Disease Diabetes

Diabetes (diabetes mellitus) is a long-term or chronic disease characterized by blood sugar levels (glucose) are far above normal. Glucose is very important for our health because it is the main energy source for the brain and the cells that make up the muscles and tissues in our body.



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This disease has two main types, namely type 1 and type 2 diabetes.


What are the Symptoms of Diabetes?

It is important for us to know the early symptoms of diabetes. Both for high-risk and for those who feel healthy and have no history or potential for diabetes.

Type 1 diabetes can develop rapidly in a few weeks, even a few days. While many people with type 2 diabetes do not realize that they have diabetes for years because the symptoms tend not to be specific. Some of the symptoms of type 1 and type 2 diabetes include:
  • Often feel thirsty.
  • Frequent urination, especially at night.
  • Extreme hunger.
  • Weight loss for no apparent reason.
  • Reduced muscle mass.
  • There is ketone in urine. Ketones are a by-product of muscle and fat metabolism that occurs when insufficient insulin production.
  • Fatigue.
  • Vague views.
  • Long wound healed.
  • Often have infections, such as the gums, skin, vagina, or urinary tract.

If you experience any of these symptoms, consult your doctor immediately. Early detection may allow us to prevent further aggravation of our diabetes condition.
Effects of Insulin and Diabetes Hormones

All cells in the human body need glucose to work normally. Blood sugar levels are usually controlled by the hormone insulin produced by the pancreas, the organ located behind the stomach.

But pancreatic organs belonging to diabetics are unable to produce the hormone insulin as needed by the body. Without insulin, the body's cells can not absorb and process glucose into energy.


Overview of Type 1 Diabetes

People with type 1 diabetes are very dependent on insulin because the immune system of the patient will attack and destroy the pancreatic cells that produce insulin. This triggers an increase in glucose levels resulting in damage to the organs of the body. Until now, the cause behind type 1 diabetes is not known for certain.

People with this type of diabetes generally aged under 40 years, usually appear in adolescence or children. Therefore, type 1 diabetes is also referred to as juvenile diabetes.

Type 1 diabetes is less common than type 2 diabetes. Among 10 people with diabetes, it is estimated that only 1 person has type 1.

In addition to receiving daily insulin injections, type 1 diabetics are also advised to keep blood glucose levels in balance. For example by applying a healthy diet and undergoing blood tests regularly.

Overview of Type 2 Diabetes

Type 2 diabetes is a more common type of diabetes. About 90 percent of diabetics in the world suffer from this type of diabetes.

This type of diabetes is caused by a lack of insulin production in the body or body cells that become less sensitive to insulin. This lack of body cells is known as insulin resistance.

Symptoms in people with this type of diabetes can usually be controlled with a healthy diet and monitor blood glucose levels. However, stay alert because this disease will continue to grow in the body and gradually you will need treatment steps.

Type 2 diabetes is often associated with obesity. Indeed, not everyone who suffers from obesity will automatically suffer from type 2 diabetes. However, the higher a person's body mass index, the risk of this type of diabetes also increases. Diabetes due to obesity generally attacks the elderly.
The Risks of Pregnancy Diabetes

Diabetes also often attacks pregnant women. There are some women who have very high blood glucose levels during pregnancy, so their body can not produce enough insulin to absorb it. Diabetes known as gestational diabetes can occur in about 15 to 18 people among 100 pregnant women.

Patients with type 1 diabetes who become pregnant will also have a high risk because it can affect the mother and fetus. It is important for pregnant diabetics to maintain their blood sugar balance.

Pregnant women should be more careful to monitor blood sugar levels in the second trimester (weeks 14-26). It was during this time that gestational diabetes generally progressed and then disappeared after delivery. However, the risk of type 2 diabetes in women who have had gestational diabetes is about three times higher than the general population.

Type 1 Diabetes


Diabetes is a chronic (chronic) disease that occurs when the pancreas (the salivary glands) does not produce enough insulin, or when the body does not effectively use insulin. While type 1 diabetes itself is a type of diabetes with low insulin production. Therefore, type 1 diabetes is also called insulin dependency diabetes, otherwise known as diabetes autoimmune disease with a cause that is not known for sure.

Blood sugar levels are usually controlled by the hormone insulin. If the body is less insulin, blood sugar levels will increase dramatically due to the buildup, this is called hyperglycemia. This is what happens when a person has type 1 diabetes mellitus.

