home remedies for diabetes

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The normal range of blood glucose is from 70 to 100 mg/dL in an individual without diabetes, Most people will feel the effects and symptoms of low blood sugar when blood glucose levels are lower than 50 mg/dL.|Low blood sugar (also known as hypoglycemia) is when your blood sugar levels have fallen low enough that you need to take action to bring them back to your ...|Signs of low blood sugar include hunger, trembling, heart racing, nausea, and sweating. In severe cases, it can lead to coma and death. Hypoglycemia can occur with several conditions, but it most commonly happens as a reaction to medications, such as insulin. People with diabetes use insulin to treat high blood sugar.|Hypoglycemia occurs when blood sugar levels drop below 70 milligrams per deciliter (mg/dl). ... In people with diabetes, taking too much insulin can cause blood sugar levels to drop too low. Not eating enough or exercising too much after taking insulin can have the same effect.|The medical name of low blood sugar is hypoglycemia. Causes. Expand Section. Insulin is a hormone made by ...|What is Low Blood Sugar?|What You Can Do. Most of the sugar or glucose in your blood comes from carbohydrates. Carbohydrates are the sugars and starches in grains, beans, vegetables, ...|Hypoglycemia, also called low blood glucose or low blood sugar, occurs when the level of glucose in your blood drops below normal. For many people with ...|Signs of low blood sugar at night. If your blood sugar drops while you are sleeping, your partner or other family members may notice that you are sweating and ...|Low blood sugar, called hypoglycemia, happens when the level of sugar in the blood falls below 70 mg/dl. Blood sugar drops when there is more ...|Hypoglycemia is the condition when your blood glucose (sugar) levels are too low. It happens to people with diabetes when they have a ...|If your blood sugar level drops just slightly below your target range (mild low blood sugar), you may feel tired, anxious, weak, shaky, or sweaty, and you may have ...|If you start feeling confused or disoriented or have trouble walking or seeing, you may have very low blood sugar. If you're not able to test your blood glucose ...|Treating Low Blood Sugar. Related Conditions. Diabetes Mellitus. You ...|Hypoglycemia is low blood glucose (sugar), usually less than 70 mg/dl (although you and your health care provider may come up with a different number).|At some time, most people with diabetes experience the sweating and shakiness that occurs when blood glucose levels fall below 70 mg/dl — a condition known ...|Hypoglycemia, or low blood sugar, occurs when a diabetic has not eaten enough food, or has too much insulin within his or her body. An ...|Symptoms of mild low blood sugar You may have these symptoms when your blood sugar has dropped below 70 milligrams per deciliter (mg/dL). When you ...|Symptoms of Hypoglycemia: You may feel sweaty, shaky or hungry. You may feel faint. Extremely low blood sugar levels may cause you to be confused, ...|Hypoglycemia, also known as low blood sugar, is a fall in blood sugar to levels below normal. This may result in a variety of symptoms including clumsiness, ...|10 Warning Signs of Low Blood Sugar. Hypoglycemia can cause both short- and long-term complications. Know the signs so that you can treat ...|Low blood sugar (glucose), is called hypoglycemia (hypo = low + glyc = sugar + emia = in the blood). Hypoglycemia is caused by many different conditions and ...|Want to lower your blood sugar? Learn to better control your glucose levels by preventing blood sugar spikes and swings to avoid neuropathy ...|Hypoglycemia occurs when the level of sugar in the blood is too low. It can also be called insulin shock or insulin reaction. Hypoglycemia is when the level of ...|Hypoglycemia is a serious condition that happens when your blood glucose (sugar) level drops too low. The blood sugar level is usually too ...|When blood sugar drops below 70 mg/dL, it is a signal that the body is becoming ... Not being aware of low blood-sugar levels is a particularly ...|But some people with diabetes also are at risk for blood sugar to swing in the opposite direction and dip far too low, triggering a dangerous ...|Low blood sugar can happen if you are taking insulin for your diabetes. It is important to know what can cause low blood sugar and how to treat it. You can ...|You might get low blood sugar (also called hypoglycemia) if you: • Take certain medicines and eat too few carbohydrates. • Skip or delay meals. • Take too much ...|If their blood sugar is low enough, they may not be able to process the question. You can try to get them to eat or drink something to slowly raise it.|The importance of preventing low blood sugar (hypoglycemia) in newly diagnosed people with type 1 diabetes is #1. Check blood sugar and eat a healthy diet.|When blood sugar levels fall too low, the body releases the hormone adrenaline, which helps get stored glucose into the bloodstream quickly. Paleness, sweating, ...|At some point everyone will have a low blood sugar. If you can, test first to confirm low BG. Treat with 15gms fast acting carbohydrate (1/2 cup juice or regular soda ...|Usually, a blood sugar level of less than 70 mg/dL is considered too low and needs to be treated. Anything that lowers your blood sugar can cause.|Hypoglycemia, on the other hand, is when your fasting glucose is low. Hypoglycemia is a very unusual event and is usually caused by a tumor that produces too ...|Hypoglycaemia is an abnormally low level of glucose in your blood (less than four millimoles per litre). Learn about its symptoms and treatment.|Hypoglycemia is the state of having a blood glucose level that is too low to effectively fuel the body's cells. Glucose, which comes from carbohydrates found in ...