Cells in the human body needs energy from sugar ( glucose ) to function properly . Which normally controls blood sugar is insulin . If the body lacks insulin or develop resistance to insulin in the body's cells , the levels of sugars ( glucose ) blood will increase dramatically . This is what triggers and causes of diabetes ( diabetes mellitus ) .
Diabetes sufferers in Indonesia
In 2013, people with diabetes in Indonesia is estimated to reach 8.5 million people with an age range 20-79 years (quoted from the International Diabetes Federation). But less than half of them were aware of his condition. So in general, diabetes is a disease that is common in people of Indonesia.
In 2011, adults with diabetes in Southeast Asia is expected to reach 71.4 million, or approximately 8.3% of the total adult population in the region.
What are the types of Diabetes?
Diabetes has two major types, namely diabetes type 1 and type 2. Type diabetes is most common is diabetes type 2. Approximately 80% of people with diabetes in Indonesia suffer from this type.
Type 2 diabetes is due to decreased production of insulin in the body so that its function was not optimal or body starts to become less sensitive to insulin. This reaction is known as insulin resistance.
This type usually affects people over the age of 40 years. Pengidapnya age but lately getting any younger. Type 2 diabetes is also more often experienced by Asian ethnicity than other ethnic groups.
What are the Symptoms of Diabetes?
Symptoms of diabetes vary, and there are several similar between the symptoms of type 1 diabetes and type 2 diabetes Among them:
Consult your doctor if you experience symptoms over so the diagnosis and early detection can be performed.
- Frequent urination, especially at night.
- Frequent thirst and frequent tiredness.
- Decreased muscle mass.
- Weight loss.
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Conditions Still Causes Type 2 Diabetes
Blood sugar levels are normally controlled by the hormone insulin produced by the pancreas, an organ located behind the stomach. Insulin serves to remove the sugars from the blood into body cells which will convert it into energy.
But the pancreas in Type 2 diabetes the body does not produce enough insulin to keep blood sugar levels steady substances. It can also occur because the body can not use insulin effectively.
Measures Treatment of Type 2 Diabetes
Although diabetes can not be cured, early diagnosis is very important that diabetes can be addressed. Early detection allows the blood sugar levels of diabetics to control.
The goal of treatment of diabetes is to keep blood sugar levels steady substances and controlling symptoms to avoid complications that may occur. Changing lifestyles also can control the symptoms of type 2 diabetes, for example by implementing a healthy diet.
But this type of diabetes is a progressive disease. Therefore, patients with type 2 diabetes will usually require medication to keep blood sugar levels steady substances. The treatment process generally begins with the drug in tablet form that can then be followed by an injection therapy, such as insulin.
Complications caused by diabetes
Diabetes can lead to a number of complications if neglected. Levels of substances of high blood sugar can cause damage to blood vessels, nerves, and organs. Increased sugar levels without triggering mild symptoms can lead to long-term impact.
Suggestions Beneficial for Patients with Diabetes
Patients with type 2 diabetes should carefully maintain health. Through a health monitoring, treatment process will go more smoothly undertaken patients, as well as to minimize the risk of complications. The following steps can also be helpful for diabetics.
Suffered Diabetes Pregnancy
- Applying a healthy diet and balanced .
- Regularly in sports .
- Limiting consumption of liquor .
- Quit smoking. ( read also :dangers-of-tobacco-cigarettes-for )
Diabetes can also be experienced by pregnant women . This happens because the woman during pregnancy sometimes have blood sugars levels were very high during pregnancy , so the body can not produce enough insulin to absorb it.
This type of diabetes known as gestational diabetes occurs in about one in 20 pregnant women and generally will recover after the baby is born . But the risk of developing type 2 diabetes is higher ( about three times ) in women who have had gestational diabetes .
Diabetes in pregnancy can increase the risk of health complications in the fetus . Because it is very important for people with diabetes who are pregnant to balance blood sugar levels.