The cause of the lack of insulin production by the pancreas in type 1 diabetics is not known until now so can not be concluded how to prevent it. This type of diabetes can arise at any age, generally affecting patients under the age of 40, especially children (childhood-onset diabetic). Sometimes known as diabetes 'teenagers'

Diabetes Patients in Indonesia

By 2015, diabetics in Indonesia are estimated to reach 10 million people with an age range of 20-79 years (quoted from the International Diabetes Federation). However, only about half of them are aware of his condition.

Southeast Asia is one of the areas with high prevalence for Type 1 diabetes. In 2010, it is estimated that there are about 113,000 children under 15 years who have type 1 diabetes with an estimated 18,000 new cases each year.
General Symptoms and Complications of Type 1 Diabetes Patients

Common symptoms of diabetes in early diseases, also known as classical symptoms in the medical community, are frequent urination (polyuria), often thirsty (polydipsia) and often hungry (polyphagia). These symptoms will develop and worsen with the uncontrolled blood sugar levels (hyperglycemia) that damage tissues and organs, and complicate.

Without insulin, the sugar in the blood can not enter and be used by the cells of the body. Eventually the body will process fat and muscle into energy causing weight loss. This can lead to an acute condition called diabetic ketoacidosis, a condition in which the blood becomes too acidic and the occurrence of harmful dehydration.

High blood glucose levels can also cause damage to blood vessels, nerves, and organs. Therefore, diabetes can lead to a number of complications if not controlled properly. Increased blood sugar levels are not significant and does not trigger any symptoms can cause damage if it occurs in the long term.

Diagnosis and Treatment of Type 1 Diabetes

Insulin dependence or type 1 diabetes includes diseases that can not be cured and can only be controlled. Early diagnosis of diabetes is very important so that treatment can be done so that high blood sugar levels of patients can be controlled. Treatment of diabetes aims to maintain the balance of blood sugar levels and control the symptoms to prevent possible complications.

Pancreatic organs in the body of type 1 diabetics do not produce insulin anymore so they must receive insulin supply from outside the body on a regular basis. They are also required to learn to adjust their doses with the food consumed, blood sugar levels, and activities performed.

The process of adjustment should be done in stages. Some types of insulin that can be used include:

    Long working insulin that can last a day.
    Short working insulin that can last up to eight hours.
    Fast-acting insulin that does not last long, but reacts quickly.

The way of treatment for diabetics can use a combination of the above types of insulin.

Transplantation of insulin-producing pancreatic cells (islet cells) may also help some people with type 1 diabetes. In this process, islet cells from those taken from deceased donors will be inserted into the pancreas of type 1 diabetics.

Islet transplantation is effective to reduce the risk of severe hypoglycemia attacks. Hypoglycemia is a condition in which the blood sugar level falls too low. This condition is as dangerous as blood sugar levels that are too high. However, although there are countries that have implemented islet transplants, many diabetics are also reluctant to run because of the high risk.

A healthy and balanced diet and regular exercise can reduce blood sugar levels for diabetics. Quitting smoking can also reduce the risk of heart disease complications.

Symptoms of Type 1 Diabetes

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Early symptoms of type 1 diabetes or known as classic symptoms, namely:

     Frequent urination, especially at night (polyuria).
     Frequent thirst (polydipsia).
     Often feel hungry (polyphagia).

It can also be accompanied by other symptoms that arise suddenly, among others:

     Weight loss.
     Blurred vision due to changes in the shape of the lens in the eye.
     Fatigue

Symptoms of type 1 diabetes can progress and worsen rapidly within weeks or even days. If the patient has nausea, vomiting, severe deep breathing, fruity-smelling breath, loss of appetite, stomachache, or high fever, see your doctor immediately.

Causes of Type 1 Diabetes

The cause of type 1 diabetes is unknown, but it is suspected that genes may contribute to the onset of the disease.

Type 1 diabetes was once considered an autoimmune condition. In general, the human immune system serves to resist and destroy anything that is considered foreign or dangerous. In the case of type 1 diabetes, the immune system has mistakenly attacked the cells in the pancreas so that the production of insulin stops. This is because the immune system thinks the pancreas is harmful to the body.

The cause behind the immune system's reaction to these pancreatic cells is not known for certain. However, a combination of several factors is believed to cause this condition.

Hereditary factors are a major predisposing factor in diabetes. A person's risk of developing type 1 diabetes will be slightly higher if there is a nuclear family (mother, father, or sibling) who suffer from the same disease.

