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Diabetes- An Overview and the Latest Approaches

Diabetes is a condition in which an individual has high blood sugar (blood glucose). Glucose is the source of energy in the body. People get glucose from food and from muscles and liver secretions. Insulin is a hormone, produced by the pancreas. Insulin aids in getting glucose into the cells of a person.

Types of Diabetes

There are three major types of diabetes: gestational, type 1 and type 2 diabetes.

Type 1 diabetes
It occurs mostly in young people though it can also develop in adults. A person with type II diabetes either does not make insulin or the insulin produced is not enough. This happens because the immune system of the individual by then has already attacked and destroyed the insulin-producing cells. Such patients receive insulin through injections.

Type 2 diabetes
Previously known as non-insulin dependent or adult onset diabetes, it is found to occur mostly in middle-aged and older people and is the most common type of diabetes. However, people can develop type two at any age; even during childhood. It begins with insulin resistance where muscle, liver cells and fat fail to use insulin to carry glucose into body cells for energy production. Therefore, the body requires more insulin to aid glucose molecules to enter cells. In the beginning, the pancreas can keep up with the new insulin demand. With time, however, the pancreas is unable to make insulin especially when blood glucose increases. At this point, it is important seek treatment.

Gestational diabetes
Some women develop gestational diabetes during the late stages of pregnancy. It is caused either by the pregnancy hormones or shortage of insulin. Although it goes away after the birth of the child, a woman who may have had it and her child are more susceptible to developing diabetes later in life.

Most patients who have type II diabetes once had prediabetes. This is where the blood sugar is high but not enough to meet a diabetes diagnosis.

Symptoms of Diabetes

Typical signs include:

  • Irritability or fatigue
  • Unusual thirst
  • Frequent urination
  • Unusual weight loss

Diabetes is recognized through tests that measure blood sugar levels. Since its symptoms are not easily recognized, people at risk of type 2 diabetes are urged to go through these tests too.

Latest Approach to Diabetes – New Therapy

Traditionally, injection of insulin was the only way of dealing with diabetes. However, new treatments that do not rely on insulin injections have been developed. They include:

Thiazolidinediones (TZDs)
These drugs act be decreasing insulin resistance so as to increase glucose uptake in the liver and muscles. Pioglitazone (Actos) and rosiglitazone (Avandia) are agents under this class that are available in the United States.

Incretin mimetic drugs
They act by preventing the action of dipeptidyl peptidase IV; which does the following: inhibits glucagon secretion, improves insulin sensitivity and undertakes glucose-dependent insulin stimulation. An example of a drug in this category includes Gleeson et al., 2005.

PPAR agonist drugs
Peroxisome proliferator agonist treats lipid and glucose abnormalities related to type II diabetes. These medicines reduce triglycerides and increase HDL levels, and develop insulin resistance. Examples of such drugs include muraglitazar (Pargluva) and tesaglitazar (Galida). The latter is currently in phase three clinical trials.

Amylinometric drugs
Drugs in this class mimic amylin hormone and regulate blood glucose. An example is acetate (Symlin); which received approval by FDA in March 2005.

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