وصف
Diabetes mellitus (DM) is a condition marked by poor glucose regulation in the blood. There are numerous subtypes of it, including type 1, type 2, maturity-onset diabetes of the young (MODY), gestational diabetes, neonatal diabetes, and steroid-induced diabetes. The two primary subtypes of DM are type 1 and type 2; each has a unique mechanism, presentation, and therapy, although both can result in hyperglycemia. Diabetes complications might involve microvascular, macrovascular, or neuropathy problems, regardless of the exact type of diabetes. Diabetes has a comprehensive physiology and treatment plan that necessitates numerous interventions for effective disease control.
ملخص
- Post-COVID, there has been a surge in young diabetics. While the correlation between COVID and diabetes remains unclear, this increase is a significant concern that needs to be addressed. Conventional diagnostic criteria for diabetes include fasting blood sugar levels, where less than 110 is non-diabetic, 110-124 is pre-diabetic, and above 124 is diabetic.
- It's crucial to avoid directly jumping to treatment upon initial high blood sugar readings. Confirm the diagnosis with a proper blood sugar test including fasting and postprandial (PP) levels, and glycosylated hemoglobin (HbA1c) to assess average glucose levels over three months. PP testing should involve consuming 75 grams of glucose for accuracy.
- Effective diabetes management involves a combination of diet, exercise, and medication. Physicians should not focus solely on medication but also emphasize diet and exercise. High glycemic index foods like potato and rice should be minimized, while protein and fiber intake should be increased.
- Exercise, even simple steps like 500 after each meal, aids digestion and glucose metabolism. A routine workout schedule should gradually increase from 15 minutes to an hour or more. Maintaining a proper sleep pattern and avoiding prolonged hunger are also important.
- Medication typically starts with metformin, with considerations for kidney function. Glibenclamide is often added alongside metformin for enhanced results. Depending on HbA1c levels, DPP-4 inhibitors like vildagliptin or teneligliptin may also be incorporated. Acarbose can be added if there is high postprandial glucose level and SGLT2 inhibitors such as canagliflozin, empagliflozin, or dapagliflozin can be added, too, if this fails to control the HbA1c.
- In cases of hypertension or deranged lipid profiles in diabetic patients, medication should be started immediately without waiting for lifestyle changes alone to take effect. Regular eye checkups and blood workups, including HbA1c, kidney function tests (KFT), and lipid profiles, are essential.
- Foot care is vital due to potential blood vessel and nerve damage. Prompt treatment of abscesses is necessary to prevent ulcers. If complications arise, consulting an endocrinologist is recommended.
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