The environment is also believed to increase the risk of type 1 diabetes. Examples are as follows:

  • Virus. There is one theory that describes that there are a number of allegedly stimulating autoimmune responses that will attack infected cells and beta cells in the pancreas. For example, enterovirus, Epstein-Barr virus, rubella virus, rotavirus, and mumps virus.
  • Drugs and chemical compounds. There are a number of drugs or chemical compounds that are believed to destroy pancreatic cells, namely pyrinuron and strepzotocin.
  • Gluten. One of the proteins in gluten, gliadin, is thought to potentially affect the development of type 1 diabetes.

Type 1 Diabetes Diagnosis

Early diagnosis of diabetes is very important so that treatment can be done immediately. If you have diabetes symptoms, you should immediately consult a doctor.
Urine Test and Blood Glucose to Determine Glucose Content

The regular doctor will ask you for a urine test and a blood test. The urine sample will be tested to check the glucose content. Under normal conditions, urine does not contain glucose. However, the substance will accumulate and flow to the kidneys and urine, if you have diabetes. The doctor will also usually check whether there is a ketone content (a compound that indicates type 1 diabetes already complicated) in your urine.

If there is glucose in the urine, you will usually be advised to have a blood test to confirm the diagnosis. Your blood sample is generally taken twice, ie fasting glucose and two hours after meals.

Blood samples for fasting glucose test will be done on the morning after you have fasted for 8 to 12 hours. You will then be given a glass containing a predetermined sugar content.

Exactly two hours later, your blood sample will again be taken for glucose testing to evaluate the activity of insulin in your body.
HbA1c test

The results of this examination will show the average sugar level in the patient's blood over the last 2 to 3 months. HbA1c levels of 6.5% or more indicate that the patient has diabetes. This test can also be used as a preliminary examination for people at risk of developing diabetes.
Autoantibody test

This procedure can be used to differentiate type 1 and 2 diabetes before the patient has hyperglycemia.

Type 1 Diabetes Treatment

Diabetes can not be cured. Treatment of diabetes aims to maintain the balance of blood sugar levels and control the symptoms to prevent possible complications.
Step Treatment with Insulin

Pancreatic organs in the body of type 1 diabetics are not able to produce insulin so patients should receive daily insulin supply. There are several types of insulin that can be used. Among them:

    Fast-acting insulin whose effect does not last long, but reacts quickly.
    Short-acting insulin that can last a maximum effect of eight hours.
    Long-acting insulin that can last a maximum effect a day.

Treatment for diabetics may use a combination of the above insulin types.

Insulin by injection

The most common way of insulin delivery is by injection. This method is chosen because if taken in tablet form, insulin will be digested in the stomach like food and can not get into the blood.

In the early stages of use, doctors will usually help you to inject insulin. Then you will be taught how to inject and store insulin and throw the needle safely.

There are two methods that are usually used to give insulin injections, namely through needles and syringes or pens. Diabetics generally need two to four injections per day.

Insulin Pump

Another alternative to inject insulin is with an insulin pump. This insulin container is small. A small hose complete with a needle at the end will connect the pump to your body. The needle is generally inserted into the body through the abdomen, but there are also put it through the hips, thighs, buttocks, or arms.

This pump will deliver insulin to the bloodstream at adjustable doses, so you do not have to do any more insulin shots. But you still need to be vigilant and monitor your blood sugar levels thoroughly to ensure you receive the right dose of insulin.

Insulin pump is very practical and can be used by all people with type 1 diabetes, especially those who often have low sugar levels. This tool is also not widely used in Indonesia because of its expensive price.

Blood Sugar Level Monitoring

Keep your blood sugar level balanced

The main goal of diabetes treatment is to maintain the balance of blood glucose. You can do it with insulin treatment and a healthy diet, but to ensure normal blood sugar levels, you need regular blood sugar checks.

Some factors that can affect your blood sugar levels are:

    Stress.
    The frequency and intensity of the sport.
    Other diseases such as runny nose or cough.
    Taking other drugs.
    Consumption of alcoholic beverages.
    Changes in the amount of hormones during menstruation.

Examination of blood sugar itself can be done through a simple blood test with a small prick on the finger. This test is generally recommended for diabetics. You may need to do it four or more times a day. The type of insulin treatment you undergo will affect the required test frequency. The doctor will also explain about the ideal blood sugar levels.

Milligrams / deciliter (mg / dL) is the unit of blood glucose used in general in Indonesia. Therefore, you should be careful, make sure the unit first when buying a blood glucose test kit and know the value of referrals.

Regular blood sugar checks

In addition to your own daily monitoring, you are encouraged to take HbA1c test every 2-6 months. This process will show the balance of your blood sugar level and the level of effectiveness of the type of treatment you are taking.

