Increasing use of Gliptins

Over the last few years the use of gliptins in South Asians and Indians has increased dramatically. This has been mirrored with evidence of the decreasing benefits of sulfonylureas. Sulfonylureas used to and still is a drug that is very commonly used. The fear that use of sulfonylureas results in an increase in the death or failure of beta cells has led many clinicians to use the medication with caution.

Gliptins initially made their appearance in 2006. This group of medication are DPP-4 inhibitors. The group of enzymes were discovered as far back as 1967 but it took close to 40 years to be able to utilise them for our benefit. The method of action is to increase incretins. This increase in the levels of incretins results in decrease in the amount of glucagon released. Glucagon is a hormone that increases the levels of glucose. Gliptins actions do not stop there but they also increase the amount of insulin being released, slow the transit of food in the gastrointestinal tract and lower the levels of glucose in the body. The medication though needs to be used with caution in patients with deranged liver function tests and also with any history of pancreatic disease. 

Exercise and Diabetes

• Regular physical activity decreases insulin resistance and also decreases the Cholesterol content in the body. 
• Exercise increases the good cholesterol namely HDL Cholesterol.
• The benefits of exercise in Diabetes are lost within 3-10 days of stopping any regular exercise.
• Physical activity also protects against the development of type 2 diabetes.

 Recommendations

• The recommended minimum amount of activity for:
  • Adults - 30 minutes on at least five days of each week.
  • Children - one hour each day

Type 2 diabetes

Type 2 diabetes developes when a body cannot produce adequate amount of insulin or the insulin that is produced is unable to work adequately.

Type 2 diabetes is a more common variety of Diabetes and its incidence has been on the increase.                 

This increased incidence of Diabetes has particularly affected South Asians, Indians and more so South Indians.

What are the symptoms for Type II Diabetes?

Some of the common symptoms encounted include an increased thirst known as Polydipsia                 increase in hunger known as Polyphagia and an increase frequency of urination known as Polyuria.

Quite often there is a family history of Diabetes. Being over weight contributes to the development of Diabetes.  Also as we age specialy greater than 40 years we are more prone to this condition.

What can we do to prevent Diabetes?

Preventing Diabetes is possible if we lead a very health life style with a regime of daily exercise for atleast 30 mintues a day and also eating the right kind of food to include plenty of vegtables and decreasing high fat diet.

Gestational Diabetes

Gestational Diabetes is a type of Diabetes that occurs during pregnancy

Though quite often the condition occurs in the second and third trimester it is not uncommon to find women devolping Diabetes even first trimester.

How can you look for Gestational Diabetes

Gestational Diabetes is diagnosed by way of Oral Glucose tolerance test

What are the risk factors Gestational Diabetes

History of over weight or obese

Family history of Diabetes

A previous of history a large infant

A past history of Gestational Diabetes

An unexplained miscarriage or if you are of South Asian origin 

Type 1 Diabetes

Type 1 Diabetes is a condition where your body does not produce adequate amounts of insulin. This condition is usually a life long problem and requires insulin for treatment from the very beginning.

Type I Diabetes is more common in younger people but with improving treatment more and more people who are ederly have learnt to live and cope very well with this condition.

The Week Health Cover Story 'Earlier the better'

Diabetes and the heart
Earlier, the better

By Dr D.K. Sriram
Indians are known to have a predilection for heart disease and the prevalence of diabetes is an important risk factor. What is worrisome is that this trend of increased incidence of heart disease seems to be occurring at a young age. The sight of patients in their thirties and forties being wheeled into the emergency room with chest pain has become common.
The reasons for this rather dramatic increased risk include diabetes, hypertension, high cholesterol levels, dietary factors, lack of exercise and other genetic factors that give rise to an exaggerated effect in Indians when compared to other races. It is postulated that our genetic makeup, used to a more frugal diet, has yet to adapt to the change in dietary habit to high fat and carbohydrate food.
The need of the hour is an increased awareness of the risks, especially in patients with diabetes. In dealing with such patients, a review of associated risks and adequate medication and lifestyle modification is important. Current evidence points to a large number of patients with diabetes and pre-diabetes, who have not had tests to confirm the diagnosis and allow early intervention of the disease process. We also have good evidence to suggest that if we deal with the associated risk factors such as high blood pressure and elevated cholesterol levels in diabetes adequately, then we find a significant decrease in the development of heart disease and other complications. This timely intervention will result in a healthier society with lesser need for invasive and expensive management at a later date.
The author is consultant diabetologist at Apollo Hospitals, Chennai.

First Apollo insulin pump clinic kicks off

By Express News Service - CHENNAI

Published: 12th September 2013 07:25 AM

Last Updated: 12th September 2013 07:25 AM

• Photos

• 
  Dr S Venkataraman, Dr TS Boochandran, Prof Dr D Shantaram, Dr D K Sriram and Dr Jayashree Gopal during the launch. (Express photo)