Diabetes

What causes diabetes?

Type one diabetes occurs when something – doctors are still unsure what – causes the immune system to attack the pancreas, which is an organ with cells that produce insulin. So the body produces less insulin than it needs. Type one diabetes cannot be prevented, and can develop very quickly.

The cause of type two diabetes is insulin resistance. This means that the body can’t use insulin to process sugars, and so the sugars stay in the blood rather than being converted into energy or stored as fat. This results in high blood sugar levels or hyperglycemia. One effect of consistently high blood sugar levels is damage to the pancreas. This makes it even harder for the body to control blood sugar levels.

What causes insulin resistance?

The mechanism of insulin resistance is poorly understood. But there are certain factors that are linked to insulin resistance. They are:

• obesity
• a diet that is high in calories, carbohydrates and or sugar
• a lifestyle with little physical activity
• stress over a long period
• steroid use over a long period

There is a genetic component to diabetes risk, so if you have a family history of diabetes, you may be at greater risk than average. People of Indigenous, Hispanic, South Asian, Asian or African descent are also at greater risk from diabetes.

Some medical conditions may increase your risk of insulin resistance. They include:

• high blood pressure
• high cholesterol
• mental health disorders
• polycystic ovary syndrome
• Cushing’s disease
• gestational diabetes
• HIV infection
• blood vessel diseases

Some medications can also increase your risk of developing diabetes.

Health Canada has a questionnaire that will help you to assess your risk of developing diabetes.

There are some unfortunate myths floating around about the causes of diabetes. It is not caused by eating too much sugar, and people do not bring diabetes upon themselves through lifestyle choices.

What are the symptoms of diabetes ?

The main symptoms of diabetes are:

• thirst
• needing to urinate at night, and more frequently than you would expect
• frequent episodes of genital thrush or itching
• tiredness
• blurred vision
• weight loss
• muscle loss
• slow healing of cuts

Not every case of diabetes is symptomatic, though, and diabetes type 2 is commonly picked up during tests and screenings for other conditions.

Diabetes and hyperglycemia can cause damage to other parts of your body. It is a major cause of heart disease in Canada, and of blindness and kidney failure. Diabetes causes circulatory problems, and if you have it, you are 20 times more likely to have a lower extremity amputated than the general population. It also causes erectile dysfunction in men.

But diabetes can be managed and treated with medications and lifestyle changes. NX Pharmacies can fill your prescription for diabetes meds and send your meds straight to your home.

If you suspect you might have diabetes, make an appointment with your GP.

How does a doctor diagnose diabetes?

Diabetes is often picked up during a general health check, or while you are being tested for something else. A GP will arrange for tests on your blood and your urine to see if you have diabetes.

What to do if you think you have diabetes

If you suspect you have diabetes, see a GP. You will have the best outcomes if you get your diabetes treated early.

Diabetes is a complex long-term condition with many implications for your health and daily life. It is best to get medical support with managing it. Your GP can give you reliable information about what diabetes is and how to manage it.

The medications used to treat diabetes are not available over the counter from pharmacists. You will need a prescription from a GP or diabetes specialist to get your diabetes meds. You can then get that prescription filled at a pharmacy, like NX Pharmacies.

How will a doctor treat my diabetes ?

Your doctor will talk to you about what diabetes is and how to manage it.

You may need some meds to manage your diabetes. Your GP will prescribe these diabetes meds.

Many people with a new diabetes diagnosis need to change their lifestyle and diet and play an active role in managing their conditions. When you are managing diabetes, it is important to eat appropriate food and maintain good activity levels.

What medications will I get for diabetes?

Not everyone living with diabetes needs to inject insulin. Most people with type 2 diabetes do not use insulin. But if you have type 1 diabetes, it is more likely that you will need to use insulin. Your doctor or a diabetes nurse will show you how to administer insulin, and how to store it. There are online training courses you can use to learn how to use insulin.

Your GP might prescribe medications that lower your blood sugar. There are a lot of choices when it comes to prescribing for diabetes and it can take a while to find a drug, or a combination of drugs and a dose that suits you.

Not everyone has symptoms of diabetes, and so your meds might not make you feel different. It’s important to keep taking diabetes medication even if you think it’s not making a difference to your health.

You may experience side-effects from your diabetes meds. If this happens to you, speak with your doctor, the diabetes nurse or you pharmacist. They can often advise on steps you can take to alleviate the effects of diabetes meds.

Metformin

Metformin is a common diabetes medication. It is also known as Axpinet, Diagemet, Glucient, Glucophage and Metabet. Metformin helps your body to use insulin more efficiently. Take Metformin with a meal.

Sulphonylureas

Your doctor will prescribe sulphonylureas to stimulate the pancreas so that it generates more insulin to help your body process sugar. Sulphonylureas also support insulin so it works more efficiently.

Acarbose

Acarbose, which is also known as Glucobay makes your body slower to absorb carbohydrates and starches. This slows the rate at which your blood sugars rise.

Repaglinide and nateglinide

Repaglinide (Prandin) and nateglinide (Starlix) are prandial glucose regulators. They are taken half an hour before meals. They stimulate insulin production. It’s important not to take them if you are not going to eat because they could cause your blood sugar to drop, resulting in low blood sugar, or hypoglycemia.

