condition called “insulin resistance“
Diabetes is a lifelong disease. Approximately 18.2 million Americans have the disease and almost one third are unaware that they have it. An additional 41 million people have pre-diabetes. As yet, there is no cure. People with diabetes need to manage their disease to stay healthy.
How To Perform A Ketone Test
1. Assemble the required equipment to perform the urinalysis
3. Check the urine sample is fresh – observe the colour and odour. Cloudy urine may indicate the sample is contaminated or infection is present. A strong fishy smell may indicate infection and a sweet odour like pear drop sweet may indicate ketones are present.
4. Check the sample is from the correct person and note any medications they are taking .
5. Wash hands and apply gloves/apron.
6. Remove a test strip from the bottle and replace the lid.
7. Immerse the full length of the test strip in the urine sample, ensuring all the test pads are covered. Remove excess urine on the lip of the sample bottle.
8. Place the test strip on the tissue/absorbent paper to prevent the colours on the pads contaminating each other.
9. Start the timer/note the time.
10. Replace the lid on the urine specimen.
11. When the appropriate amount of time has passed, align the test pads with the corresponding result gauge on the test strip bottle.
12. Be sure to line the pads up with the corresponding test on the container. This is where most errors with urine testing are made!
13. Remove your glove and record the result of the urine test in the persons medical record. Report any abnormal result to a senior nurse, the diabetes care team or the persons doctor as appropriate to your role and care setting.
14. Dispose of all equipment in the clinical waste bag.
15. Wash your hands.
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How Much Does Insulin Cost Without Insurance
Insulin can be a costly monthly expense. The cost of insulin without insurance will vary depending on the brand of insulin you buy and the way its administered. Insulin typically comes in pre-filled syringes, in self-injecting pen devices, or in vials to be used in syringes or in an insulin pump. Costs will also vary by retailer.
As a general guide, one self-injecting insulin pen, that can last from around one week to two can cost from $80 to $250. The price varies by manufacturer.
If you get your insulin with our help, youll always pay a flat monthly fee of $49.
Having A Quality Conversation About Emotional Health And Diabetes
Its important to ask people about their emotional health at every appointment. Just because everything may seem okay the first time you ask, this can change over time. Dont think of this as an added extra. If someone is struggling emotionally, theyre going to find looking after their diabetes much more difficult
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What Can Happen If Blood Sugars Are High
In the short term, high blood sugars can turn into diabetic ketoacidosis . This is an emergency condition that needs treatment right away. DKA can happen to kids with type 1 diabetes and, less often, kids with type 2 diabetes. Kids with type 2 diabetes also can get another type of emergency called hyperosmotic hyperglycemic state . Both conditions need treatment in the hospital and are very serious.
Untreated hyperglycemia can lead to serious health problems later in life. If it happens a lot, it can harm blood vessels, the heart, kidneys, eyes, and nerves.
What Are The Complications Or Effects Of Diabetes
When the pancreas does not produce insulin, glucose builds up in your blood. This condition is known as hyperglycemia. Fluctuations of blood glucose levels outside of the target range can lead to serious health problems involving the blood vessels and nerves, including heart disease, stroke, kidney failure, heart attack, and blindness.
When the body does not have glucose for fuel, it starts to use fat. As a result of that process, the cells produce ketones that are then released into the blood. Some of these ketones will pass out of the body through the urine. However, high levels of ketones in the blood can cause the blood to become acidic. In people with diabetes, this is called diabetic ketoacidosis or DKA. DKA can lead to coma or death if not treated. DKA is more common in those with type 1 diabetes, but can also happen to those with type 2 diabetes.
Hypoglycemia can also occur. Hypoglycemia is too little glucose in the blood. It can occur when insulin removes too much glucose from the blood as a result of increased physical activity, too much medication, too little food , and the effects of drinking alcohol.
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Storage Conditions For Pre
In relation to the storage, stability and sterility of pre-loaded insulin syringes in the home, studies have shown these can remain stable and sterile at refrigerator temperatures for up to 28 days .
Pre-loaded insulin syringes should be stored in the main part of the refrigerator at between 2ºC and 8ºC, and should not be placed in the freezer or at the back of the refrigerator. The needle should point upwards in mixtures containing isophane insulin to prevent blockage by suspended substances in the insulin .
Lantus or Abasglar are unsuitable for use in pre-loaded syringes as it will become turbid . Tresiba and Toujeo are also not suitable and should not be drawn from the cartridge or the pre-filled pen into a syringe as it is available in different doses and can overdose the patient.
Syringes should be stored in a sealable container, and both syringes and container should be clearly labelled. If the patient is required to administer insulin more than once per day there should be a separate container for each administration time even if the doses that are utilised are the same.
Glycemic Control During Serious Medical Illness And Surgery
Serious medical illness and surgery produce a state of increased insulin resistance and relative insulin deficiency. Hyperglycemia can occur even in patients without diabetes as a consequence of stress-induced insulin resistance coupled with the use of dextrose-containing IV fluids. Increases in glucagon, catecholamines, cortisol, and growth hormone levels antagonize the effects of insulin, and the alpha-adrenergic effect of increased catecholamine levels inhibits insulin secretion. Counterregulatory hormones also directly increase hepatic gluconeogenesis.
