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Diabetes Medicines

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

type 1 diabetestype 2 diabetes

What are the treatments for diabetes?

Treatments for diabetes can depend on the type. Common treatments include a diabetic meal plan, regular physical activity, and medicines. Some less common treatments are weight loss surgery for either type and an artificial pancreas or pancreatic islet transplantation for some people with type 1 diabetes.

Who needs diabetes medicines?

People with type 1 diabetes need to take a diabetes medicine called insulin to control their blood sugar.

Some people with type 2 diabetes can control their blood sugar with healthy food choices and physical activity. But for others, a diabetic meal plan and physical activity are not enough. They need to take diabetes medicines.

The kind of medicine you take depends on your type of diabetes, daily schedule, medicine costs, and any other health conditions that you have. Over time, you may need to take more than one diabetes medicine.

What are the types of medicines for type 1 diabetes?

If you have type 1 diabetes, you must take insulin because your body no longer makes it. There are different types of insulin that start to work at different speeds, and the effects of each last a different length of time. Your health care provider will measure your blood glucose to decide on the type of insulin. You may need to use more than one type.

You will also need to check your blood sugar at home. Your provider will tell you how often. The results of your blood sugar testing can help you make decisions about food, physical activity, and medicines.

You can take insulin several different ways. The most common are with a needle and syringe, an insulin pen, or an insulin pump. If you use a needle and syringe or a pen, you have to take insulin several times during the day, including with meals. An insulin pump gives you small, steady doses throughout the day. Less common ways to take insulin include inhalers, injection ports, and jet injectors.

In rare cases, taking insulin alone might not be enough to manage your blood sugar. Then you would need to take another diabetes medicine.

What are the types of medicines for type 2 diabetes?

There are several different medicines for type 2 diabetes. Each works in a different way. Many of them are pills. There are also medicines that you inject under your skin, such as insulin.

Over time, you may need more than one diabetes medicine to manage your blood sugar. You might add another diabetes medicine or switch to a combination medicine. A combination medicine contains more than one type of diabetes medicine in the same pill. Some people with type 2 diabetes take both pills and injections.

Even if you don't usually take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.

What else should I know about taking medicines for diabetes?

Even if you take medicines for diabetes, you still need to eat a healthy diet, stop smoking, take your other medicines, and get regular physical activity. These will help you manage your diabetes.

It is important to make sure that you understand your diabetes treatment plan. Talk to your provider about:

  • What your target blood sugar level is
  • What to do if your blood sugar gets too low or too high
  • Whether your diabetes medicines will affect other medicines you take
  • If you will have any side effects from the diabetes medicines

You should not change or stop your diabetes medicines on your own. Talk to your provider first.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Diet

What is diabetes?

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose builds up in your blood and causes high blood sugar levels.

Prediabetes means that your blood sugar levels are higher than normal but not high enough to be called diabetes. If you have prediabetes, you are more likely to develop type 2 diabetes.

How do the foods I eat affect my blood sugar levels?

The sugar in your blood comes from certain foods called carbohydrates, or "carbs." Foods that are high in carbs include candy and sweets, sodas, breads, tortillas, and white rice. The more carbs you eat, the higher your blood sugar level will be.

Whether you have type 1 or type 2 diabetes, making the right food choices is an important way to keep your blood sugar at a healthy level. When you control your blood sugar, you lower your chance of having serious health problems from diabetes, such as vision loss and heart problems.

And if you have prediabetes or are at risk for diabetes, eating foods that keep your blood sugar levels healthy may help prevent type 2 diabetes later on.

What's the best diet for diabetes?

There isn't a specific diet or meal plan that works for everybody. Your health care provider may have you see a registered dietician (RD) or a diabetes educator who can help design the best eating plan for you. The plan will consider:

  • Any medicines that you take
  • Your weight
  • Any other health conditions you have
  • Your lifestyle and tastes
  • Your goals

All eating plans for diabetes have a few things in common, including eating the right foods in the right amounts at the right times.

What foods should I eat if I have diabetes?

Eating the right foods for diabetes means eating a variety of healthy foods from all the food groups:

  • Fruits and vegetables
  • Whole grains, such as whole wheat, brown rice, barley, quinoa, and oats
  • Proteins, such as lean meats, chicken, turkey, fish, eggs, nuts, beans, lentils, and tofu
  • Nonfat or low-fat dairy, such as milk, yogurt, and cheese
What foods should I limit to control my blood sugar?

To keep your blood sugar under control, you may need to cut back on foods and drinks that are high in carbs. This doesn't mean that you can never enjoy them. But you will need to have them less often or in smaller amounts.

The high-carb foods and drinks you should limit include:

  • Sugary foods, such as candy, cookies, cake, ice cream, sweetened cereals, and canned fruits with added sugar
  • Drinks with added sugars, such as juice, regular soda, and regular sports or energy drinks
  • White rice, tortillas, breads and pasta - especially those made with white flour
  • Starchy vegetables, such as white potatoes, corn, and peas

You may also need to limit how much alcohol you drink, as well as how much fat and salt you eat.

What else do I need to know about diabetic diets?