Methods of Handling Hyperglycemia

High blood sugar levels (hyperglycemia) can occur for several reasons, such as excessive eating, lowered health conditions, or insufficient doses of insulin. Adjustment of diet or dose of insulin will be needed diabetics who have hyperglycemia. Doctors can also help you to find the best adjustments.

Untreated hyperglycaemia can cause serious complications. The body will process fat and muscle as an alternative energy source, and increase the level of acid in the blood (diabetic ketoacidosis).

Diabetic ketoacidosis is very dangerous and can lead to dehydration, vomiting, loss of consciousness, even death. Therefore, people with diabetes who experience hyperglycemia should be treated immediately in the hospital. Patients also usually will be given infusion to increase body fluids, such as saline and potassium.

Hypoglycemia Treatment Method

When your blood sugar level is too low, you will experience hypoglycemia. This condition can occur in all diabetics, but generally occurs in people with type 1 diabetes.

Some of the symptoms for mild hypoglycemia are weakness, tremor, and hunger. This condition can be overcome by eating sweet foods or drinks, such as soft drinks (not the type of diet), sugar, or raisins. Pure glucose in tablet or liquid form can also be consumed to treat hypoglycemia rapidly.

Severe hypoglycemia will lead diabetics to feel dazed, drowsy, and even loss of consciousness. Diabetics who experience this condition should be given a glucagon injection (a hormone that can increase blood sugar levels quickly) directly on the muscles or veins.

Loss of consciousness due to hypoglycemia means that hypoglycemia may recur again a few hours later. Therefore, take a break and make sure someone is with you.

You will need immediate medical help and glucagon injections again if you remain drowsy or unwell for 10 minutes after receiving the first glucagon injection of the muscle.

Handling with Islet Transplant

Islet transplantation may also help some people with type 1 diabetes. In this process, islet cells are obtained from deceased donors and transplanted into the pancreas of type 1 diabetics. Islet cells are a type of pancreatic cells that produce insulin.
Handling with Pancreatic Transplant

Pancreatic transplantation can restore the body's glucose control ability, especially for people with type 1 diabetes with conditions that are fluctuating or have unstable blood sugar levels. However, this procedure is high risk because it requires a more harmful immunosuppression process than insulin replacement therapy so it is only recommended along with or after a kidney transplant.

Other Drugs to Reduce the Risk of Complications

People with type 1 diabetes have a higher risk of developing complications, such as heart disease, stroke, and kidney disease. Therefore doctors may suggest the following medications to reduce the risks, such as:

  • Statins to reduce high cholesterol levels.
  • High blood pressure-lowering drugs.
  • ACE inhibitor drugs, such as enalapril, lisinopril, or ramipril, if there are indications of diabetic kidney disease. The development of disease characterized by the presence of albumin protein in the urine can be controlled if treated promptly.
  • Low dose aspirin to prevent stroke.

In addition to medical treatment, applying a healthy lifestyle can also help in treating type 1 diabetes. For example by low-carbohydrate diet, enough exercise, and avoid stress.

Type 1 Diabetes Complications

High blood sugar levels can cause damage to blood vessels, nerves, and organs. Therefore, diabetes can trigger a number of complications if not controlled properly. Increased blood sugar levels are not significant and not trigger any symptoms can result in long-term impact.

Diabetic Retinopathy

Diabetes can cause damage to blood vessels in the retina (retinopathy). These blood vessels may become blocked, leaked, or grow randomly, blocking the light to reach the retina. This complication can lead to blindness if left unchecked.

Checking your eyes every year will help the early detection of retinopathy so that it can be treated promptly.

Early detectable diabetic retinopathy can be treated with laser surgery. However, this procedure is only to maintain the power of sight and not to heal.

Diabetes Neuropathy (Neural Damage)

Excess blood glucose can damage the fine blood vessels and nerves. This can trigger the sensation of tingling or stinging that usually starts from the fingertips of the hands and feet, then spread to other body parts. Neuropathy that attacks the digestive system can cause nausea, vomiting, diarrhea, or constipation.

Something we usually realize too late, ie damage to the nerves or inhibition of blood flow in the legs can increase the risk of foot health complications. If left unchecked, small cuts and scratches on the feet of diabetics can develop into serious infections.

Patients who have experienced nerve damage should check the condition of his feet every day. In the event of a change, consult with your doctor. Foot examination by the doctor is also recommended at least once a year. Complications on the foot that you should be aware of are:

    Injuries that do not heal.
    Skin that feels hot to the touch.