Much less is known about optimal blood glucose levels in hospitalized patients with preexisting diabetes whose hyperglycemia reflects both their diabetes and a stress response to illness. Nonetheless, it is clear that management of hospitalized patients with preexisting diabetes requires modification of treatment regimens to compensate for both the decreased caloric intake and the increased physiologic stress. Near-normal blood glucose levels should be maintained in medical and surgical patients with diabetes, for the following reasons:
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To prevent the development of ketosis
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To prevent electrolyte abnormalities and volume depletion secondary to osmotic diuresis
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To prevent the impairment of leukocyte function that occurs when blood glucose levels are elevated
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To prevent the impairment of wound healing that occurs when glucose levels are elevated
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The Following Side Effects Have Also Been Reported:
Side effects that you should report to your doctor or health care professional as soon as possible:
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- breathing problems
- signs and symptoms of high blood sugar such as dizziness, dry mouth, dry skin, fruity breath, nausea, stomach pain, increased hunger or thirst, increased urination
- signs and symptoms of low blood sugar such as feeling anxious, confusion, dizziness, increased hunger, unusually weak or tired, sweating, shakiness, cold, irritable, headache, blurred vision, fast heartbeat, loss of consciousness
Side effects that usually do not require medical attention :
- increase or decrease in fatty tissue under the skin due to overuse of a particular injection site
- itching, burning, swelling, or rash at site where injected
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Infection Prevention During Blood Glucose Monitoring And Insulin Administration
The Centers for Disease Control and Prevention has become increasingly concerned about the risks for transmitting hepatitis B virus and other infectious diseases during assisted blood glucose monitoring and insulin administration.
CDC is alerting all persons who assist others with blood glucose monitoring and/or insulin administration of the following infection control requirements:
- Fingerstick devices should never be used for more than one person
- Whenever possible, blood glucose meters should not be shared. If they must be shared, the device should be cleaned and disinfected after every use, per manufacturers instructions. If the manufacturer does not specify how the device should be cleaned and disinfected then it should not be shared.
- Insulin pens and other medication cartridges and syringes are for single-patient-use only and should never be used for more than one person
Monitoring of blood glucose levels is frequently performed to guide therapy for persons with diabetes. Blood glucose monitoring and insulin administration can be accomplished in two ways: self-monitoring of blood glucose and insulin administration, where the individual performs all steps of the testing and insulin administration themselves, and assisted monitoring of blood glucose and insulin administration, where another person assists with or performs testing and insulin administration for an individual.
- Hospitals or clinics
- Schools or camps
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What Role Does Insulin Play In The Body
Insulin. We know that our bodys produce it, but that in the case with type 1 or type 2 diabetes, sometimes our bodies decide not to produce enough or any at all! We know that it is typically given as an injection and we also know that there are some misconceptions associated with insulin for example, that it causes amputations.
So, lets discuss insulin in greater detail. Doing so will most likely clear up those pesky misconceptions as well!
Context: A Growing Issue
In recent years the arrival of innovative insulin delivery devices means more people with diabetes have been able to find an insulin pen that suits their needs, reducing the number of people requiring pre-loaded insulin syringes.
However, there remains a small number of people who will not or cannot use an insulin pen for a variety of reasons: poor manual dexterity visual impairment an inability to find a pen device that suits their needs or a reluctance to make the change from the standard insulin injection syringe they are familiar with .
As a result, these patients will be unable to autonomously inject once or twice a day and, consequently, will require nursing support to pre-load the insulin syringes they use in order to maintain their independence. The RCN is aware that the potential number of people requiring such support in the community is likely to increase for two reasons:
- the number of people with Type 2 diabetes that require insulin treatment is growing: over the past two decades the number of people with diabetes in the UK has more than doubled, from 1.4 million in 1996 to 4.5 million in 2016
- Diabetes UK estimates that by 2025, 5.2 million people will have diabetes: most of these cases will be Type 2 diabetes because of the ageing population and the rapidly rising number of overweight people .
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How Can Chemicals Affect The Endocrine System
Scientific research on human epidemiology, laboratory animals, and fish and wildlife suggests that environmental contaminants can disrupt the endocrine system leading to adverse-health consequences. It is important to gain a better understanding of what concentrations of chemicals found in the environment may cause an adverse effect. Various types of scientific studies are necessary to resolve many of the scientific questions and uncertainty surrounding the endocrine disruptor issue. Many such studies are currently underway by government agencies, industry, and academia.
Learn more with EDSP about concerns and examples of endocrine disruption.
What Are The Side Effects Of Insulin Lispro 75/25
With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.
Contact your doctor immediately if you experience any of the following:
- Severe hypoglycemia : if not treated, severe hypoglycemia can lead to unconsciousness, seizures, and even death
- Severe allergic reactions: rash, hives, swelling of face, tongue, and throat, difficulty breathing
- Dangerously low levels of potassium: if not treated, it can lead to difficulty breathing, irregular heartbeat, and even death
The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.
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From Biodegradable To Bio
It all starts with the plastic that makes up our pens. We previously focused on using biodegradable plastics that dissolve when they become waste. However, looking at our products life cycle has taught us that such plastics are not necessarily biodegradable in a landfill or in nature, but only when put into industrial composting plants. We also found that biodegradable plastics may not be the right solution when we consider recycling pens.
Because we want our product components to be recycled and reused, we are moving from using biodegradable to high quality, bio-based plastics. We are also looking for more sustainable raw materials from natural sources as opposed to traditionally-produced plastics made from oil and gas. Research is currently being done for how to best use such bio-based materials in our products.
Typical Dosing For Insulin Lispro 75/25
The dose of insulin lispro 75/25 will be different for each person. The dose depends on whether you’re using it for type 1 diabetes or type 2 diabetes, your weight, how well you respond to insulin, and your blood sugar levels. Please follow the directions from your provider carefully.
Insulin lispro 75/25 is typically dosed twice a day . It should be injected under the skin within 15 minutes before a meal.
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