Diabetes is a chronic disease that has no cure, but it is possible to control blood glucose levels with the use of remedies and lifestyle changes, both for the effectiveness of treatment,and for the reduction of side effects .
It is caused by low production or insulin resistance, which is the hormone that regulates the entry of glucose (sugar) into cells for energy production.
Insulin is like the transporter and the key, so that glucose arrives and can enter the cells, coming out of the bloodstream. Inside the cell, glucose is transformed into energy, the fuel for all vital functions of the body. People with diabetes have little insulin or their cells do not recognize it, as a result blood glucose levels get high.
According to the International Diabetes Federation, about 8% of the Brazilian population is diabetic, resulting in more than 15 million Brazilians living with the disease. There are 4 forms of diabetes, type 1, type 2, prediabetes and gestational diabetes:
- Type 1: Insulin-producing pancreatic cells are attacked by the cells of the immune system themselves, resulting in little or no insulin production. It is associated with genetic factors and treatment is done with daily insulin injections and blood glucose monitoring
- Type 2:Cells produce insulin but cannot absorb it properly, keeping glucose high in the blood. It has a strong relationship with unruly feeding, sedentary lifestyle, high blood pressure, overweight/obesity and family history. Disease control is done with medications and changes in habits
- Pre-diabetes: signaling phase of the body, in which glucose levels are above normal, but still do not configure diabetes, and can be reversed with changes in diet and physical exercise
- Gestational diabetes :it is a situation of temporary diabetes, which offers risks during pregnancy and childbirth.
The medications are used to control blood glucose levels and prevent complications of the disease, such as kidney disease and skin and eye problems.
Treatment with the remedies can cause side effects, especially at first. It is important to know these possible side effects, so that the doctor makes adjustments in the treatment if necessary.
Currently, SUS provides the following medicines: human nph and regular insulins, metformin, glibenclamide, glyclazide and dapagliflozin.
See what are the possible side effects of the remedies used in the treatment of diabetes.
Insulin Side Effects
There are several types of insulin available, and what sets them apart is the time of action. Regular insulin is identical to insulin naturally produced by pancreatic cells. Modified insulins contain added substances, which make their action time shorter, intermediate or prolonged, depending on the patient’s need, evaluated by the endocrinologist.
It is the exaggerated reduction of blood glucose levels and causes the following symptoms:
Hypoglycaemia should be treated as it can cause fainting and even coma. Therefore, when presenting the symptoms of hypoglycemia, the person should ingest some food or drink with fast-absorbing carbohydrates, such as a fruit juice, a glass of water with a spoonful of sugar or a sweet. When the ingestion of something sweet does not solve, one should go to the emergency room.
To avoid this side effect, it is important that the person undergoing treatment eats every 3 hours of small parts, so that it keeps glucose levels constant in the blood. One should avoid having large meals and spending hours fasting. Of course all food should be suitable for diabetes, so the follow-up of a nutritionist is essential in treatment.
If hypoglycemia episodes are very frequent, it is important to report this to the doctor, so that the case is evaluated and, if necessary, adjustments are made to the dose or type of insulin.
Insulin is a hormone that has anabolic effect, since it carries excess glucose into the cells, where it is stored in the form of fat. For this reason, treatment should be accompanied by changes in eating habits and regular practice of physical exercises, to avoid this side effect.
Eating excesses can be promoted by fear of an episode of hypoglycemia, which brings serious discomfort and risks. Therefore, the organization of the diet is the greatest ally to avoid weight gain and episodes of hypoglycemia.
They are reactions that appear at the injection site and usually disappear with treatment: redness, itching and swelling.
Lipodystrophy is the abnormal accumulation or loss of fat at the injection site, and is related to incorrect application of insulin. To avoid this side effect, it is important to perform a rotation in applications, which is to switch the injection site within the same area.
In addition, the application of the correct dose and cleaning at the site of application are important to avoid lipodystrophy.
Side effects of metformin
Metformin decreases blood glucose levels by inhibiting a certain amount of glucose produced by the liver. In addition, this medicine causes muscle cells to absorb glucose better.
The most common side effects are digestive problems:
- Excess gases
- Tummy ache
- Loss of appetite
- Change in taste
To avoid these problems, it is advisable to take the medicine during or after a meal.
Side effects of glibenclamide
Glibenclamide reduces blood glucose levels, so one of the possible side effects is hypoglycemia. Other side effects are:
- Temporary visual disturbances
- Abdominal pain
- Weight gain
- Yellowish skin coloring.
In the presence of these side effects, the doctor will decide whether treatment with glibenclamide should be discontinued or not.
Side effects of glyclazide
Like other medicines that reduce blood glucose levels, glyclazide can cause hypoglycaemia, which can be avoided with frequent feedings throughout the day.
Glyclazide can cause adrenergic dysfunction, resulting in:
- Cold and moist skin
- High pressure
These symptoms, as well as hypoglycemia, tend to disappear after sugar intake.
Gastrointestinal problems are also common side effects:
- Abdominal pain
These discomforts can be reduced and even avoided if glyclazide is given for breakfast.
Side effects of dapagliflozin
Dapagliflozin lowers blood glucose levels by reducing glucose resorption in the kidneys, causing more glucose to be eliminated in the urine.
It is a medicine that has recently been inserted under the SUS and has interesting benefits for the treatment of type 2 diabetes, such as:
- Rare occurrence of hypoglycaemia
- Reduced body weight
- Decreased blood pressure
- Disease stabilization
- Reduction of hospitalizations and mortality.
The most commonly reported side effects were:
- Renal dysfunction
- Increased creatinine levels in the blood
- Decreased renal clearance of creatinine
- Urinary tract infection
Discontinuation of therapy due to adverse effects is evaluated by the physician responsible for the case.
It is important to remember that in any type of treatment, food control, with a low intake in sugars, and changes in lifestyle, with the regular practice of physical exercises, are essential for the effectiveness of treatment.
In addition, correctly following the doctor’s instructions regarding the doses, schedules and forms of administration of medications are decisive for reducing the side effects of treatment.