|Low blood sugar, a.k.a. hypoglycemia, happens when the level of glucose in your blood drops below normal, according to the National ...|Hypoglycemia (low blood sugar) occurs when your blood sugar (glucose) levels are less than or equal to 70 mg/dL and symptoms are present.|In people who do not have diabetes, low blood sugar can be caused by a variety of factors, including alcohol consumption, infections and some medications or ...|Hypoglycemia, also known as low blood sugar, occurs when levels of glucose (sugar) in the blood are too low. Hypoglycemia is common in ...|Juice is my preferred method of treating a low when my blood sugar levels have gone below 70 mg/dL and are trending low. I prefer this method ...|In hypoglycemia, the glucose level becomes too low. Although diabetes mellitus, a disorder involving blood glucose levels, is characterized by high levels of ...|Insulin and exercise both lower blood sugar and food raises it. Hypoglycemia is common in people who are taking insulin or oral medications that ...|Most students can tell when their blood sugar is low; however, a low level can occur with little warning. Causes. Too much insulin in the body; Meals and snacks ...|Hypoglycemia is the term for low blood sugar (or blood glucose). Glucose is the “fuel” that your brain and body need to function properly.|Discusses hypoglycemia (low blood sugar) in people who don't have diabetes. Explains blood sugar (glucose) in the body. Describes symptoms of mild, ...|Hypoglycemia occurs when the levels of glucose (sugar) in your blood are too low. It is a complication that can affect people with diabetes, but it ...|If you check your blood sugars, these are the desired blood sugar ranges to aim for. Also included in this handout is a list of signs and symptoms ...|What is low blood sugar? Blood sugar is considered to be too low if it is lower than 70 milligrams per deciliter (mg/dL), or 4 millimoles per liter (mmol/L). If low ...|Hypoglycemia most often affects those at the extremes of age, such as infants and the elderly, but may happen at any age. Generally, hypoglycemia is defined as a ...|Very low blood sugar can cause fatigue, dizziness, headache, visual disturbances, drowsiness and ultimately loss of consciousness and seizures ...|Low blood sugar, or hypoglycemia occurs when blood sugar levels drop lower than where they should be. Some people may refer to this as a ...|Low blood sugar, also called hypoglycemia, occurs when your blood sugar gets below 70 mg/dL. When this happens, you can consume sugary foods or drinks ...|Blood sugar disturbances, including high blood sugar and low blood sugar, are already included as a warning in most fluoroquinolone drug ...|Significantly, the most common problem diabetics experience today is not “high blood sugar” but “low blood sugar!” Diabetes medications are powerful but ...|Low blood sugar occurs when the sugar (glucose) level in your blood drops below what your body needs. Not eating enough food or skipping ...|You may recognize the feeling—feeling hungry, dizzy, sweaty or just a little bit "off." These signs of hypoglycemia, or low blood glucose, mean it's time to take ...|Low blood sugar, known as hypoglycemia, occurs in 20 to 60 percent of patients with diabetes. It has substantial negative effects on a person's ...|Irritability/Confusion; Fainting. Causes of low blood sugar include: Too much insulin or too many diabetes pills; Not enough food or missing a meal ...|Which drugs increase the risk of hypoglycemia (low blood sugar)?. Updated: Sep 12, 2019. Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, ...|Having frequent low blood sugar can trick your body into thinking hypoglycemia is normal. Without symptoms like tremors, headaches, or ...|Medicines that can cause drug-induced low blood sugar include: Bactrim (an antibiotic); Beta-blockers; Haloperidol; Insulin; MAO inhibitors ...|Saudek answers the question: 'How to Recognize/Treat Low Blood Sugar?' By. Christopher D. Saudek, M.D., Hugh P. McCormick Family ...|Alcohol can reduce the amount of glucose produced by the liver and can put you at risk for a low blood sugar. The solution: Drink alcohol in moderation. Eat ...|In people with type 1 and type 2 diabetes, low blood sugars are generally caused by an imbalance of food, activity, and insulin — or other ...|In this article, we will explore what low blood sugar feels like for different people with diabetes. We will look at the symptoms, how they can ...|Hypoglycemia happens when your blood glucose levels have fallen low enough that you need to take action to bring them back to your target ...|If you have diabetes, you don't just need to watch out for high blood sugar but low blood sugar (also known ...|One danger of low blood sugar (hypoglycemia) is that you might not know you're having it. Low glucose levels affect your brain.|A low blood sugar, also called hypoglycemia or an insulin reaction, is defined as a blood glucose level below 60 to 70 mg/dl. It is usually companied by one or ...|What are the symptoms of low blood sugar? Watch for these early signs of low blood sugar: • You have nausea. • You are hungry.|If your blood sugar drops low enough that you need help to recover, it is considered to be a low blood sugar emergency, or severe hypoglycemia. Mild or moderate ...|What causes blood sugar to be high or low? What are ketones, ketosis, and ketoacidosis? How do carbs affect blood sugar levels? What else ...|If your blood sugar is still less than 70 mg/dL when you retest, take another 15 grams of sugar. Retest 15 minutes later. Keep doing this until your ...|Symptoms of low blood sugar. A low blood sugar causes different symptoms for everybody. You'll learn how it makes you feel if you keep getting it, although your ...

