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Diabetes Prevention: Taking Control

Terri Ackerman

Last updated: October 20, 2016 7:24 pm

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According to the National Diabetes Education Program, more than 29 million Americans nationwide have diabetes and roughly 86 million Americans 20 years of age and older have prediabetes. Diabetes is a serious disease in and of itself, but it can also lead to other significant health problems, including heart disease, stroke, nerve damage and kidney disease. 1

What Is Prediabetes?

Prediabetes means that a person’s blood glucose (sugar) levels are somewhat higher than normal. If you are diagnosed with this condition, you do not have diabetes. Instead, think of it as a warning. 2

You can take preventative measures if you have been diagnosed with prediabetes, such as losing weight, engaging in physical activity, and reducing overall fat and caloric intake to lower your blood glucose levels so that you don’t develop type 2 diabetes. Left unchecked, high glucose levels can lead not only to a diagnosis of diabetes but also to many possible complications, such as a heart attack or stroke. 3

What Is Diabetes Mellitus?

According to the Cleveland Clinic, diabetes mellitus, which is often simply called “diabetes,” is a disease that affects the pancreas. This organ, which is located behind your stomach, produces insulin, a hormone. Insulin aids in processing sugar (glucose) for energy. 4

People with diabetes mellitus have a pancreas that doesn’t function normally. In some cases, the pancreas doesn’t produce enough insulin. In other cases, the insulin doesn’t function correctly or insufficient amounts are produced; glucose remains in the bloodstream and cannot enter the body’s cells efficiently to be used as energy. 5

Type 1 Diabetes

In type 1 diabetes, the cells in the pancreas that create insulin are damaged. Little or no insulin is produced to help the body metabolize glucose to fuel the body’s cells to create energy. Those with type 1 diabetes must take insulin injections to manage their blood glucose levels. 6

Type 2 Diabetes

Often linked to obesity, with type 2 diabetes the pancreas makes insulin, but it isn’t enough or does not work correctly. Sometimes, diet, exercise and weight management can keep a person’s blood glucose levels in a healthy range. 7

Diabetes Mellitus Prevention: Tips for Long-Term Health

A variety of sources, including the Mayo Clinic, the American Diabetes Association, and the Centers for Disease Control and Prevention have offered the following guidelines to help you prevent diabetes mellitus. 8

  1. Aim to exercise at a moderate intensity for 30 minutes, five days a week or more. Both resistance training and aerobic exercise provide benefits.
  2. Eat a healthy diet high in fiber, including fruits, vegetables, nuts and seeds, beans, and whole grains. Avoid fad diets. At first, you may lose weight, but the overall long-term effects are unknown. It’s best to eat a variety of foods that offer various nutrients and simply control the portions you eat.
  3. If you’re overweight, lose a few extra pounds. Just 10 to 15 pounds can make a big difference. 9

Types of Diabetes Mellitus Medications

According to the American Diabetes Association, there are a variety of types, or classes, of diabetes medications. Each type works in a different way, with the overall goal of lowering your blood glucose (sugar) level. 10 They include:

  • Sulfonylureas
  • Biguanides
  • Meglitinides
  • Thiazolidinediones, including Avandia and Actos
  • DPP-4 inhibitors, including Januvia, Onglyza, Tradjenta, and Nesina
  • SGLT2 inhibitors, including Invokana and Farxiga
  • Alpha-glucosidase inhibitors, including Precose and Glyset
  • Bile Acid Sequestrants, including Welchol

The National Institute of Diabetes and Digestive and Kidney Diseases provides a list of questions to ask your doctor regarding your diabetes medications. Questions include, What are the names of my medications and what do they do? When, what dosage, and how often do I need to take these mediations. What side effects are possible? 11

SGLT2 Inhibitors Side Effects

According to the American Diabetes Association, two common side effects of SGLT2 (sodium-glucose cotransporter-2) inhibitors include urinary tract and yeast infections. 12 A more serious condition called ketoacidosis can also develop, according to the U.S. Food and Drug Administration. Just recently, the agency issued a safety warning regarding this safety issue. 13

FDA Issues Diabetes Drug Warning for Class

The U.S. Food and Drug Administration (FDA) has issued an official warning about certain type 2 diabetes medications. “Canagliflozin, dapagliflozin, and empagliflozin may lead to ketoacidosis, a serious condition where the body produces high levels of blood acids called ketones that may require hospitalization.” 14

This class of drugs, SGLT2 inhibitors, is intended to be used to lower blood sugar in addition to diet and exercise because it causes “the kidneys to remove sugar from the body through the urine.” 15

If you are taking an SGLT2 inhibitor, including the medications Invokana, Invokamet, Farxiga, Xigduo XR, Jardiance and Glyxambi, the FDA instructs that “Patients should pay close attention for any signs of ketoacidosis and seek medical attention immediately if they experience symptoms such as difficulty breathing, nausea, vomiting, abdominal pain, confusion and unusual fatigue or sleepiness.” 16

Diabetic Ketoacidosis Treatment

According to the Mayo Clinic, if you develop diabetic ketoacidosis may need to be treated either in the emergency room or in the hospital itself. Your health care professionals may provide the following general types of treatment:

  1. Replace lost fluids.
  2. Replace your electrolytes, which are minerals such as sodium, potassium and chloride. Minerals such as these help your heart, muscles and nerve cells function in a healthy way.
  3. Provide insulin therapy so that your blood glucose level returns to normal. 17
  1. http://ndep.nih.gov/am-i-at-risk/diabetesispreventable.aspx 

  2. http://ndep.nih.gov/am-i-at-risk/diabetesispreventable.aspx 

  3. http://ndep.nih.gov/am-i-at-risk/diabetesispreventable.aspx 

  4. http://my.clevelandclinic.org/health/diseases_conditions/hic_Diabetes_Basics/hic_Diabetes_Mellitus_An_Overview 

  5. http://my.clevelandclinic.org/health/diseases_conditions/hic_Diabetes_Basics/hic_Diabetes_Mellitus_An_Overview 

  6. http://my.clevelandclinic.org/health/diseases_conditions/hic_Diabetes_Basics/hic_Diabetes_Mellitus_An_Overview 

  7. http://my.clevelandclinic.org/health/diseases_conditions/hic_Diabetes_Basics/hic_Diabetes_Mellitus_An_Overview; http://www.cdc.gov/diabetes/home/ 

  8. http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-prevention/art-20047639; http://www.cdc.gov/diabetes/basics/prevention.html; http://www.diabetes.org/are-you-at-risk/lower-your-risk/  

  9. http://www.diabetes.org/are-you-at-risk/lower-your-risk/overweight.html 

  10. http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/oral-medications/what-are-my-options.html 

  11. http://www.niddk.nih.gov/health-information/health-topics/Diabetes/diabetes-medicines/Pages/index.aspx; http://www.niddk.nih.gov/health-information/health-topics/Diabetes/diabetes-medicines/Pages/insert_B.aspx 

  12. http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/oral-medications/what-are-my-options.html 

  13. http://www.fda.gov/Drugs/DrugSafety/ucm446845.htm 

  14. http://www.fda.gov/Drugs/DrugSafety/ucm446845.htm 

  15. http://www.fda.gov/Drugs/DrugSafety/ucm446845.htm 

  16. http://www.fda.gov/Drugs/DrugSafety/ucm446845.htm; http://jama.jamanetwork.com/article.aspx?articleid=2382957  

  17. http://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/basics/treatment/con-20026470