Symptoms of Type 2 Diabetes
Common symptoms of diabetes are similar to Type 1 and Type 2 are:
Frequent urination, especially at night.Other symptoms of diabetes are:
Frequent thirst and frequent tiredness.
Decreased muscle mass.
Weight loss.
The itching and yeast infections in the vagina or penis.The severity of symptoms experienced every patient is different. Moreover, not all people experience the symptoms above.
Blurred vision due to dry eye lens.
Infection of the skin.
The early symptoms of type 2 diabetes tend to be mild. Therefore, many sufferers are often unaware that they are contracting the disease for many years.
Diagnosis and treatment of early diabetes can reduce the risk of complications. Consult your doctor immediately if you experience symptoms of diabetes.
Levels Too High blood sugar (hyperglycaemia)
Type 2 diabetes is caused by lack of insulin production from the pancreas or the cells of the body less sensitive to insulin. As a result, blood sugar levels can increase dramatically.
Blood sugar levels that are too high (hyperglycemia) can occur for several reasons such as eating too much, the decline in health, or lack of the administered dose. The main symptoms of hyperglycemia include:
Causes of Type 2 Diabetes
- dry mouth
- Feeling very thirsty
- Sleepy
- blurred vision
- Frequent urination
- Dizzy
Type 2 diabetes occurs when the pancreas in a patient's body does not produce enough insulin to maintain normal blood sugar levels. Other causes are the cells of the body becomes less sensitive to insulin, which is known as insulin resistance
Blood sugar levels are normally controlled by the hormone insulin produced by the pancreas. Insulin serves to move sugar from the blood into body cells which will convert it into energy.
The risk factors behind the lack of insulin production by the pancreas in type 2 diabetes are over the age of 40 years, are obese, have a family member with the same disease, as well as ethnic Asian. Here's a complete explanation.
Type 2 Diabetes and Age Factor
One of the main risk factors for type 2 diabetes is age. The risk of developing this type of diabetes will be higher with age. This may occur because the weight tends to increase and frequency of exercise decreases as we get older.
Applying a healthy and balanced diet and regular exercise can help you to maintain a healthy weight. It can also prevent and deal with diabetes.
Type 2 diabetes usually develops in people over the age of 40 years. We were ethnically Asia even have a risk of developing diabetes at a younger age.
Diabetes Type 2 and Factor Descendants
Descendants also included a major risk factor for diabetes type 2. Have a family member (especially a nuclear family such as father, mother, siblings) who suffer from diabetes will increase your risk. Risks for children with a parent with type 2 diabetes are also third higher for developing diabetes.
Effects of Type 2 Diabetes and Weight Loss
The condition of being overweight or obese is determined by the number of body mass index of 30 or more. The risk of type 2 diabetes is higher in people who have the condition because the accumulation of fat.
Fat around the abdomen will increase the risk for you because it can release chemical compounds that would disrupt the cardiovascular system and metabolism. This will increase your risk of health problems, including heart attack, stroke, and some types of cancer.
Measuring waist to check fat in the abdomen (high-risk obesity) is the fastest way to measure your diabetes risk. Who have a higher risk for developing type 2 diabetes are:
Women with a waist size of 80 cm or more.If you belong to one of the above categories, you are encouraged to reduce your weight by 5% and regular exercise. Both of these factors can reduce by half the risk of developing diabetes.
Asian men with a waist size of 90 cm or more.
Type 2 Diabetes and Ethnic Factors
The risk of type 2 diabetes is higher stalks us who are ethnically Asian. Besides the risk of complications, such as heart disease, are also more vulnerable to attack people are ethnically Asian at a younger age.
Risk Factors for Type 2 Diabetes Else
The risk of type 2 diabetes may also increase if the person is suffering from impaired fasting glucose ( IFG ) or impaired glucose tolerance ( IGT ) . The condition is sometimes called pre - diabetes , which means blood sugar levels than normal , but not yet reached the stage of diabetes . The level of IFG and IGT should still watch out because it can develop into diabetes Jike trend continues .