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Type of diabetes mellitus with high blood sugar and insulin resistance

Type 2 diabetes
Other namesDiabetes mellitus type 2;
adult-onset diabetes;[1]
noninsulin-dependent diabetes mellitus (NIDDM)
Universal blue circle symbol for diabetes[2]
Pronunciation
SpecialtyEndocrinology
SymptomsIncreased thirst, frequent urination, unexplained weight loss, increased hunger[3]
ComplicationsHyperosmolar hyperglycemic state, diabetic ketoacidosis, heart disease, strokes, diabetic retinopathy, kidney failure, amputations[1][4][5]
Usual onsetMiddle or older age[6]
DurationLong term[6]
CausesObesity, lack of exercise, genetics[1][6]
Diagnostic methodBlood test[3]
PreventionMaintaining normal weight, exercising, eating properly[1]
TreatmentDietary changes, metformin, insulin, bariatric surgery[1][7][8][9]
Prognosis10 year shorter life expectancy[10]
Frequency392 million (2015)[11]

Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is a form of diabetes that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.[6] Common symptoms include increased thirst, frequent urination, and unexplained weight loss.[3] Symptoms may also include increased hunger, feeling tired, and sores that do not heal.[3] Often symptoms come on slowly.[6] Long-term complications from high blood sugar include heart disease, strokes, diabetic retinopathy which can result in blindness, kidney failure, and poor blood flow in the limbs which may lead to amputations.[1] The sudden onset of hyperosmolar hyperglycemic state may occur; however, ketoacidosis is uncommon.[4][5]

Type 2 diabetes primarily occurs as a result of obesity and lack of exercise.[1] Some people are more genetically at risk than others.[6] Type 2 diabetes makes up about 90% of cases of diabetes, with the other 10% due primarily to type 1 diabetes and gestational diabetes.[1] In type 1 diabetes there is a lower total level of insulin to control blood glucose, due to an autoimmune induced loss of insulin-producing beta cells in the pancreas.[12][13] Diagnosis of diabetes is by blood tests such as fasting plasma glucose, oral glucose tolerance test, or glycated hemoglobin (A1C).[3]

Type 2 diabetes is largely preventable by staying a normal weight, exercising regularly, and eating properly.[1] Treatment involves exercise and dietary changes.[1] If blood sugar levels are not adequately lowered, the medication metformin is typically recommended.[7][14] Many people may eventually also require insulin injections.[9] In those on insulin, routinely checking blood sugar levels is advised; however, this may not be needed in those taking pills.[15] Bariatric surgery often improves diabetes in those who are obese.[8][16]

