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diabetes is when your body doesn’t use insulin properly. In type 2 diabetes, some people are insulin resistant, meaning that their body produces a lot of insulin but can’t use it effectively. Some people with type 2 diabetes don’t produce enough insulin. Type 2 is different from type 1 diabetes because in type 1, your body doesn’t produce any insulin at all.

Diabetic hypoglycemia is a low blood glucose level occurring in a person with diabetes mellitus. It is one of the most common types of hypoglycemia seen in emergency departments and hospitals. According to the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP), and based on a sample examined between 2004 and 2005, an estimated 55,819 cases (8.0% of total admissions) involved insulin, and severe hypoglycemia is likely the single most common event.
In general, hypoglycemia occurs when a treatment to lower the elevated blood glucose of diabetes inaccurately matches the body’s physiological need, and therefore causes the glucose to fall to a below-normal level.
Each person with diabetes may have different symptoms of hypoglycemia. You’ll learn to spot yours.
Early symptoms include:

  • Confusion
  • Dizziness
  • Feeling shaky
  • Hunger
  • Headaches
  • Irritability
  • Pounding heart; racing pulse
  • Pale skin
  • Sweating
  • Trembling
  • Weakness
  • Anxiety

Without treatment, you might get more severe symptoms, including:

  • Poor coordination
  • Poor concentration
  • Numbness in mouth and tongue
  • Passing out
  • Nightmares or bad dreams
  • Coma

Hyperglycemia, or high blood sugar (also spelled hyperglycaemia or hyperglycæmia, not to be confused with the opposite disorder, hypoglycemia) is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a blood sugar level higher than 11.1 mmol/l (200 mg/dl), but symptoms may not start to become noticeable until even higher values such as 15–20 mmol/l (~250–300 mg/dl). A subject with a consistent range between ~5.6 and ~7 mmol/l (100–126 mg/dl) (American Diabetes Association guidelines) is considered hyperglycemic, while above 7 mmol/l (126 mg/dl) is generally held to have diabetes. Chronic levels exceeding 7 mmol/l (125 mg/dl) can produce organ damage.
The following symptoms may be associated with acute or chronic hyperglycemia, with the first three composing the classic hyperglycemic triad:

  • Polyphagia – frequent hunger, especially pronounced hunger
  • Polydipsia – frequent thirst, especially excessive thirst
  • Polyuria – increased volume of urination (not an increased frequency for urination)
  • Blurred vision
  • Fatigue
  • Weight loss
  • Poor wound healing (cuts, scrapes, etc.)
  • Dry mouth
  • Dry or itchy skin
  • Tingling in feet or heels
  • Erectile dysfunction
  • Recurrent infections, external ear infections
  • Cardiac arrhythmia
  • Stupor
  • Coma
  • Seizures

If blood sugar is consistently high, over time it can affect the heart, eyes, kidneys, nerves, and other parts of the body. These problems are called complications. Sometimes people with diabetes don’t realize that they have the disease until they begin to have other health problems. For example, a doctor or health care provider may detect signs of diabetes damage even though the patient does not know that he/she has the disease.
Complications of diabetes include:

  • Heart Disease – People with diabetes have a higher risk for heart attack and stroke.
  • Eye Complications – People with diabetes have a higher risk of blindness and other vision problems.
  • Kidney Disease – Diabetes can damage the kidneys and may lead to kidney failure.
  • Nerve Damage (neuropathy) – Diabetes can cause damage to the nerves that run through the body.
  • Foot Problems – Nerve damage, infections of the feet, and problems with blood flow to the feet can be caused by diabetes.
  • Skin Complications – Diabetes can cause skin problems, such as infections, sores, and itching. Skin problems are sometimes a first sign that someone has diabetes.
  • Dental Disease – Diabetes can lead to problems with teeth and gums, called gingivitis and periodontitis.

The goal of treatment at first is to lower your high blood glucose levels. Long-term goals are to prevent problems from diabetes. The most important way to treat and manage type 2 diabetes is with activity and healthy eating.
Learning diabetes management skills will help you live well with diabetes. These skills help prevent health problems and the need for medical care. Skills include:

  • How to test and record your blood glucose
  • What and when to eat
  • How to safely increase your activity and control your weight
  • How to take medications, if needed
  • How to recognize and treat low and high blood sugar
  • How to handle sick days
  • Where to buy diabetes supplies and how to store them

Alpha-glucosidase inhibitors are oral anti-diabetic drugs used for diabetes mellitus type 2 that work by preventing the digestion of carbohydrates (such as starch and table sugar). Carbohydrates are normally converted into simple sugars (monosaccharides), which can be absorbed through the intestine. Hence, alpha-glucosidase inhibitors reduce the impact of carbohydrates on blood sugar.

There are different types, or classes, of drugs that work in different ways to lower blood glucose (blood sugar) levels:

  • Sulfonylureas
  • Biguanides
  • Meglitinides
  • Thiazolidinediones
  • DPP-4 inhibitors
  • SGLT2 Inhibitors
  • Alpha-glucosidase inhibitors
  • Bile Acid Sequestrants

You should know that alcohol and some diabetes pills may not mix. Occasionally, chlorpropamide and other sulfonylureas, can interact with alcohol to cause vomiting, flushing or sickness. Ask your doctor if you are concerned about any of these side effects.

Because the drugs listed above act in different ways to lower blood glucose levels, they may be used together. For example, a biguanide and a sulfonylurea may be used together. Many combinations can be used. Though taking more than one drug can be more costly and can increase the risk of side effects, combining oral medications can improve blood glucose control when taking only a single pill does not have the desired effects. Switching from one single pill to another is not as effective as adding another type of diabetes medicine.

Most people with type 2 diabetes may need one injection per day without any diabetes pills. Some may need a single injection of insulin in the evening (at supper or bedtime) along with diabetes pills. Sometimes diabetes pills stop working, and people with type 2 diabetes will start with two injections per day of two different types of insulin. They may progress to three or four injections of insulin per day.
Insulin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • redness, swelling, and itching at the injection site
  • changes in the feel of your skin, skin thickening (fat build-up), or a little depression in the skin (fat breakdown)
  • weight gain
  • constipation

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

  • rash and/or itching over the whole body
  • shortness of breath
  • wheezing
  • dizziness
  • blurred vision
  • fast heartbeat
  • sweating
  • difficulty breathing or swallowing
  • weakness
  • muscle cramps
  • abnormal heartbeat
  • large weight gain in a short period of time
  • swelling of the arms, hands, feet, ankles, or lower legs
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