00:01
So let's look get type 1
diabetes and type 2 diabetes.
00:06
Type 1 diabetes is that pancreas has
really suffered some destruction, okay?
So, the beta cells have taken a hit, and it's
probably from some type of autoimmune disorder.
00:16
Most people develop this as a
pediatric patient or a child,
but people can also develop
type 1 diabetes as adults.
00:22
But predominantly, Type 1 diabetes
is identified as a child.
00:27
Now this pancreas produces no insulin.
00:31
Circle that really big.
00:33
No insulin.
00:35
These cells are destroyed.
00:37
So the pancreas is no longer
able to secrete insulin.
00:41
All insulin that type 1 diabetic needs
has to be taken as a medication.
00:47
It's probably taken --
it can be taken SubQ, it can be taken from a pump,
but all insulin has to be replaced by medication.
00:54
We don't really have any oral
medications for insulin replacement.
00:58
Now there is 1 medication that we'll talk
about in the Oral Medication's video
that is showing some promise with Type 1
diabetics, but it's still not insulin.
01:08
We have no oral forms of insulin
that are reliable at this point.
01:12
Okay, so that's why I wanted to highlight this.
01:14
There has been some progress made,
some research that really supports the
use of one of the oral antidiabetics
in conjunction with insulin replacement
has been shown to be kind of
effective for type 1 diabetics.
01:27
So that's actually exciting news,
that we might have the opportunity for
diabetics that are type 1 type --
their pancreas isn't making any insulin --
to have another option
for effective management.
01:40
Now, type 1 diabetics and type 2,
but type 1 diabetics particularly require
frequent blood glucose monitoring.
01:48
And then the titration means they'll adjust
their insulin based on those readings.
01:53
Many type 1 diabetics use a pump and that
can help them with automatic adjustments,
but every type 1 diabetic has to check
their blood sugar frequently, monitor it,
and then make sure they titrate their
medication according to the plan
they set up with their health care provider.
02:10
Now, type 2 diabetes is a little bit different.
02:13
This one, the pancreas just --
sometimes it's good, sometimes it's not, right?
In type 1, we know for sure, that pancreas --
that function is gone.
02:24
In type 2 diabetes, it's variable.
02:27
The pancreas might be pushing out extra
insulin, but they're resistant to it.
02:31
The pancreas might be putting out just a
little bit of insulin and it's not enough.
02:35
But it is very likely in a type 2 diabetic
that they have insulin resistance.
02:41
Okay.
02:41
So these guys also need regular
and frequent monitoring,
depending on what level the disease is.
02:48
Now, progression of the disease
impacts how you treat it.
02:52
Initially, you might be able to treat
it with just an oral medication,
but if the patient is not able
to control their blood sugar,
then eventually, you're going
to progress to the point
where these patients will also need insulin.
03:03
So we encourage everyone to improve
their lifestyle to become more healthy,
no matter what your diagnosis is, but
it really matters in type 2 diabetes.
03:12
My blood sugar was out of control
and my weight was out of control.
03:18
When I was able to lose half my body weight,
I no longer had any more blood
pressure or blood sugar issues.
03:27
So, I don't say that to be judging because I
know how hard it is to change your lifestyle,
but what I want you to see here is if you can
encourage a patient to even make small changes,
it's going to have significant
changes in their body.
03:42
So lifestyle is key for any diagnosis,
but particularly, for diabetes.
03:46
We'll start with lifestyle and
usually we start with oral meds.
03:49
We'll talk about those in a little more detail.
03:51
And then, if the disease progresses and we're
not able to get that blood sugar under control,
the pancreas may become worse and just tire out,
and so, we have to start replacing the insulin too.
04:03
So for type 2 diabetes, this i s
developed usually in adulthood,
but we're seeing with the
rates of obesity in America,
we're seeing it in our younger and
younger and younger patients.
04:14
So, this is 1 disease that is
significantly impacted by lifestyle.
04:20
As much as we can be positive role models
for our patients, we can help them avoid,
or at least, prolong the development of type 2
diabetes so they don't develop it right away.