Heart Disease and Stroke

Diabetics are five times more likely to develop heart disease or stroke. Blood sugar levels are not balanced and left long enough to increase the risk of atherosclerosis, ie narrowing of blood vessel flow that usually occurs due to accumulation of cholesterol. These complications have the following risks:

Inhibits blood flow to the heart and causes angina attacks (known as sitting wind). Angina attacks are indicated by chest pain that is suppressing.

Causes a heart attack or stroke because it increases the risk of blockage of blood vessels in the heart or brain.

Diabetic Nephropathy (Kidney Damage)

The kidneys have millions of fine blood vessels that filter waste from the blood. If the blood vessels are clogged or leaky, your kidney's performance will decrease.

Severe damage to the kidneys can lead to kidney failure. If you have kidney failure, you will need dialysis (dialysis) or even a kidney transplant.
Sexual Dysfunction

Diabetes can damage both the blood vessels and the nerves. Therefore, male diabetics (especially those who smoke) may experience erectile dysfunction. This disorder can usually be treated with medication.

Meanwhile, women with diabetes also have the potential to experience sexual dysfunction, such as decreased sexual satisfaction, lack of sex drive, failed to reach orgasm, pain during intercourse, and a dry vagina. Handling in diabetic women who have vaginal discharge or feel pain during intercourse can use lubricants or gels.

Miscarriage and Birth Death in the Fetus

This disease can harm the mother and the fetus. The risk of miscarriage and stillbirth will increase if pregnant women's diabetes is not handled thoroughly. Unsaved blood sugar levels during early pregnancy may also heighten the risk of birth defects.

Pregnant women with diabetes are advised to check their diabetes condition regularly to a hospital or clinic. This routine consultation will make it easier for doctors to monitor their blood sugar levels and control the dose of insulin that should be given.


Type 2 Diabetes

Diabetes is a chronic (chronic) disease that occurs when the pancreas (the salivary glands) does not produce enough insulin, or when the body does not effectively use insulin. Ordinary diabetes is characterized by blood sugar levels above normal. While type 2 diabetes is a diabetes caused by the body is not effective use of insulin or lack of insulin relative to blood sugar levels.

Causes of Type 2 Diabetes

The cells in the human body need energy from sugar (glucose) to function normally. What usually controls blood sugar is the hormone insulin. Insulin helps cells take and use glucose from the bloodstream. If the body lacks the relative insulin, it means that blood sugar levels are very much due to excessive intake so that insulin levels appear to be reduced; or the emergence of resistance to insulin in the body's cells, blood sugar (glucose) will increase dramatically. This is what triggers and causes diabetes (diabetes mellitus).

Type 2 diabetes usually occurs in people who are overweight and lack of physical movement. Usually the lifestyle that is not actively trigger the occurrence of this disease. That's why type 2 diabetes has long been common in adults. But now, the number of people with type 2 diabetes in children also began to increase.

Symptoms of Diabetes

Symptoms of type 2 diabetes is a classic symptom, meaning it is a symptom that is always present in diabetes, either type 1 or type 2. Among them:

    Frequent urination, especially at night.
    Often feel thirsty.
    A growing hunger often.

Other symptoms that can also appear in type 2 diabetes, among others:

    Fatigue.
    Reduced muscle mass.
    Weight loss.
    Slow wounds heal or often have an infection.
    Vague views.

Consult your doctor if you feel the symptoms above so that early diagnosis and treatment can be done.

Treatment and Complications of Type 2 Diabetes

Although diabetes can not be cured, early diagnosis is essential for diabetes to be addressed immediately. Early detection allows blood sugar levels of diabetics to be controlled.

The goal of diabetes treatment is to maintain a balance of blood sugar levels and control the symptoms to prevent possible complications. Changing lifestyle can also control the symptoms of type 2 diabetes, for example by applying a healthy diet, regular exercise, limit consumption of alcoholic beverages, and quit smoking.

This type of diabetes is a progressive disease. Therefore, people with type 2 diabetes will generally need drugs to maintain the balance of blood sugar levels.

Diabetes can lead to a number of complications if ignored. High blood sugar levels can cause damage to blood vessels, nerves, and organs.
Diabetes Experienced by Pregnant Women

Diabetes can also be experienced by pregnant women and is usually known as gestational diabetes. This happens because pregnant women sometimes have blood sugar levels that exceed normal but still not including sugar levels in diabetes, but insulin also can not control it.

