Specialized Type 2 Diabetes Care
Specialized Type 2 Diabetes Care
Type 2 diabetes occurs more frequently among all ages and is being observed increasingly in children due to obesity. Obesity and inactivity are on the rise especially after the pandemic and there is a 10-15% chance of it especially if other family members also have the same disease.
At least quarter of patients are unaware of their diagnosis of type 2 diabetes and it occurs because there is not enough insulin produced by the beta cells in the pancreas and because there is resistance to the effective action of insulin. In time, insulin production slowly declines and treatment with insulin may become necessary (normally after ten years).
Type 2 Diabetes Symptoms
If you have been recently diagnosed then you would have noticed these main symptoms which include;
Pain and tingling in feet
Type 2 Diabetes can present without any symptoms and you might not realize that you have the condition until your condition will develop complications.
Are you at risk of developing diabetes?
There are certain factors that can put you at risk of developing type 2 Diabetes which include;
Age 45 or above
Inactive life style
Having immediate family with the condition
Being obese or over weight
Having polycystic Ovarian Syndrome
Otherwise known as borderline diabetes at blood sugar levels where the amount of glucose is high but high enough to call it type 2 Diabetes. If left untreated it can progress to type 2 Diabetes which can be associated with serious complications. It can be tough to manage this condition without appropriate help like life style changes and dietary modifications.
Our dedicated team can work closely with you to provide nutrition, exercise advice and monitor your progress.
Technology can be useful for you to monitor your blood sugar levels with help of Apps on smart phones or watches or insulin injections with digital display. We encourage you to work with our team to improve your control and use Diasend, which is web based solution for virtual diabetes management.
Do I need a medication?
For many people medication may be needed to keep glucose levels down and help you stay healthy. Most recent diabetes medications assists weight loss as well as prevent heart and kidney complications.
The expert specialists at The London Endocrine and Diabetes Centre have access to the latest medications to provide personalized care, targeted to your personal needs, health, and lifestyle.
Metformin (Glucophage) is usually the first diabetes medication offered, it reduces the amount of glucose produced by the liver and helps the body respond to the insulin it produces.
Sulphonylureas like Glibenclamide (Daonil) or gliclazide (Diamicron) stimulate insulin release and can sometimes cause hypos, when the blood glucose drops, if meals are missed or irregular. They offer no benefits for weight loss, hypoglycaemia avoidance or heart or kidney protection
Alpha-glucosidase inhibitor - Acarbose (Glucobay) slows down the absorption of starchy foods, so there is a more gradual rise in glucose levels after a meal. They offer no benefits for weight loss, hypoglycaemia avoidance or heart or kidney protection
Prandial glucose regulators – Repaglinide (Prandin) Like sulphonylureas, they stimulate the pancreas to produce more insulin. However, because they act more quickly and for a shorter time, they’re usually taken thirty minutes before a meal. They offer no benefits for weight loss, hypoglycaemia avoidance or heart or kidney protection
Glitazones – Pioglitazone (Actos) reduces the body’s resistance to the action of insulin so that insulin can work more effectively. It can also help lower blood pressure and improve the proportion of good to bad cholesterol in the blood-stream. They may cause weight gain and fluid retention.
DPP4 inhibitors - Gliptins such as sitagliptin (Januvia), alogliptin (Vipidia), vildagliptin (Eucreas), saxagliptin (Onyglyza) and linagliptin (Trajenta) block the DPP4 enzyme, which breaks down the hormone incretin. With higher incretin levels, the body produces more insulin and less glucose. They do not offer benefits for heart or kidney disease and their use does not result in weight loss
SGLT2 Inhibitors – Dapagliflozin (Forxiga), canagliflozin (Invokana), empagliflozin (Jardiance), ertugliflozin (Steglatro) all reduce blood glucose by increasing the amount excreted by the kidneys. In general, the drugs cause some weight loss, and never cause low glucose. Most are protective for kidney and heart disease
Injection treatments other than insulin for type 2 Diabetes
Not all injectables are insulin and we have used GLP1 receptor agonists that are taken daily by injection. Unlike insulin, they result in weight loss, never cause hypoglycaemia, and recently Semaglutide has been shown to be useful for patients with cardiovascular and renal disease. The availability of once weekly effective GLP1 agonists dulaglutide (Trulicity) and semaglutide (Ozempic) has made this more convenient for patients with superior benefits and cardiac and renal protection. They are likely to become main treatments for diabetes in the future and can be used with insulin in combination injections