Rates of type 2 diabetes have increased markedly since 1960 in parallel with obesity.[17] As of 2015 there were approximately 392 million people diagnosed with the disease compared to around 30 million in 1985.[11][18] Typically it begins in middle or older age,[6] although rates of type 2 diabetes are increasing in young people.[19][20] Type 2 diabetes is associated with a ten-year-shorter life expectancy.[10] Diabetes was one of the first diseases described.[21] The importance of insulin in the disease was determined in the 1920s.[22]

Signs and symptoms

Overview of the most significant symptoms of diabetes.

The classic symptoms of diabetes are frequent urination (polyuria), increased thirst (polydipsia), increased hunger (polyphagia), and weight loss.[23] Other symptoms that are commonly present at diagnosis include a history of blurred vision, itchiness, peripheral neuropathy, recurrent vaginal infections, and fatigue.[13] Other symptoms that may include loss of taste.[24] Many people, however, have no symptoms during the first few years and are diagnosed on routine testing.[13] A small number of people with type 2 diabetes can develop a hyperosmolar hyperglycemic state (a condition of very high blood sugar associated with a decreased level of consciousness and low blood pressure).[13]

Complications

Main article: Complications of diabetes

Type 2 diabetes is typically a chronic disease associated with a ten-year-shorter life expectancy.[10] This is partly due to a number of complications with which it is associated, including: two to four times the risk of cardiovascular disease, including ischemic heart disease and stroke; a 20-fold increase in lower limb amputations, and increased rates of hospitalizations.[10] In the developed world, and increasingly elsewhere, type 2 diabetes is the largest cause of nontraumatic blindness and kidney failure.[25] It has also been associated with an increased risk of cognitive dysfunction and dementia through disease processes such as Alzheimer''s syndrome, hyperthyroidism, pheochromocytoma, and certain cancers such as glucagonomas.[44] Individuals with cancer may be at a higher risk of mortality if they also have diabetes.[47] Testosterone deficiency is also associated with type 2 diabetes.[48][49] Eating disorders may also interact with type 2 diabetes, with bulimia nervosa increasing the risk and anorexia nervosa decreasing it.[50]

Pathophysiology

Type 2 diabetes is due to insufficient insulin production from beta cells in the setting of insulin resistance.[13] Insulin resistance, which is the inability of cells to respond adequately to normal levels of insulin, occurs primarily within the muscles, liver, and fat tissue.[51] In the liver, insulin normally suppresses glucose release. However, in the setting of insulin resistance, the liver inappropriately releases glucose into the blood.[10] The proportion of insulin resistance versus beta cell dysfunction differs among individuals, with some having primarily insulin resistance and only a minor defect in insulin secretion and others with slight insulin resistance and primarily a lack of insulin secretion.[13]

home remedies for diabetes ⭐️how to home remedies for diabetes for Other the 1 last update 2020/07/12 potentially important mechanisms associated with type 2 diabetes and insulin resistance include: increased breakdown of lipids within fat cells, resistance to and lack of incretin, high glucagon levels in the blood, increased retention of salt and water by the kidneys, and inappropriate regulation of metabolism by the central nervous system.[10] However, not all people with insulin resistance develop diabetes since an impairment of insulin secretion by pancreatic beta cells is also required.[13] Other potentially important mechanisms associated with type 2 diabetes and insulin resistance include: increased breakdown of lipids within fat cells, resistance to and lack of incretin, high glucagon levels in the blood, increased retention of salt and water by the kidneys, and inappropriate regulation of metabolism by the central nervous system.[10] However, not all people with insulin resistance develop diabetes since an impairment of insulin secretion by pancreatic beta cells is also required.[13]

Diagnosis

WHO diabetes diagnostic criteria[52][53]  edit
Condition 2-hour glucose Fasting glucose HbA1c
Unit mmol/L(mg/dL) mmol/L(mg/dL) mmol/mol DCCT %
Normal <7.8 (<140) <6.1 (<110) <42 <6.0
Impaired fasting glycaemia <7.8 (<140) ≥6.1(≥110) & <7.0(<126) 42-46 6.0–6.4
Impaired glucose tolerance ≥7.8 (≥140) <7.0 (<126) 42-46 6.0–6.4
Diabetes mellitus ≥11.1 (≥200) ≥7.0 (≥126) ≥48 ≥6.5