Gestational diabetes can increase the risk of maternal and fetal health complications. Therefore, it is very important for diabetics who are pregnant to maintain the balance of blood sugar levels.

Symptoms of Type 2 Diabetes

The classic symptoms of type 2 diabetes are similar to type 1 diabetes, namely:

    Frequent urination, especially at night.
    Often feel thirsty.
    Increased hunger.

In addition, these symptoms can also accompany classic symptoms, among others:

    Weight loss.
    Slow wounds heal or often have an infection.
    Itchy.
    Vague views.
    Often exhausted.

These symptoms occur after blood sugar rises in the blood for some time. Initially, symptoms of type 2 diabetes tend to be mild. Therefore, many sufferers are often not aware if they already have this disease.

When blood sugar levels continue to rise and become too high (hyperglycemia), it will arise:

    The mouth is dry and feels very thirsty.
    Frequent urination.
    Infections that often recur, such as canker sores and bladder infections.
    Fainting.
    Low blood pressure.

Early diagnosis and treatment of diabetes can reduce the risk of complications. Consult a doctor as soon as possible if you have diabetes symptoms.

Causes of Type 2 Diabetes

Type 2 diabetes occurs when the pancreatic organ in the patient's body does not produce enough insulin to keep blood sugar levels within normal limits. Another cause is the body cells that become less sensitive to insulin or known as insulin resistance.

Blood sugar levels are usually controlled by the hormone insulin produced by the pancreas. Insulin serves to move the sugar from the blood to the cells of the body that will turn it into energy.

There are a number of factors behind the lack of insulin production in type 2 diabetes. Some of these risk factors include:

  • Age factor. The risk of type 2 diabetes will increase with age. This may be triggered by increasing body weight and reduced exercise frequency as we get older. This type of diabetes generally attacks people aged 40 years and over. The risk of Asian ethnicity even high, ie at the age of 25 years and over.
  • Influence of hereditary factors. Having family members (especially nuclear families like fathers, mothers, and siblings) who have diabetes will also increase your risk. The risk for children with fathers or mothers with type 2 diabetes is also a third higher for diabetes.
  • The Impact of Weight. The risk of type 2 diabetes is higher in people who are overweight and obese. Measuring your waist to check the fat piles in this section is the fastest way to measure your diabetes risk. The higher risk is women with waist size of 80 cm or more and Asian men with waist measurements of 90 cm or more.
  • Ethnic Factors. Asian ethnicians have a higher risk of type 2 diabetes.
  • Prediabetes, the condition of blood sugar levels always exceeds normal, but has not reached the stage of diabetes. If you experience this condition, then the risk of developing diabetes is also increasing.
  • Gestational diabetes. Women who have experienced this condition have a higher risk of developing type 2 diabetes.

Diagnosis of Type 2 Diabetes

Early diagnosis is essential so that diabetes can be treated as soon as possible. If you have diabetes symptoms, you should immediately consult a doctor. A number of checks that will generally be recommended are as follows:
HbA1c test

This examination will show the average sugar level in the patient's blood over the past 2-3 months. HbA1c levels of 6.5% or more will indicate that patients have type 2 diabetes. This test may also be used as a baseline for people at risk of developing diabetes.

Oral Glucose Tolerance Test

This test serves to evaluate the activity of insulin in the body. The patient's blood sample was taken twice for fasting glucose and two hours after meals.

Fasting glucose test will be done in the morning after you fast for 8 hours, only water is allowed to drink. You are also advised not to take certain medications that may affect the test results. Blood samples will be taken towards the end of the fasting phase.

Then, you will be asked to drink a syrup containing 75 grams of glucose (sugar). Exactly two hours later, your blood sample will again be taken for glucose testing to evaluate the activity of insulin in the body.
How To Know Your Test Results

Your known sugar levels from oral glucose tolerance test results will determine whether you suffer from impaired glucose tolerance or diabetes.

Milligrams / deciliter or commonly abbreviated mg / dL is the unit of blood glucose used in general in Indonesia. Normal blood sugar levels are:

    80-100 mg / dL before meals.
    80-144 mg / dL after meals (checked exactly two hours after meals).

While the blood sugar doses of patients with impaired glucose tolerance are:

    108-126 mg / dL before meals.
    142-198 mg / dL after meals (checked exactly two hours after meals).

Lifestyle changes will be recommended if the test results show you suffer from impaired glucose tolerance. Your doctor may also give you medications to lower your blood sugar levels.

