There are three tests that can measure your blood glucose level: fasting glucose test, random glucose test and A1c test.
Welcome back most of us have been in a situation where we go for a random blood test and we actually find abnormalities that we were unaware of if you were one of these individuals who tested your glucose levels and they either came back as being too high or too low you are probably slightly worried management as well as prevention of diabetes is actually critical
This can also then prevent further unwanted complications such as heart attacks strokes amputations kidney damage and much more so today we’ll be discussing the diagnostic procedures management the prevention as well as the prognosis of diabetes let’s now look at the different diagnostic procedures for a patient to have diabetes and we currently have three different
Tests and these are your fasting plasmid glucose test your hba1c as well as your oral glucose tolerance test so let’s first start by looking at your fasting plasmid glucose test this test is best done in the morning after an eight hour fast where you’ve had nothing to eat or drink except a couple sips of water with your random plasma glucose test this test can
Actually be done at any time without the need to follow us the second test is your hba1c test or also otherwise known as your glycated hemoglobin test and this provides your average blood glucose level over the past two to three months this test actually measures the amount of glucose attached to your hemoglobin which is the protein in your red blood cells that
Carries oxygen and for this test you don’t need to fast before and the third test is your oral glucose tolerance test in this test your blood glucose level is first measured often overnight fast then you drink a sugary drink your blood glucose level is then checked at what hours one two and three so exactly would we manage a patient who has diabetes well diabetes
Affects your whole body so the best thing that you can do is to first start off by managing your risk factors and these will include keeping your blood glucose levels within or near a normal level and this will include following a diet plan taking prescribed medication as well as increasing your activity level the second thing you’d want to do is maintain a good
Cholesterol level so when i speak about these cholesterol levels i’m referring to your hdl and your ldl and typically you want to keep them closer to the normal ranges as possible the third thing you want to do is control your blood pressure and your blood pressure should essentially not be over 140 over 90 millimeters of mercury what are the typical glucose
Readings that you’re aiming for before meal as well as after that meal well before meal you’ll aim anywhere between 80 to 130 milligrams per day liter and about two hours after the start of your meal you’ll aim for anything less than 180 milligrams per deciliter let’s move on to the treatment of each type of diabetes we’ll first start by looking at an overview
Within each type and then look at the specific medications and treatment methodologies for each type let’s start by looking at type 1 diabetes in this case you must take insulin every day as your pancreas will no longer make any insulin with type 2 diabetes you will need medications and this will be both for your diabetes and to control any conditions that are
Risk factors for diabetes you’ll also need to combine this with taking insulin improving lifestyle factors such as losing weight your diet and being more physically active with pre-diabetes if you have this your goal is then to keep you from progressing to diabetes and treatments are focused on treatable risk factors such as losing weight by eating a healthy diet
Like the mediterranean diet as well as exercising at least 5 days a week for 30 minutes and finally let’s look at gestational diabetes if you have this type and your glucose stable is not too high your initial treatment might be modifying your diet and getting in regular exercise for the treatment we can either use a couple of the following drugs or insulin let’s
Start by looking at the main drug clauses so if you can follow the quick summary as well as picture on screen we can go through the mechanism of action as well as a couple examples of these drug classes starting with sulfonylureas these drugs typically lower your blood glucose by causing the pancreas to release more insulin an example of this will be glomepyride
Without bigonites these drugs actually reduce how much glucose the liver actually produces and it may also improve how insulin works in the body and slows down the conversion of carbohydrates into sugar an example of this will be metformin otherwise known as glucophage if we look at our glp-1 analogs these drugs typically increase the release of insulin reduce
Glucose release from the liver after meals as well as delay food emptying from the stomach without dpp-4 inhibitors these drugs typically help your pancreas release more insulin after meals they also help to lower the amount of glucose released by the liver without sglt2 inhibitors these drugs typically work on your kidneys to remove glucose in your body through
Your urine and we can also have our bile acids equestrians and these drugs actually lower your cholesterol and your blood sugar levels and finally we also have dopamine agonists and this medication typically lowers the amount of glucose released by the liver throughout our discussion today we’ve actually spoken about insulin quite a bit and there are many different
Types of insulin used to treat your diabetes and these include rapid acting short acting intermediate acting as well as long acting insulin so let’s go through each type and you can follow the summary on the screen as well as the picture on the screen starting with rapid acting insulins these incidents are taken about 15 minutes before meals and they peak in about
One hour and work for another two to four hours examples include insulin less pro as well as insulin asphalt without short acting insulins these insulins take about 30 minutes to reach your bloodstream reach their peaky fix in about two to three hours and last for about three to six hours an example this will include insulin regular without intermediate acting
Insulins these insulins actually reach your bloodstream in about two to four hours peak in four to twelve hours and work for up to 18 hours an example of this will include nph and finally with our long-acting insulins these insulins work to keep your blood sugar stable all day usually these insulins last for about 18 hours an example this will include insulin
Detonate apart from taking your incident and the other medications which we spoke about there are other treatment options for diabetes and these include your two transplantations typically your pancreas transplantation as well as your pancreatic eyelid transplantation and we also have our third type known as your bariatric surgery so let’s quickly look at your
Pancreas transplantation this is possible however getting an organ transplant requires taking immune suppressing drugs for the rest of your life as well as dealing with the side effects of these drugs however if the transplant is successful you’ll likely be able to stop taking insulin if we look at the other type of transplant otherwise known as your pancreatic
Eyelid transplant in this transplant clusters of eyelid cells which are the cells that back insulin are then transplanted from an organ donor into your pancreas to replace those that have been destroyed and finally now let’s look at your bariatric surgery and that is another option which is an indirect treatment for diabetes bariatric surgery is an option if you
Have type 2 diabetes if you’re obese essentially having a bmi of over 35 and if you’re considered a good candidate for this type of surgery much improved blood glucose levels are seen in people who have lost a significant amount of weight so that then concludes today’s lecture i hope you guys have enjoyed it and i shall see you in the next one
Transcribed from video
Diabetes Mellitus Management | UGLY Truth By Vithal Panday M.D.
