Study Notes on Diabetes Management

Patients often prescribed medications to increase insulin sensitivity.
- Insulin Sensitivity: Refers to how responsive the body's cells are to insulin, which is crucial for glucose uptake.
- Without proper pairing of medication and diet, patients may experience complications, including adverse reactions due to high blood glucose levels.
Over-medication may occur where patients feel shaky due to a drop in blood glucose levels after having been accustomed to high levels (300-400 mg/dL).
- Body reacts to lower levels of glucose as if it's hypoglycemia, leading to misinterpretation of symptoms.

It is crucial to ensure that diabetic patients consume an adequate amount of carbohydrates.
Malnutrition Risk: Lack of carbohydrates may lead to insufficient blood sugar rise for insulin action.
Consideration of meal timing (e.g., changes in blood sugar levels around nighttime) is vital for effective diabetes management.

Students reminded of the fall break, during which assignments are due.
Instructions for completing assignments and using online resources (e.g., nutrition information, formulas) are provided.
Use of practical quizzes and extra credit opportunities mentioned for improving grades.

Insulin Types:
- Basal Insulin: Covers metabolic needs throughout the day (e.g., long-acting insulin).
- Prandial Insulin: Insulin doses timed with meals, which adjusts based on carbohydrate intake and activity level.
Diabetes Math:
- Instructions for calculating insulin-to-carbohydrate ratios and blood glucose adjustments.

Emphasis on understanding various medications for diabetes, which may include:
- GLP-1 Agonists: Injectable medications aiding glucose regulation, appetite control, and possibly heart health.
- Oral Medications: Commencement typically before insulin therapy for many type 2 patients.

Education covers both practical management and the psychological aspects of diabetes care, including mental health evaluations and support system assessments.
Understanding dietary patterns is essential to tailor individual plans for those with diabetes and ensure adherence to treatment programs.

Different medications work through various mechanisms to manage diabetes, including:
- SGLT-2 Inhibitors: Help with glucose excretion in urine, potentially benefiting heart and kidney health.
- DPP-4 Inhibitors: Slow down the breakdown of incretins, increasing insulin release and reducing glucose levels in the blood.

ADA has released guidelines focusing on individualized therapy to consider dietary patience, mental health, and overall well-being.
Importance of maintaining balanced carbohydrate intake and avoiding sugar spikes through meal planning.

Alcohol consumption carries risks for those with diabetes, including:
- Rapid absorption raising potential hypoglycemia risk if consumed on an empty stomach due to interrupted gluconeogenesis in the liver.
- Requires monitoring blood sugar levels especially after consumption to adjust for potential fluctuations.

Strategies for managing diabetes during Ramadan fasting need to be considered.
- Requires careful planning around eating, medication adjustments, and risk assessment related to fasting.

Multiple drugs serve to achieve blood sugar regulation via different pathways:
- Incretin Mimetics: Enhance insulin secretions post-meals, reduce appetite, and lower glucagon levels.
- Importance of understanding both the effectiveness and side effects is paramount in patient consultation.
- Continuous evaluation of medication regimens is necessary to optimize patient outcomes.
Special mention of metabolic side effects including gastrointestinal disturbance and mental health alerts due to medication interactions.
Continuing education about newer drug formulations, including weight management and other positive health implications, is essential for guiding treatment.