The World Health Organization definition of diabetes (both type 1 and type 2) is for a single raised glucose reading with symptoms, otherwise raised values on two occasions, of either:[54]

  • fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl)
or

A random blood sugar of greater than 11.1 mmol/l (200 mg/dl) in association with typical symptoms[23] or a glycated hemoglobin (HbA1c) of ≥ 48 mmol/mol (≥ 6.5 DCCT %) is another method of diagnosing diabetes.[10] In 2009 an International Expert Committee that included representatives of the American Diabetes Association (ADA), the International Diabetes Federation (IDF), and the European Association for the Study of Diabetes (EASD) recommended that a threshold of ≥ 48 mmol/mol (≥ 6.5 DCCT %) should be used to diagnose diabetes.[55] This recommendation was adopted by the American Diabetes Association in 2010.[56] Positive tests should be repeated unless the person presents with typical symptoms and blood sugars >11.1 mmol/l (>200 mg/dl).[55]

ADA diabetes diagnostic criteria in 2015[57]  edit
Diabetes mellitus Prediabetes
HbA1c ≥6.5% 5.7-6.4%
Fasting glucose ≥126 mg/dL 100-125 mg/dL
2h glucose ≥200 mg/dL 140-199 mg/dL
Random glucose with classic symptoms ≥200 mg/dL Not available

Threshold for diagnosis of diabetes is based on the relationship between results of glucose tolerance tests, fasting glucose or HbA1c and complications such as retinal problems.[10] A fasting or random blood sugar is preferred over the glucose tolerance test, as they are more convenient for people.[10] HbA1c has the advantages that fasting is not required and results are more stable but has the disadvantage that the test is more costly than measurement of blood glucose.[58] It is estimated that 20% of people with diabetes in the United States do not realize that they have the disease.[10]

Type 2 the 1 last update 2020/07/12 diabetes is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.[59] This is in contrast to type 1 diabetes in which there is an absolute insulin deficiency due to destruction of islet cells in the pancreas and gestational diabetes that is a new onset of high blood sugars associated with pregnancy.[13] Type 1 and type 2 diabetes can typically be distinguished based on the presenting circumstances.[55] If the diagnosis is in doubt antibody testing may be useful to confirm type 1 diabetes and C-peptide levels may be useful to confirm type 2 diabetes,[60] with C-peptide levels normal or high in type 2 diabetes, but low in type 1 diabetes.[61] Type 2 diabetes is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.[59] This is in contrast to type 1 diabetes in which there is an absolute insulin deficiency due to destruction of islet cells in the pancreas and gestational diabetes that is a new onset of high blood sugars associated with pregnancy.[13] Type 1 and type 2 diabetes can typically be distinguished based on the presenting circumstances.[55] If the diagnosis is in doubt antibody testing may be useful to confirm type 1 diabetes and C-peptide levels may be useful to confirm type 2 diabetes,[60] with C-peptide levels normal or high in type 2 diabetes, but low in type 1 diabetes.[61]

Screening

No major organization recommends universal screening for diabetes as there is no evidence that such a program improve outcomes.[62][63] Screening is recommended by the United States Preventive Services Task Force (USPSTF) in adults without symptoms whose blood pressure is greater than 135/80 mmHg.[64] For those whose blood pressure is less, the evidence is insufficient to recommend for or against screening.[64] There is no evidence that it changes the risk of death in this group of people.[63] They also recommend screening among those who are overweight and between the ages of 40 and 70.[65]

The World Health Organization recommends testing those groups at high risk[62] and in 2014 the USPSTF is considering a similar recommendation.[66] High-risk groups in the United States include: those over 45 years old; those with a first degree relative with diabetes; some ethnic groups, including Hispanics, African-Americans, and Native-Americans; a history of gestational diabetes; polycystic ovary syndrome; excess weight; and conditions associated with metabolic syndrome.[23] The American Diabetes Association recommends screening those who have a BMI over 25 (in people of Asian descent screening is recommended for a BMI over 23).[67]