Diagnosis of Type 2 Diabetes
Early diagnosis is very important as a step that diabetes can be addressed immediately. If you experience symptoms of diabetes, you should immediately consult a doctor.
Sampling Urine and Blood Samples
You will be asked to describe your symptoms and advised to undergo regular blood and urine tests. Your urine sample will be tested to check the sugar content. Normal urine contains no sugar (diabetes), but these substances can accumulate and flow to the kidneys and urine if you are suffering from diabetes.
If there is sugar in urine, you will normally be advised to undergo a blood test to confirm the diagnosis of diabetes.
Oral Glucose Tolerance Test To Evaluate Insulin Activity in the Body
Your blood samples are generally taken twice, namely glucose fasting and two hours after a meal. Blood samples for fasting glucose test will be done in the morning after you eat and drink fasting for 8-12 hours. You are also advised not to take certain drugs that can affect test results.
Then you will be given a sugar solution with pre-determined levels. Exactly two hours later, a blood sample is taken you will come back for a glucose test in order to evaluate the activity of insulin in the body.
Results Test Your Blood Sugar Levels
Your sugar levels will be known from the results of an oral glucose tolerance test (fasting glucose test and the glucose test two hours after drinking the sugar solution). The figure will determine whether you suffer from impaired glucose tolerance or diabetes.
Milligrams / deciliter or commonly abbreviated as mg / dL is the unit for blood sugar levels that are used in general in Indonesia. The dose of normal blood sugar are:
80-100 mg / dL before meals.Dose blood sugar in people with impaired glucose tolerance are:
80-144 mg / dL after meals (checked exactly two hours after eating).
108-126 mg / dL before eat.Changes in lifestyle would be advisable if the test results indicate you are suffering from impaired glucose tolerance. The doctor also might give drugs to lower your blood sugar levels.
142-198 mg / dL after meal (checked exactly two hours after eating).
The dose of blood sugar for people with diabetes are:
More than 126 mg / dL before eat.If the test results indicate you have diabetes , your doctor may give you medicines to reduce and balance your blood sugar levels .
More than 198 mg / dL after meal (checked exactly two hours after eating).
Treatment of Type 2 Diabetes
Although diabetes can not be cured, early detection allows the blood sugar levels of diabetics can be controlled. This is done so that blood sugar levels remain within normal limits and the symptoms can be controlled to prevent complications that might occur.
The doctor will explain the disease in detail, helping you to understand the treatment process, as well as monitoring other diseases that can happen to you. The goal of treatment of diabetes is to maintain blood sugar levels and minimize the risk of complications.
Patients with type 2 diabetes are encouraged to maintain the health carefully. But you should not feel discouraged because the doctor can help you in the process of treatment can you live. Do not hesitate to ask for help with family or friends.
Starting a Healthy Lifestyle
Early treatment is generally applied to patients with type 2 diabetes is to make lifestyle changes. For example, a healthy diet, regular exercise, and weight loss for those who are overweight or obese (body mass index 30 or greater).
This initial step will be very effective for treating type 2 diabetes at an early stage and can help the treatment process if done with discipline and meticulous.
Drugs for Lowering Blood Sugar Levels
Type 2 diabetes is a progressive disease that generally can get worse. Keeping a diet and regular exercise alone may not be enough to control blood sugar levels of patients completely.
People with this type of diabetes will eventually need drugs to lower blood sugar levels are high. The treatment process generally begins with the drug in tablet form and sometimes with a combination of more than one type of tablet. Then followed with insulin or other medications given by injection.
Monitoring Blood Sugar Levels
HbA1c tests
People with diabetes are encouraged to undergo a blood sugar concentration in every 2-3 months. This examination will show the level of blood sugar levels in recent months, and the effectiveness of your treatment.