Pioglitazone

Pioglitazone, branded as Actos, works by helping your body to use available insulin. It also protects the cells in the pancreas.

Incretin mimetics

Incretin mimetics like Byetta, Bydureon and Victoza are injected daily, or a couple of times a week to aid the production of insulin, slow down digestion and reduce sugar production from the liver. They may also lower appetite.

DPP-4 inhibitors

DPP-4 inhibitors like Januvia, Janumet and Galvus block the action of DPP-4, the enzyme that breaks down the hormone, incretin. Incretin helps the body produce insulin.

SGLT2 inhibitors

SGLT2 inhibitors such as Forxiga, Invokana, Jardiance and Steglatro act on the kidneys so that they absorb less sugar, instead passing it out in the urine. This lowers your blood sugar levels. SGLT2 inhibitors are taken as pills, once a day.

Statins

Diabetes puts you at increased risk of heart disease, including heart attack and stroke. So many people living with diabetes get a prescription of statins to lower their cholesterol. Statins reduce the risk of atherosclerosis, or a build-up of cholesterol plaques in blood vessels that increases your risk of heart attack and stroke.

Insulin

Your pancreas produces insulin and it transforms sugar in your blood in to energy. If your body no longer makes insulin because your pancreas is damaged, you will have to take it as a medication. Insulin is taken by injection or by using an insulin pump.

There are two types of insulin, long-acting insulin and fast-acting insulin.

Long-acting insulin

Long-acting insulin (or background or basal insulin) is taken once or twice a day. It works whether you eat or not and keeps your blood sugars stable overnight and between meals.

Fast-acting insulin

Fast-acting insulin (or mealtime or bolus insulin) is taken with food or drink to minimize the increase in blood sugar levels.

Injecting insulin

If you are injecting insulin, you will need an insulin pen, a sharp, fine single-use needle to go under the skin, and a sharps bin so you can safely dispose of your needle. Your healthcare team will tell you how to get rid of the sharps bin once it is full.

Where do I keep insulin?

Most Insulin needs to be kept at a temperature lower than 25 °C or 77 °F, ideally between 2°C and 6°C (36 °F to 43 °F). It is fine to keep insulin you are using that day at room temperature. Check with your healthcare team though, as your insulin may have specific storage instructions.

How do I get medications for diabetes ?

Diabetes meds and insulin can only be obtained with a prescription from your GP. This prescription will then be filled by a pharmacist who will give you the medication.

In Canada you can depend on NX Pharmacies for your diabetes meds. We serve all areas of Canada and can fill your prescription of diabetes medication. We can help with renewals and refills. Our discretion is assured, and you can depend on us for authentic Health Canada-approved medications.

Even if you’ve been successfully managing your diabetes for years, you can still benefit from the support of a doctor or pharmacist.

If something changes with your diabetes , talk to your GP. And if your meds stop working, or you start to get uncomfortable side-effects, ask for a medicines review. Your pharmacist may also be able to advise on managing side-effects of your diabetes meds.

Can I take my diabetes meds with other drugs?

If you need to take some medication for another condition, talk with your doctor about how these meds will interact with your prescription for diabetes. Your doctor may suggest checking your blood sugar levels more often.

How to manage diabetes with lifestyle changes

Your GP will recommend some lifestyle changes to alleviate your diabetes symptoms. Ask for support if you need help with implementing any of these lifestyle changes.

Learn about your diabetes

It’s important to engage with any training offered to help you manage your diabetes. It will help you to understand what diabetes is and how your meds are working.

Diabetes can result in other health problems, such as kidney damage, eye problems and damage to small blood vessels. Your GP will tell you about signs that you should see a doctor.

Attend your diabetes check-ups

When you live with diabetes it’s important to have regular check-ups. This is to check for other health problems and to make sure your condition is under control. You can use these appointments to ask any questions you might have, and to let your doctor know about any side-effects you are getting from these meds.

Diabetes is a progressive illness, which means it gets worse over time. So your doses and medications may need adjusting from time to time. Your doctor will need to check your symptoms and run tests from time to time to ensure you are getting the best possible combination of meds.

Keep your weight within healthy limits to manage diabetes

Obesity is one of the causes of insulin resistance and type 2 diabetes. By keeping your weight within healthy limits, you may be able to reduce the amount of medication you need.

Diet and diabetes

For type 2 diabetes, your doctor will have advice on dietary changes, which will include eating reduced amounts of fat, sugar and salt.

With type 1 diabetes you may have to learn how to manage your carbohydrate intake and balance it with your insulin doses. There are courses available to help you understand what, how and when you should eat to manage diabetes and your diabetes nurse and doctor will help you.

Take appropriate exercise to manage diabetes

Staying active will help you to control your blood sugar levels if you have diabetes type 2. A good aim is 2h30min of activity each week. You can weave activity into your everyday life. These all count toward your 2h30min:

• a brisk walk
• vigorous gardening and housework
• stair climbing

Stop smoking to alleviate diabetes symptoms

Stopping smoking will help you manage your diabetes. Many of the problems caused by diabetes, such as heart disease, are made worse by smoking. Ask for help from your doctor or pharmacist if quitting tobacco is difficult for you.