While the blood sugar doses for diabetics are:

    More than 126 mg / dL before meals.
    More than 198 mg / dL after meals (checked exactly two hours after meals).

If the test results show you have diabetes, your doctor will usually give you medication to lower and maintain your blood sugar balance.

Type 2 Diabetes Treatment

Although diabetes can not be cured, early detection allows blood sugar levels of diabetics can be controlled. The goal of diabetes treatment is to maintain the balance of blood sugar levels and minimize the risk of complications. The following detailed description of diabetes treatment is generally recommended.
Starting a Healthy Lifestyle

This is an early treatment for people with type 2 diabetes while helping the treatment process and prevent complications. These simple steps can be:

  • Applying a healthy diet, such as increasing the consumption of fiber-rich foods, avoid fatty foods or high sugar content.
  • Regular exercise, at least for 2.5 hours a week.
  • Lose weight, especially for those who are overweight or obese (weight index 30 or more).
  • Stop smoking because it can increase the risk of cardiovascular disease in people with diabetes.
  • Limit or stop consuming alcoholic beverages. Alcohol content in liquor can increase the risk of hyperglycemia and hypoglycemia. Do not consume alcoholic beverages on an empty stomach.
  • Maintain foot condition. Ulcers in the legs are a common complication experienced by people with type 2 diabetes. Therefore, keep your foot condition and be wary of wounds that do not heal.
  • Check eye condition regularly. The recommended frequency of routine eye examination is once every 2 years.

The Right Drugs for Overcoming Diabetes Type 2

The balance of blood sugar levels in diabetes can sometimes not be well preserved only through the application of a healthy diet and regular exercise. You may also need medication to handle it.

There are several types of drugs (usually in tablet form) that can be used for type 2 diabetes. You may also be given a combination of two or more types of drugs to control your blood sugar levels.

Metformin to reduce blood sugar levels

Metformin works by reducing the sugar content that is channeled to the bloodstream and makes the body more responsive to insulin. This is the first drug that is often recommended for people with type 2 diabetes.

Unlike other medications, metformin does not cause weight gain. Therefore this drug is usually given to patients who are overweight.

But metformin can sometimes cause mild side effects, such as nausea and diarrhea. Doctors also do not recommend this drug for people with diabetes who have kidney problems.

Sulfonylureas to increase insulin production in the pancreas

Sulfonylurea serves to increase insulin production in the pancreas. Diabetics who can not take metformin or are not overweight may be given this drug. If metformin is less effective at controlling your blood sugar levels, your doctor may combine it with sulfonylureas. Examples of these drugs are glimepiride, glibenclamide, glipizide, gliclazide, and gliquidone.

sulfonylureas will increase insulin levels in the body so that it can increase the risk of hypoglycemia if there is an error in its use. These drugs also have side effects such as weight gain, nausea, vomiting, and diarrhea.

Pioglitazone as a trigger for insulin

Pioglitazone is usually combined with metformin, sulfonylurea, or both. This drug will trigger the body's cells to be more sensitive to insulin, so more glucose is removed from the blood.

These drugs can cause weight gain and swelling of the ankles. You are not recommended to take pioglitazone if you have had heart failure or are at risk of fracture.

Gliptin (DPP-4 inhibitor) as a deterrent to the breakdown of GLP-1

Gliptin or DPP-4 inhibitors prevent the breakdown of the GLP-1 (glucagon-like peptide-1) hormone. GLP-1 is a hormone that plays a role in the production of insulin when high blood sugar levels. Thus, gliptin helps to increase insulin levels as the sugar levels rise.

Gliptin (eg, linagliptin, saxagliptin, sitagliptin, and vildagliptin) may inhibit elevated high blood sugar levels without causing hypoglycemia. This drug does not cause weight gain and is usually given if the patient can not take sulfonylurea or glitazone, or in combination with both.

SGLT-2 inhibitors that affect urine

SGLT-2 inhibitors will increase the sugar levels secreted through the urine. However, these drugs increase the risk of infection in the urinary and genital tract for people with diabetes.

This drug is recommended if metformin and DPP-4 are not suitable for use by the person. Examples of SGLT-2 inhibitors include dapagliflozine, canagliflozine, and empagliflozine.

Agonis GLP-1 as an insulin trigger without risk of hypoglycemia

The GLP-1 agonist has a similar performance to the natural GLP-1 hormone. These drugs are given by injection to stimulate insulin production when high blood sugar levels without triggering the risk of hypoglycemia.

Acarbose to slow digestion of carbohydrates

Acarbose will slow down the process of digesting carbohydrates into sugars. This drug prevents elevated blood sugar levels too quickly after diabetics eat.