When the body is processing the sugar, blood sugar automatically attaches itself to hemoglobin. The higher levels of sugar in the blood, the more hemoglobin linked with glucose and hemoglobin is called HbA1c. HbA1c test measures the amount of hemoglobin that contains glucose.
If you have high blood sugar levels during the last 2-3 months, HbA1c results will show a high rate as an indication. Because it's kind of your treatment may need to be changed. Normal reference value for HbA1c diabetes is below 6.5%.
How to monitor blood sugar levels of our own?Drugs the Right to Overcome Diabetes Type 2
A healthy diet, exercising, and taking medication or insulin therapy will help you to maintain the balance of blood sugar levels. But other diseases and stress can also be influential. Another factor that might have an impact on your blood sugar levels are:
Undergo laboratory examination once every 2-6 months is important for people with diabetes type 2. In addition, patients are also recommended to monitor blood sugar levels by testing themselves at home.
- Consumption of liquor.
- Taking the other drugs.
- Hormonal changes during the menstrual cycle.
Home inspection can be performed with this assay blood sugar levels are small. This tool can be used to detect the rise and fall of blood sugar levels.
Blood sugar levels usually is not always the same throughout the day and can be affected by your treatment process. Then you are recommended to check it several times a day. Regular monitoring will help you to keep his balance.
The unit of measure for blood sugar levels that are used in general in Indonesia is milligrams / deciliter or commonly abbreviated as mg / dL. You should make sure the unit first when buying a blood sugar test kits.
Blood sugar levels in each person is different, but the normal reference is:
- 72-108 mg / dL before meals.
- 180 mg / dL two hours after eating.
Balance blood sugar levels in diabetes sometimes can not be maintained properly only through the application of a healthy diet and regular exercise. You may also need medications to handle it.
There are several types of medications (usually in tablet form) that can be used for type 2 diabetes, you may be given a combination of two types or more drugs to control your blood sugar levels.
Metformin to decrease blood sugar levels
Metformin works by reducing sugar content which is distributed to the liver blood flow and make the body more responsive to insulin. This is the first drug that is often recommended for people with type 2 diabetes.
In contrast to other drugs, metformin does not cause weight gain. Therefore this drug is usually given to patients who are overweight.
But metformin can sometimes cause mild side effects, such as nausea and diarrhea. Doctors also would not advocate this drug for diabetics who had kidney problems.
Sulfonylureas to increase insulin production in the pancreas
Sulfonylureas serves to increase insulin production in the pancreas. People with diabetes who can not take metformin or not overweight may be given this drug. If metformin is less effective in controlling your blood sugar levels, your doctor may be combined with sulfonylureas. Examples of these drugs are:
Sulfonylureas will increase insulin levels in the body so that it can increase the risk of hypoglycemia if any use. In addition, these drugs have side effects as follows:
- glimepiride
- glibenclamide
- Glipizide
- gliclazide
- Gliquidone
- Weight gain
- Nausea and vomiting
- Diarrhea
Glitazone (thiazolidinedione) as a trigger to insulin
Glitazone (eg, pioglitazone) usually in combination with metformin, a sulfonylurea, or both. This drug functions make body cells more sensitive to insulin so that the more sugar is removed from the blood.
These drugs can cause weight gain and swelling of the ankles. It is not recommended to take pioglitazone if heart failure or at risk of fracture.
In some countries, risoglitazone which is one of the glitazone drugs have been withdrawn from the market because it is proven to increase the risk of heart disease such as heart attack and heart failure. If consumed, consult potential side effects with your doctor.
Gliptin (dipeptidyl peptidase-4 inhibitor) for the prevention of GLP-1 solution
Gliptin or DPP-4 inhibitors prevent the breakdown of the hormone GLP-1 (glucagon-like peptide-1). GLP-1 is a hormone that plays a role in the production of insulin when blood sugar is high. Thus, gliptin help raise the level of insulin when blood sugar levels rise.