Prevention

Main article: Prevention of type 2 diabetes

Onset of type 2 diabetes can be delayed or prevented through proper nutrition and regular exercise.[68][69] Intensive lifestyle measures may reduce the risk by over half.[25][70] The benefit of exercise occurs regardless of the person''s life expectancy.[25] Decreasing the systolic blood pressure to less than 140 mmHg is associated with a lower risk of death and better outcomes.[82] Intensive blood pressure management (less than 130/80 mmHg) as opposed to standard blood pressure management (less than 140-160 mmHg systolic to 85–100 mmHg diastolic) results in a slight decrease in stroke risk but no effect on overall risk of death.[83]

home remedies for diabetes 🔥how to home remedies for diabetes for Intensive blood sugar lowering (HbA1c<6%) as opposed to standard blood sugar lowering (HbA1c of 7–7.9%) does not appear to change mortality.[84][85] The goal of treatment is typically an HbA1c of 7 to 8% or a fasting glucose of less than 7.2 mmol/L (130 mg/dl); however these goals may be changed after professional clinical consultation, taking into account particular risks of hypoglycemia and life expectancy.[67][86][87] Hypoglycemia is associated with adverse outcomes in older people with type 2 diabetes.[88] Despite guidelines recommending that intensive blood sugar control be based on balancing immediate harms with long-term benefits, many people – for example people with a life expectancy of less than nine years who will not benefit, are over-treated.[89]

It is recommended that all people with type 2 diabetes get regular eye examinations.[13] There is weak evidence suggesting that treating gum disease by scaling and root planing may result in a small short-term improvement in blood sugar levels for people with diabetes.[90] There is no evidence to suggest that this improvement in blood sugar levels is maintained longer than 4 months.[90] There is also not enough evidence to determine if medications to treat gum disease are effective at lowering blood sugar levels.[90]

Lifestyle

A proper diet and exercise are the foundations of diabetic care,[23] with a greater amount of exercise yielding better results.[91] Exercise improves blood sugar control, decreases body fat content and decreases blood lipid levels, and these effects are evident even without weight loss.[92] Aerobic exercise leads to a decrease in HbA1c and improved insulin sensitivity.[93] Resistance training is also useful and the combination of both types of exercise may be most effective.[93]

A diabetic diet which includes calorie restriction to promote weight loss is generally recommended.[94][57] Other recommendations include emphasizing intake of fruits, vegetables, reduced saturated fat and low-fat dairy products, and with a macronutrient intake tailed to the individual, to distribute calories and carbohydrates throughout the day.[57][95] Several diets may be effective such as the Dietary Approaches to Stop Hypertension (DASH), Mediterranean diet, low-fat diet, or monitored carbohydrate diets such as a low carbohydrate diet.[57][96][97] Viscous fiber supplements may be useful in those with diabetes.[98]

home remedies for diabetes 👍how to home remedies for diabetes for Vegetarian diets in general have been related to lower diabetes risk, but do not offer advantages compared with diets which allow moderate amounts of animal products.[99] There is not enough evidence to suggest that cinnamon improves blood sugar levels in people with type 2 diabetes.[100]

Culturally appropriate education may help people with type 2 diabetes control their blood sugar levels, for up to 24 months.[101] If changes in lifestyle in those with mild diabetes has not resulted in improved blood sugars within six weeks, medications should then be considered.[23] There is not enough evidence to determine if lifestyle interventions affect mortality in those who already have DM2.[70]

home remedies for diabetes ⭐️how to home remedies for diabetes for As of 2015[update], there is insufficient data to recommend nonnutritive sweeteners, but note they may help reduce caloric intake.[102]

home remedies for diabetes ⭐️how to home remedies for diabetes for Medications

Metformin 500mg tablets.

Blood sugar control

See also: Anti-diabetic medication

There are several classes of anti-diabetic medications available. Metformin is generally recommended as a first line treatment as there is some evidence that it decreases mortality;[7][25][103] however, this conclusion the 1 last update 2020/07/12 is questioned.[104] Metformin should not be used in those with severe kidney or liver problems.[23] There are several classes of anti-diabetic medications available. Metformin is generally recommended as a first line treatment as there is some evidence that it decreases mortality;[7][25][103] however, this conclusion is questioned.[104] Metformin should not be used in those with severe kidney or liver problems.[23]

A second oral agent of another class or insulin may be added if metformin is not sufficient after three months.[86] Other classes of medications include: sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, SGLT2 inhibitors, and glucagon-like peptide-1 analogs.[86] As of 2015 there was no significant difference between these agents.[86] A 2018 review found that SGLT2 inhibitors may be better than glucagon-like peptide-1 analogs or dipeptidyl peptidase-4 inhibitors.[105]