If you have diabetes, it's important to eat the right amount of food every day. Your eating plan will include how much to eat, so that you get the right amount of carbs in each meal or snack. You'll learn how to count carbs and measure your food.

Eating at the right times is also important. You will want to plan for regular, balanced meals to avoid high or low blood sugar levels. Eating about the same amount of carbs at each meal can be helpful.

Your eating plan will also teach you how to stick with your plan at home and when you eat out.

Eating healthy to control your blood sugar does take some effort. But the reward is a chance to live your healthiest life with diabetes.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Foot

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

With type 1 diabetes, your body doesn't make insulin. With type 2 diabetes, your body doesn't make or use insulin well. Without enough insulin, glucose can't get into your cells as quickly as usual. The glucose builds up in your blood and causes high blood sugar levels.

How does diabetes cause foot problems?

Foot problems are common in people with diabetes. They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy, can cause numbness, tingling, pain, or a loss of feeling in your feet.

If you can't feel pain, you may not know when you have a cut, blister, or ulcer (open sore) on your foot. A wound like that could get infected. The infection may not heal well because the damaged blood vessels can cause poor blood flow in your feet.

Having an infection and poor blood flow can lead to gangrene. That means the muscle, skin, and other tissues start to die. If you have gangrene or a foot ulcer that does not get better with treatment, you may need an amputation. This is a surgery to cut off your damaged toe, foot, or part of your leg. It may prevent a bad infection from spreading and could save your life.

But there's a lot you can do to prevent a foot wound from becoming a major health problem.

How can I protect my feet if I have diabetes?

The best way to protect your feet is by controlling your blood sugar levels every day. This will help keep nerve and blood vessel damage from getting worse. The next step is to keep the skin of your feet healthy.

Good foot care for people with diabetes includes:

  • Checking your feet every day. Look for cuts, redness, and other changes in the skin and toenails, including warts or other spots that your shoes could rub. Make sure to check the bottoms of your feet too.
  • Washing your feet every day. Use warm water and soap. Don't soak your feet because that can dry out your skin. After you dry your feet, you can use talcum powder or cornstarch between your toes. They soak up moisture that can cause infection. If you use lotion, don't apply it between your toes.
  • Asking your doctor how to remove corns and calluses safely. Thick skin on your feet can rub and lead to sores. But removing it the wrong way could damage your skin. So you don't want to cut the skin or use medicated pads or liquid removers.
  • Trimming your toenails straight across with a clipper. If it's hard for you to trim your own toenails, or if they're thick or curve into the skin, have a podiatrist (foot doctor) do it for you.
  • Always wearing well-fitting shoes and socks or slippers to protect your feet when walking. You don't want to walk barefoot, even indoors. And be sure your shoes are smooth inside. A seam or pebble could rub your skin raw.
  • Protecting your feet from heat and cold. Use sunscreen on exposed skin and don't walk barefoot at the beach. In cold weather, wear warm socks instead of warming your feet near a heater or fireplace.
  • Keeping the blood flowing in your feet. Put your feet up when you're sitting. Wiggle your toes and circle your feet throughout the day. Don't wear tight socks. And get plenty of activity that's not too hard on the feet, such as walking.
  • Getting your feet checked at your health care visits. Even if you haven't noticed a problem, it's good to have your health care provider look at your feet.
When should I see my health care provider about diabetic foot problems?

Serious foot problems can develop quickly. See your health care provider right away if you notice:

  • A cut, blister, or bruise on your feet that doesn't start to heal in a few days
  • Red, warm, or painful skin on your feet
  • A callus with dried blood inside
  • A foot infection that becomes black and smells bad that could be gangrene

Remember, controlling your blood sugar and caring for your feet every day are the best steps you can take to prevent serious diabetic foot problems.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Diabetic Nerve Problems

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage the covering on your nerves or the blood vessels that bring oxygen to your nerves. Damaged nerves may stop sending messages, or may send messages slowly or at the wrong times.

This damage is called diabetic neuropathy. Over half of people with diabetes get it. Symptoms may include:

  • Numbness in your hands, legs, or feet
  • Shooting pains, burning, or tingling
  • Nausea, vomiting, constipation, or diarrhea
  • Problems with sexual function
  • Urinary problems
  • Dizziness when you change positions quickly

Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. Controlling your blood sugar can help prevent nerve problems, or keep them from getting worse. Treatment may include pain relief and other medicines.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Medical Ethics

The field of ethics studies principles of right and wrong. There is hardly an area in medicine that doesn't have an ethical aspect. For example, there are ethical issues relating to :

  • End of life care: Should a patient receive nutrition? What about advance directives and resuscitation orders?
  • Abortion: When does life begin? Is it ethical to terminate a pregnancy with a birth defect?
  • Genetic and prenatal testing: What happens if you are a carrier of a defect? What if testing shows that your unborn baby has a defect?
  • Birth control: Should it be available to minors?
  • Is it ethical to harvest embryonic stem cells to treat diseases?
  • Organ donation: Must a relative donate an organ to a sick relative?
  • Your personal health information: who has access to your records?
  • Patient rights: Do you have the right to refuse treatment?
  • When you talk with your doctor, is it ethical for her to withhold information from you or your family?