Gliptin (eg, linagliptin, saxagliptin, sitagliptin and vildagliptin) can inhibit the increase in high blood sugar levels without causing hypoglycemia. These drugs do not cause weight gain and are usually given if the patient can not take a sulfonylurea or a glitazone, or combined with both.
GLP-1 agonist as a trigger insulin without the risk of hypoglycaemia
Exenatide is a GLP-1 agonist with a performance similar to the natural hormone GLP-1. The drug is administered by injection twice a day. Exenatide can trigger the production of insulin when blood sugar levels increase without the risk of hypoglycaemia.
Most diabetics who take exenatide may also experience weight loss. These drugs are given to people with diabetes who are taking metformin and sulfonylurea and obese.
Type of other GLP-1 agonist liraglutide is injected once a day. Studies have shown that these drugs can also lose weight. Liraglutide also commonly given to people with diabetes who are taking metformin and sulfonylurea and obese.
Acarbose to slow the digestion of carbohydrates
Acarbose slows the digestion of carbohydrates into sugar in the body. These drugs prevent the increase in blood sugar levels of diabetics too soon after eating.
These drugs can cause side effects diarrhea and flatulence so rarely used to treat type 2 diabetes, but doctors still would provide it if the patient is not fit to drink other drugs.
Nateglinide and repaglinide to release insulin into the bloodstream
Both of these drugs stimulate the pancreas to release more insulin into the bloodstream. Function nateglinide and repaglinide can not last long, but effective when taken before meals. So although rarely used, both recommended if the patient has a feeding schedule during the hours are not uncommon.
All drugs have side effects remain, including nateglinide and repaglinide. The side effects of these two drugs is hypoglycemia and weight gain.
Insulin therapy as a companion to other drugs
Drugs in tablet form can be less effective for treating diabetes so you need insulin therapy. This therapy can be given in place of or in conjunction with drugs above, but depending on the dosage and how to use it. There are several types of insulin that can be used. Among them:
- Rapid-acting insulin that does not last long, but reacted quickly.
- Short-acting insulin that can last up to eight hours.
- Long-acting insulin that can last one day.
Treatment for diabetes is also possible to use a combination of the types of insulin at the top.
Doing injections of insulin for yourselfHow to cope with hypoglycemia (blood sugar levels are too low)
Insulin administration are generally by injection for insulin will be digested in the stomach and can not enter into the blood when taken in tablet form.
The doctor will explain when you need to use insulin. In the early stages of use, the doctor will usually help you to inject insulin. Furthermore, you are taught how to inject insulin and store and dispose of needles safely.
There are two common methods used to inject insulin, namely through a needle and syringe or pen. Diabetics generally need 2-4 injections per day. The doctor or nurse will also teach how to use the close friends or family.
Patients with type 2 diabetes generally use insulin or certain types of tablets to control blood sugar levels. The treatment method has the risk of causing hypoglycemia.
When your blood sugar is too low, you will experience hypoglycemia. The symptoms include feeling weak, trembling, and hungry. This condition can be overcome by eating foods or sugary drinks.
An initial treatment for diabetics who experience hypoglycemia is to eat carbohydrates (sugary drinks or glucose tablets) that can be absorbed quickly. After that the patient should consume carbohydrates that can last longer as a wafer, a sandwich, or a fruit.
The steps above are generally able to increase blood sugar levels back to normal. But this process could take several hours.
Severe hypoglycemia will lead diabetics to feel dazed, sleepy, even loss of consciousness. If you have this condition, people with diabetes should be given an injection of glucagon (a hormone that can raise blood sugar levels quickly) directly on the muscle or vein. The doctor can teach you how to injection on your family or close friends.
Alternatives in the treatment of type 2 diabetics
Patients with type 2 diabetes have a higher risk of complications (heart disease, stroke, or kidney disease). Therefore your doctor will usually suggest the following drugs to reduce the risk of complications, namely:
- Statins (eg, simvastatin) to reduce high cholesterol levels.
- High blood pressure-lowering drugs.