Rosiglitazone, a thiazolidinedione, has not been found to improve long-term outcomes even though it improves blood sugar levels.[106] Additionally it is associated with increased rates of heart disease and death.[107] Rosiglitazone, a thiazolidinedione, has not been found to improve long-term outcomes even though it improves blood sugar levels.[106] Additionally it is associated with increased rates of heart disease and death.[107]

Injections of insulin may either be added to oral medication or used alone.[25] Most people do not initially need insulin.[13] When it is used, a long-acting formulation is typically added at night, with oral medications being continued.[23][25] Doses are then increased to effect (blood sugar levels being well controlled).[25] When nightly insulin is insufficient, twice daily insulin may achieve better control.[23] The long acting insulins glargine and detemir are equally safe and effective,[108] and do not appear much better than neutral protamine Hagedorn (NPH) insulin, but as they are significantly more expensive, they are not cost effective as of 2010.[109] In those who are pregnant, insulin is generally the treatment of choice.[23]

Blood pressure lowering

Many international guidelines recommend blood pressure treatment targets that are lower than 140/90 mmHg for people with diabetes.[110] However, there is only limited evidence regarding what the lower targets should be. A 2016 systematic review found potential harm to treating to targets lower than 140 mmHg,[111] and a subsequent review in 2019 found no evidence of additional benefit from blood pressure lowering to between 130 - 140mmHg, although there was an increased risk of adverse events.[112]

2015 American Diabetes Association recommendations are that people with diabetes and albuminuria should receive an inhibitor of the renin-angiotensin system to reduce the risks of progression to end-stage renal disease, cardiovascular events, and death.[113] There is some evidence that angiotensin converting enzyme inhibitors (ACEIs) are superior to other inhibitors of the renin-angiotensin system such as angiotensin receptor blockers (ARBs),[114] or aliskiren in preventing cardiovascular disease.[115] Although a more recent review found similar effects of ACEIs and ARBs on major cardiovascular and renal outcomes.[116] There is no evidence that combining ACEIs and ARBs provides additional benefits.[116]

home remedies for diabetes 👍how to home remedies for diabetes for Other

The use of aspirin to prevent cardiovascular disease in diabetes is controversial.[113] Aspirin is recommended in people at high risk of cardiovascular disease, however routine use of aspirin has not been found to improve outcomes in uncomplicated diabetes.[117] 2015 American Diabetes Association recommendations for aspirin use (based on expert consensus or clinical experience) are that low-dose aspirin use is reasonable in adults with diabetes who are at intermediate risk of cardiovascular disease (10-year cardiovascular disease risk, 5–10%).[113]

Vitamin D supplementation to people with type 2 diabetes may improve markers of insulin resistance and HbA1c.[118]

home remedies for diabetes 🔥how to home remedies for diabetes for Surgery

Weight loss surgery in those who are obese is an effective measure to treat diabetes.[119] Many are able to maintain normal blood sugar levels with little or no medication following surgery[120] and long-term mortality is decreased.[121] There however is some short-term mortality risk of less than 1% from the surgery.[122] The body mass index cutoffs for when surgery is appropriate are not yet clear.[121] It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control.[123][124]

Epidemiology

Regional rates of diabetes using data from 195 countries in 2014

Globally as of 2015 it was estimated that there were 392 million people with type 2 diabetes making up about 90% of diabetes cases.[10][11] This is equivalent to about 6% of the world''s basic & clinical endocrinology (9th ed.). New York: McGraw-Hill Medical. ISBN 978-0-07-162243-1. OCLC 613429053. for 1 last update 2020/07/12

  • ^ Saenz A, Fernandez-Esteban I, Mataix A, Ausejo M, Roque M, Moher D (July 2005). Saenz A (ed.). "". The Cochrane Database of Systematic Reviews (3): CD002966. doi:10.1002/14651858.CD002966.pub3. PMID 16034881. (Retracted)
  • ^ Malanda UL, Welschen LM, Riphagen II, Dekker JM, Nijpels G, Bot SD (January 2012). "". The Cochrane Database of Systematic Reviews. 1: CD005060. doi:10.1002/14651858.CD005060.pub3. hdl:1871/48558. PMID 22258959.
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