Category Archives: Diabetes Signs & Symptoms

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Which Anti-Diabetes Medicines can Cause Low Blood Sugars or Hypoglycemia?

What is Hypoglycemia ?

When blood glucose level falls below 70mg/dl, person feels dizziness, headaches, sweating, confusion, anxiety symptoms, which relieve immediately after restoring blood glucose level to normal is known as Hypoglycemia.

Hypoglycemia

Credits: Oliveviewim.org

Common Symptoms of Hypoglycemia includes :

  1. Adrenergic Symptoms :
    • Hunger
    • Faintness
    • Weakness
    • Sweating
    • Palpitations
    • Tremors
    • Tingling
    • Nervousness
    • Numbness around mouth

     

  2. Neuro-glycopenic Symptoms : may require help or assistance from another person.
    • Headache
    • Double Vision
    • Lack of co-ordination
    • Inappropriate behavior
    • Confusion
    • seizures
    • Coma
    • Permanent Brain Damage & Death

Which Anti-Diabetes Medicines can cause Low blood Sugars or Hypoglycemia?

Most common is Insulin. Any type of insulin or its analogues can cause hypoglycemia.

Most commonly used insulin includes Premixes like Mixtard 30/70, Huminsulin 30/70, Novomix 3o, Humalog 25/75, regular insulin like Human Actrapid, Huminsulin R. etc or Fast acting analogues like Novorapid, Apidra, Humalog etc

Long & intermediate acting insulin & analogues like Glargine (Lantus), Detemir ( Levemir) Degludec (Tresiba), NPH, Huminsulin N etc.

In case of oral medication, those oral anti-diabetes tablets which increases insulin secretion (insulin secretagogues) from pancreas can cause hypoglycemia.

Most commonly used Insulin secretagogues includes:

  1. Sulphonyureas:

    • Glibenclamide – Daonil, Glucored, Semi daonil, etc.
    • Glimeperide – Amaryl, Zoryl, Glimestar, Glimy, Azulix, Euglim, Glimiprex, Glucoryl, etc.
    • Gliclazide – Reclide, meclazide, diamicron, Glizid, Diabend, Dianorm, Glycinorm, etc.
    • Glipizide – Glynase, Semi-glynase, Lipi, etc.
  2. Glinides:

  • Repaglinide – Eurepa, Novonorm, Repa, Regan, etc.
  • Nateglinide – Glinate, Natiz, etc.

Other anti diabetic medicines like metformin (Glyciphage, Cetapin, Metsmall, etc.), Pioglitazone (Pioz, piopar, etc.), Alfa – glucosidase inhibitors like voglibose ( PPG, Volibo, Advog, Prandial,Volix, etc.), Acarbose (Glucobay, etc.), & DPP4 inhibitors including sitagliptin ( Zita, Istavel, Januvia, etc), Viladgliptin ( Galvus, Zomelis, etc) , Saxagliptin ( Onglyza), Linagliptin ( Trajenta) DO NOT Cause Hypoglycemia when given alone or in monotherapy but can cause hypoglycemia when given in combination with insulin secretagogues or with insulin.

If you found this article useful, please share it with your friends & family. I appreciate the feedback and encouragement.

Awareness is Prevention.


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Darkening behind neck – Sign of Diabetes?

Many overweight & obese people have darkening behind neck , darkening in armpits and other parts of body with creases and folds like elbows, knees, knuckles, etc. which is commonly mistaken as smudge of dirt or uncleanliness or lack of hygiene . Some people think that it is due to repeated friction caused by necklace or chains etc. In fact it is a sign of Diabetes which is already developed or going to develop.

Acanthosis Nigricans

 

This darkening is due to excessive cell growth & differentiation of fibroblasts  caused by excess of insulin in the body especially in obese individuals and type 2 diabetes patients.

In Obese individuals and Type 2 diabetes patients excess amount of fat especially abdominal fat ( Tummy fat ) causes resistance to action of insulin secreted by pancreas and hamper its action. in return body produces more and more insulin from pancreas to keep blood sugar under control. This excess amount of insulin secreted by body promotes this skin cell growth and which leads to acanthosis nigricans.

After producing excess amount of insulin pancreas start exhausting and which leads to developing diabetes.

At this stage diabetes can be prevented by simple lifestyle modification & moderate weight loss.

Other commonly experienced warning signs & symptoms already mentioned in my previous article.

Keeping in mind that complications caused by diabetes on damaging retina, kidney, nerves , heart , vascular system etc and money burden caused by treatment, it is important to STOP DIABETES here.

Lifestyle Modification includes:

  • Replacing refined carbohydrates with whole grains foods.
  • Increase intake of fresh fruits , vegetables and other foods high in fibre content.
  • Decrease saturated fat intake like avoiding chips,biscuits,pastries, Samosas, Vada pav etc.
  • Increase intake of grilled & steammed food instead of frying and roasting.
  • Reducing Amount of meal at a time ( Portion size ) cuts down calorie intake.
  • Atleast daily 30 min moderate exercise including brisk walking, cycling etc.
  • Gradual Weight loss to keep BMI in range of  18- 23  ( for Indians )
  • Stress management with yoga, meditation etc

If you show this sign, Get your blood sugar test done and consult diabetologist immediately.

 

Feel free to share this article with your friends & family.

Awareness is Prevention.


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What are diabetes warning Signs & Symptoms ?

Most of the type 2 diabetes patient are unaware of the fact that they have diabetes. Diabetes is called Silent Killer as most of the patient suffering from it don’t know either they have high blood sugars or what organ system is getting damaged.

Usually Type 1 Diabetes is sudden onset and patient come to know that he or she has diabetes at hospital as they normally land up in Diabetic Ketoacidosis ( DKA ).

Type 2 diabetes is usually missed as most of the time it shows less or no signs at all.

Most commonly experienced signs & symptoms include :

  • Weight Loss
  • Frequent Urination especially at night
  • Increased Hunger
  • Excessive thirst ( dryness of throat )
  • Tingling Sensation or numbness in hands or feet
  • Tiredness ( weakness , body ache)
  • Vomiting & mild tummy pain
  • Blurred Vision
  • Darkening behind neck ( Acanthosis Nigricans )
  • Lack of interest & concentration
  • Repeated Infections like Urinary tract infections & chest infections.
  • Slow healing wounds

Diabetes Warning signs & symptoms Flowchart

Blood test which should be done includes :

  • Fasting Blood Sugar ( FBS )
  • Post Prandial Blood Sugar ( PPBS )
  • HbA1c ( Glycosylated Hemoglobin) – Most Reliable & Confirmatory
  • Other Tests : Urine Routine ,Serum Creatinine , Lipid Profile ( Cholesterol , Triglycerides , LDL , HDL, VLDL ) , Liver Profile , etc

If you show these signs & symptoms , Get your blood sugar test done and consult your diabetologist as soon as possible.

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Dr Nikhil Prabhu


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