Brief overview of managing diabetes

Living in Pakistan you indeed heard of diabetes commonly called "sugar". It is estimated that 33million people live with type-2 diabetes in Pakistan, an additional 11 million have glucose intolerance, and 8.9 million with undiagnosed diabetes [1]. A total of 55million people roughly 25% are suffering from this disease. But the question is;

"How can one know he is suffering from diabetes?"

Well according to the stats every fourth person is diabetic so there is a 25% chance you are diabetic if you are living in Pakistan. But, this chance doubles when this disease is already diagnosed in your family or there is a history of disease in your family. But still, there is a 50% chance that you don't have diabetes. But, if you are urinating a lot often at night, feeling thirsty most of the time, Losing weight, feeling hungry, Blurry vision, numb or tingling hands or feet, dry or dark skin. If your body shows these signs you should get yourself tested usually the most used and reliable test found in practice is Random blood glucose test or Hb1AC. Both can be done at home through different devices available at

Pakistan is a country where people spend most of their income on unhealthy food filled with a lot of carbohydrates and fats. These unhealthy foods are one of the reasons for type 2 diabetes where your body is not producing insulin (a hormone that usually controls your glucose level in the blood) according to the need of the body or your body tissues become resistant to the insulin and unable to use glucose from your blood for energy. But along with this there is also type 1 diabetes which is an autoimmune disorder and manifests in the early years of life usually between 5-15 years of age. But here another question rises;

"Can diabetes be reversed or cured?"

The answer to this question is it cannot be reversed or cured but the good news is we can manage diabetes and there is also some modern research suggesting that it can be reversed, well that's another debate we will not dig down deeper into and come to the solution which is practiced in Pakistan. They usually start their treatment by giving the oral hypoglycemic agent or insulin and that actually makes sense. One of the hormones i.e insulin is not produced by the pancreas anymore so why don't just make it in the laboratory and inject it into the body to maintain blood glucose level. But this also has its own complexities and cost associated with it.

Continuing insulin, a hormone that allows the cell to use glucose. It came in different forms under different brands, major types include Rapid-acting (, which starts to work within a few minutes and lasts a couple of hours, Regular- or short-acting, which takes about 30 minutes to work fully and lasts 3 to 6 hours, Intermediate-acting, which takes 2 to 4 hours to work fully. Its effects can last up to 18 hours, Long-acting, which can work for an entire day, and Pre-mixed. As you need to adjust doses of the insulin according to the need so there is a chance of overdosing which can be life-threatening. The major brands along with types are quoted below in the table [2].

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But before initiating insulin there is always other hypoglycemic agents which control or maintain the blood glucose level. These agents act in diffrent ways at diffrent sites, either increasing the production of insulin or by increasing the senstivity if the tissues.[2] These agents are usually effective in the initial managemnet of the diabetes or in combination with insulins. In pakistan most of the national pharmaceutical is making generics for these oral hypoglycemic agents but lack the manufacturing of insulin, but few pharmaceutical are on their way to produce insulin but their efficacy will remain a question. India and and Bangaldesh are ahead of pakistan and they are producing new compounds and diffrent formulation of insulin that is allowing the lower middle income countries to afford the treatment of diabetes.

But one should woory that is he going to take these medicines or insulin all their life? 

Answer to this question is straight yes in case of insulin, once you start using insulin then you have to use it all your life as your body will be dependent on the insulin from outer source. But, in case of oral hypoglycemic agent combine with lifestyle changes can get you out of the trouble. There are few lifestyle changes and food combination that can actually increase the blood glucose level and keep you away from this disease. Even if you don't have the diabetes you should foolow these if there is a history of diabetes in your family. But one should be anxious;

What lifestyle changes or food i need to avoid diabetes or manage diabetes in a better way?

First thing first you have to know your numbers get yourself tested for at least once in a day and get get control over it. One should know the high and low levels and how to keep them manage. you can get consuling ate for free from a qualified pharmacist on to these. 

While eating pay attention to your portions, fill half your plate with fruits and vegetables, and split the other half between a lean protein and a grain. Mostly consume fiber and take a good look on your carbs intake as these are the sugars which cause hyperglycemia or increase sugar level in blood. Keep youself cool and do physical exercises as being physically active allow your body sugars to consume. Make a check on your weight and limit alcohol consumption. Try to keep stress away from your life make healthy sleeping habits and surround yourself with fresh air. These are the things which can keep you away from diabetes or help in managing the diabtes.[3] online pharmacy


  2. Pharmacotherapy principles and practices by Julie sease and kayce shealy.