- ACE inhibitor drugs, such as lisinopril, enalapril, ramipril or, if there is an indication of diabetic kidney disease. Progression of the disease is characterized by the protein albumin in the urine can be cured if treated immediately.
Complications of Type 2 Diabetes
High blood sugar levels can damage blood vessels, nerves, and organs. Ultimately diabetes can lead to complications if not treated properly. Increased blood sugar levels are not significant and although not trigger any symptoms can result in long-term basis.
Complications Causes Heart Disease and Stroke
Diabetics have five times higher risk of developing heart disease or stroke. Balance blood sugar levels that are left unguarded in a long time can increase the risk of atherosclerosis, the narrowing of blood vessels that usually occurs as a result of the accumulation of cholesterol. This complication has risks as follows:
Causing a heart attack or stroke due to increased risk of blood vessel blockage in the heart or brain.
Obstructing blood flow to the heart and cause an attack of angina (wind seated). Angina attacks indicated the presence of chest pain that feels oppressive.
Damage Causing Complications Neuropathy (Nerve)
Excessive blood sugar levels can damage nerves and blood vessels smooth. This can cause a tingling or burning sensation usually starts from the tip of the fingers and toes and spread to other body parts. In addition, neurological complications can make the legs become numb so it does not hurt when hurt and eventually lead to ulcers. The nerve damage that attack the digestive system can cause nausea, vomiting, diarrhea, or constipation.
Complications Causing Organ Damage to Leg
Damage to the nerves or blood flow inhibition on diabetic foot can increase the risk of health complications legs usually late realized. There are about 10% of people with diabetes who have a serious infection due to injuries or just a small scratch on the leg.
Patients who have suffered nerve damage should consult their feet every day and consult on perceived changes to the physician. Complications in the legs that should watch out for include:
- Swelling.
- Skin that feels hot to the touch.
- Wounds that do not heal.
Your feet checked by a doctor regularly every year.
Complications Cause Retinal Damage
Retinopathy occurs when there are problems with blood vessels in the retina (the network of the eye that is sensitive to light) that can lead to blindness if left unchecked. The blood vessels can leak, clogged, or grow randomly and thus block the light to reach the retina.
Do a routine eye examination every year. If no serious damage, you will be referred to the ophthalmologist to be addressed immediately. Balance blood sugar levels are maintained properly can reduce your risk.
Diabetic retinopathy is detected early can be treated with laser surgery. But this treatment only aims to maintain the remaining power of vision and not a cure.
Complications Cause Kidney Damage
Kidneys have millions of fine blood vessels that filter wastes from the blood. If the fine blood vessels are blocked or leaking, your kidneys may decrease performance. These complications usually associated with high blood pressure. It is important to choose the right treatment.
Severe damage to the kidney may even lead to kidney failure. If you are experiencing kidney failure, you need dialysis (a treatment process that mimics the function of the kidney) or even a kidney transplant.
Complications Cause Sexual Dysfunction
Damage to small blood vessels and nerves in the diabetic men (especially smokers) can lead to erectile dysfunction. These disorders can usually be solved with drugs.
Diabetics can also experience female sexual dysfunction, for example:
- Decreased sexual satisfaction.
- Lack of sex drive.
- Vaginal dryness.
- Pain during intercourse.
- Failure to attain orgasm.
People with diabetes are women who experience vaginal fluid deficiency or pain during intercourse can use lubricants or gels.
Miscarriages and Birth Death
High blood sugar levels can be harmful to the mother and fetus . The risk of miscarriage and stillbirth increases when diabetes in pregnant women are not handled carefully. Blood sugar levels are not maintained properly during early pregnancy can also increase the risk of birth defects .
Pregnant women with diabetes are encouraged to regularly check the condition of diabetes to the obstetrician , hospital , or clinic . This will facilitate the regular consultation the doctor to monitor blood sugar levels of the mother , including controlling the insulin dose should be given , and the development of the fetus
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