Diabetes consists of serious diseases characterized by high blood sugar levels that result from defects in the body's ability to produce and/or use insulin. Type 1 is an autoimmune disorder in which the body destroys the beta cells in the pancreas, leading to a total inability to produce insulin. Type 2 diabetes involves insulin resistance — the body's inability to properly use its own insulin supply. Some people havea form of diabetes that is in between the two types.
Diabetic nephropathy is a complication of diabetes involving damage to the kidneys, impairing their ability to filter blood and form urine properly. At its earliest stages, called microalbuminuria, small amounts of protein appear in the urine - and this may persist for many years before proteinuria, signaling high protein levels in the urine, occurs. Over time, diabetic nephropathy may eventually lead to chronic kidney failure and end-stage kidney disease.
Commonly Prescribed (On-Label) Drugs: Irbesartan, Losartan
Off-Label Prescription Drugs Breakthrough Options: Enalapril, Lisinopril, Ramipril, Candesartan, Telmisartan, Valsartan
Diabetic neuropathy is a complication of diabetes due to nerve damage throughout the body. Neuropathy can cause sensations ranging from numbness to "pins and needles" to severe pain to weakness in the hands, arms, feet, and legs. Problems can also occur in every organ of the body including the digestive tract, heart, urinary tract, and sex organs. Although a wide range of drugs may help somewhat, a single drug has not been found for everyone.
Commonly Prescribed (On-Label) Drugs: Capsaicin, Duloxetine, Pregabalin
Off-Label Prescription Drugs Breakthrough Options: Bupropion, Carbamazepine, Clonidine, Gabapentin, Lamotrigine, Lidocaine, Memantine, Mexiletine, Oxcarbazepine, Citalopram, Paroxetine, Topiramate, Tramadol, Amitriptyline, Clomipramine, Desipramine, Imipramine, Nortriptyline, Venlafaxine
Diabetic retinopathy is a complication of the high blood glucose levels of diabetes in which tiny blood vessels inside the retina, the light-sensitive tissue at the back of the eye, are damaged. Initially, it causes no symptoms, although it can be diagnosed by an eye doctor. However, if poor glucose control allows diabetic retinopathy to progress, it will eventually lead to loss of vision. It is the leading cause of blindness in adults in the United States.
Commonly Prescribed (On-Label) Drug: Indocyanine green
Off-Label Prescription Drug Breakthrough Option: Lisinopril
Because type 2 diabetes is associated with being overweight, having a poor diet, and not getting adequate exercise, along with a gradual escalation in blood sugar levels over a period of years, several large studies have explored the feasibility of preventing it with lifestyle modification or glucose-lowering drugs approved for treating diabetes. According to the American Diabetes Association, intensive lifestyle modification was more effective than any of the drugs discussed below, yielding a 58% reduction in diabetes incidence in one study.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Acarbose, Metformin, Orlistat, Pioglitazone, Rosiglitazone
Heart disease and stroke are the most life-threatening consequences of diabetes and occur to people with diabetes more than twice as often as to others. High blood glucose levels damage artery walls and contribute to premature atherosclerosis (hardening of the arteries). People with diabetes also seem to have high levels of inflammation in their bodies, high cholesterol levels, and central obesity (apple shapes), all of which increase the risk of cardiovascular disease.
Commonly Prescribed (On-Label) Drugs: Atorvastatin, Pravastatin, Simvastatin
Off-Label Prescription Drug Breakthrough Option: Pioglitazone, Rosiglitazone
Atherosclerosis (hardening of the arteries) and peripheral vascular disease (damaged blood vessels other than those immediately surrounding the heart) occur twice as often and at an earlier age in people with diabetes as in those without. This higher risk is due to multiple risk factors including: high blood glucose levels that damage artery walls; high levels of inflammation in the body, high cholesterol levels; and central obesity (apple shapes).
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Cilostazol
About 50% of people who have diabetes develop diabetic nephropathy, one of its major complications, which involves damage to the kidneys that impairs their ability to filter blood and form urine properly. At its earliest stages, called microalbuminuria, small amounts of protein appear in the urine. If this persists unchecked for many years, eventually proteinuria develops, which signals high protein levels in the urine. Proteinuria leads to chronic kidney failure and end-stage kidney disease.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Eplerenone
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