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Changing Diabetes

How diabetes damages the body

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Glucose is a type of sugar that all cells of the body use as fuel. It moves through the blood to different parts of the body at normal levels (5.0-7.7mmol/dl). But if glucose levels are persistently elevated in the bloodstream, it becomes a slow-acting poison killing the body.

When a person has diabetes mellitus, his or her blood glucose levels are high. This condition is called hyperglycemia. The substance or hormone that enables the body’s cells to utilize glucose efficiently is insulin. It is produced by the beta cells of the pancreas.

However in individuals with prediabetes and type 2 diabetes mellitus, the pancreas overcompensates and releases excess amounts of insulin, a condition known as hyperinsulinemia. Over time, the beta cells are permanently damaged. By the time diabetes mellitus is diagnosed, about 50 percent of beta cells are no longer able to function.

Not only are people with diabetes at increased risk of developing atherosclerosis (hardening of blood vessels), but the process also tends to be accelerated, more severe and more widespread in these individuals. Diabetes also contributes to high blood pressure and is linked with high cholesterol.

The persistent hyperglycemia and atherosclerosis cause a multitude of complications associated with diabetes mellitus. These include kidney disease or kidney failure, requiring dialysis; stroke; heart attack; eye damage or blindness; immune system suppression, with increased risk for infections; erectile dysfunction; nerve damage (neuropathy) causing tingling, pain or decreased sensation in the feet, legs and hands; poor circulation to the lower extremities, with poor wound healing and increased risk for amputation.

New-generation medications with novel mechanisms of action have been developed for the management of type 2 diabetes mellitus. One of these novel treatments is liraglutide. Liraglutide mimics the action of an intestinal hormone called GLP-1 that helps the pancreas release the right amount of insulin to move glucose from the blood into the cells. It stimulates the beta cells in the pancreas to release insulin when blood sugar is too high after meals. GLP-1 also helps lower the amount of glucose produced by the liver.

Liraglutide is a once-daily injectable medication for adults with type 2 diabetes mellitus. Liraglutide is prescribed as monotherapy in conjunction with a healthy diet and regular physical activity. It can also be combined with one or more common oral antidiabetes medications such as metformin, sulfonylureas (e.g., glipizide, glimepiride) or thiazolidinediones (e.g., pioglitazone).

Liraglutide offers several advantages. Aside from its convenient once-a-day dosing, liraglutide provides substantial reduction in HbA1c, a key measure of blood glucose control; has a lower risk of hypoglycemia, abnormally low blood glucose associated with other types of antidiabetes medications, particularly sulfonylureas); results in weight loss, a desirable effect for overweight and obese patients; and requires no dose adjustment for patients with kidney impairment.

By working closely with your doctor, leading a healthy lifestyle and taking the right medications, you can achieve optimal blood glucose control and prevent diabetes-related complications.

DIABETES TRIVIA

CONTEST: What intestinal hormone crucial in blood glucose control does Liraglutide mimic? E-mail your answer to changingdiabetesph@gmail.com and get the chance to win a prize! Congratulations to Ryan Aradillos! Your correct answer to the question in the June 29, 2013 column was chosen as this week’s winner in the Diabetes Trivia Contest. You will receive an e-mail on how to claim your prize.

Dr. Richard Elwyn V. Fernando is a diabetes specialist. The “Changing Diabetes” column commemorates the 92nd anniversary of insulin’s discovery. It aims to increase awareness on diabetes prevention, diagnosis and management. Novo Nordisk supports “Changing Diabetes.” Headquartered in Denmark, Novo Nordisk is a global healthcare company with 90 years of innovation and leadership in diabetes care. For questions or comments, e-mail changingdiabetesph@gmail.com or follow us at www.facebook.com/ChangingDiabetesPH.


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