This drug can cause side effects of diarrhea and flatulence. Acarbose is also rarely used to treat type 2 diabetes, unless the person is not fit to take another drug.

Nateglinide and repaglinide to release insulin into the bloodstream

Both of these drugs will stimulate the pancreas to release more insulin into the bloodstream. The function of nateglinide and repaglinide can not last long, but effective when taken before meals. Although rarely used, both are recommended if the patient has a meal schedule at unusual hours.

All drugs still have side effects, including nateglinide and repaglinide. Side effects of both drugs are hypoglycemia and weight gain.

Insulin Therapy As A Companion Other Drugs

Drugs in tablet form may be less effective to treat diabetes, so you need insulin therapy. Based on the dosage and how to use it, this therapy may be given to replace or be given in conjunction with the above medications.

Other Drugs Commonly Needed for Type 2 Diabetes Patients

People with type 2 diabetes have a higher risk for complications (heart disease, stroke, or kidney disease). Doctors will usually suggest the following medications to reduce the risk of complications:

  • Statins (eg, simvastatin) to reduce high cholesterol levels.
  • Hypertension-lowering drugs.
  • ACE Inhibitor drugs, such as lisinopril, enalapril, or ramipril, if there are indications of diabetic kidney disease. The development of disease characterized by the presence of albumin protein in the urine can be cured if treated promptly.

Blood Sugar Level Monitoring

The risk of hypoglycemia (blood sugar levels are too low) generally accompanies people with type 2 diabetes who use certain insulin or tablets in controlling their blood sugar levels. Symptoms of mild hypoglycaemia include weakness, trembling, and hunger.

The initial treatment for diabetics with hypoglycemia is to consume a source of carbohydrates (sugary drinks or glucose tablets) that can be absorbed quickly. After that, the patient may consume carbohydrate sources that can last longer such as a piece of wafer, a piece of sandwich, or eat fruit.

The steps above can generally increase blood sugar levels to return to normal. But this process can take several hours.

Severe hypoglycemia will lead diabetics to feel dazed, drowsy, and even loss of consciousness. When experiencing this condition, diabetics should be given an injection of glucagon (a hormone that can increase blood sugar levels quickly) directly on the muscles or veins.

Type 2 Diabetes Complications

Very high blood sugar levels can cause damage to blood vessels, nerves, and organs. Diabetes is a chronic disease that develops gradually, until it can trigger a number of complications if not treated properly. Here are some of the complications commonly experienced by diabetics.

  • Cardiovascular Disease. Diabetics have a higher risk for heart disease, stroke, atherosclerosis, and high blood pressure.
  • Nerve or neuropathy damage. Excess blood sugar levels can damage the nerves and blood vessels smooth. This condition can cause the emergence of the sensation of tingling or stinging that usually starts from the fingertips of the hands and feet, then spread to other body parts. Neuropathy in the digestive system can trigger nausea, vomiting, diarrhea, or constipation.
  • Damage to the leg organs. Neuropathy or blocked blood flow in diabetic feet may increase the risk of foot health complications that are usually too late to realize. About 10 percent of diabetics suffer serious infections due to minor injuries or scratches on the feet. Symptoms of foot complications to watch out for are swelling, skin that feels hot to the touch, and wounds that do not heal.
  • Eye damage, especially the retina. Retinopathy occurs when there is a problem with the blood vessels in the retina that can lead to blindness if left alone. Glaucoma and cataracts also include complications that may occur in diabetics.
  • Kidney damage. The kidneys have millions of fine blood vessels that filter waste from the blood. If the blood vessels are clogged or leaky, your kidney's performance may decrease. Severe damage to the kidneys can lead to kidney failure requiring dialysis (the process of dialysis) or even kidney transplantation.
  • Sexual dysfunction. Damage to fine blood vessels and nerves in male diabetics (especially smokers) can lead to erectile dysfunction. In female diabetics, these complications may include decreased sexual satisfaction, lack of sex drive, dry vagina, or failure to reach orgasm.
  • Skin disorders. Diabetes will make the sufferer susceptible to skin diseases such as fungal and bacterial infections.
  • Miscarriage or stillbirth. High blood sugar levels can harm the mother and fetus. The risk of miscarriage and stillbirth will increase if gestational diabetes is not treated promptly. Blood sugar levels are not maintained at the beginning of pregnancy can also increase the risk of birth defects. Pregnant women with diabetes are advised to monitor their blood sugar levels regularly.