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Rx Online Pharmacy:
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: I’ll start by Introducing Myself.

I am Chioma.
A pharmacist by profession.
I practice at WELNEX PHARMACY here in Lagos.
It is a community/Retail Pharmacy.
I am passionate about creating awareness on living healthy. I am also passionate about helping people understand their ailments while providing solution(s) and top notch Pharmacare to them.
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: *Outline*
Definition
Types
Symptoms
Diagnosis/tests
Pre disposing/Risk Factors
Treatment
Complication
Myths and realities
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: In type 2(unlike in 1),insulin is produced but its effect is not optimal hence leaving lots of glucose moving freely in the blood instead of being absorbed by the cells
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: Of these four types, the most common is *type 2*
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: *Type 1*
This is also known as Insulin dependent or Juvenile diabetes.

In this type, the body does not produce insulin at all.
An individual with type 1 will have to be on exogenous insulin for the rest of His/Her lifetime.
He/She will not be able to eat without getting a shot of insulin.

Type 1 occurs mostly at Juvenile age but can also occur at any age.
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: An individual with type 1 is highly prone to having keto acidosis (ketoacidosis will be explained later.)
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: We will take them one at a time
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: *Definition*
Diabetes is simple defined as a group of metabolic diseases/disorders in which the blood sugar remains *persistently* elevated
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: It has to be confirmed that the blood sugar has remained persistently elevated despite non drug approaches to lowering it
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: In essence,tests especially the FBS(fasting blood sugar) needs to have been carried out at least thrice within a given time interval and baring all non drug interventions,before a sure diagnosis can be made
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: *Type 2*
This is the most common type of Diabetes Melitus.
It occurs as a result
1) insufficient insulin production by the body

2)decreased sensitivity to the insulin produced by the body.
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: Treatment in type 2 may or may not require external injection of insulin but will require oral medications.
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: So what this implies is that you can not make a diagnosis of diabetes by a single test.
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: *Types*
There are 4 types of diabetes;
-Type 1(insulin dependent) diabetes

-Type 2(Non Insulin diabetes)

-Gestational Diabetes

-Prediabetes
[14/11, 7:52 pm] Rx Online Pharmacy-Welnex: Remember,it is a metabolic disorder not a contagious illness.

[14/11, 8:04 pm] Rx Online Pharmacy-Welnex: Treatment in type 2 may or may not require external injection of insulin but will require oral medications.
[14/11, 8:13 pm] Rx Online Pharmacy-Welnex: I hope we now have a better understanding of diabetes and the different types.
[14/11, 8:13 pm] Rx Online Pharmacy-Welnex: *Prediabetes*
This is a condition in which the blood glucose is elevated but not high enough to be classified as Type 2 diabetes.

Most people are in this category and may eventually progress to type 2 diabetes if not well managed.
[14/11, 8:13 pm] Rx Online Pharmacy-Welnex: *Gestational Diabetes*
Gestation refers to the process of being pregnant.

Therefore Gestational Diabetes(GD) is simply the elevated blood glucose levels in pregnacy.
This is majorly due to hormonal changes. In GD,the placenta produces hormones which cause build up of glucose in the blood. In most cases,the body can handle it. If the body fails to,the blood glucose level rises,leading to GD.

Other factors that can predispose a woman to having GD include Obesity (excess body weight), sedentry(inactive)lifestyle , poor eating habits,amongst others.

[14/11, 8:13 pm] Rx Online Pharmacy-Welnex: I hope we now have a better understanding of diabetes and the different types.
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: *Diagnosis/Testing*

Diagnosis is usually by blood glucose Test.

This should be confirmed after carrying out FBS (Fasting Blood Sugar) Test on more than one occasion,within a short specified period of time.

For those already living with this condition, you should not only be concerned with your Fasting Blood Sugar (FBS) levels, but also your 2HPP (2 hours Post Prandial (meal))levels,HbA1c levels (shows your body’s glucose control over a 3month period).
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: Average peeing time for individuals is between 6-8times a day.
It could be less.
Some medications( e.g diuretics),excessive intake of water,body temperature can also increase urine output.

Just as being on some medications e.g steroids like prednisolone and dexamethasone can cause elevated blood glucose levels

Pls take note
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: I just saw my notes..i forgot to add that the urine colour can also be used to differentiate between diabetes insipudus(D.I) and Diabetes Melitus(DM)

The urine colour in DM is usually yellow,pale and can also be cloudy.

In D.I,It is usually clear and transparent.
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: *You can Send in your Questions if its getting late for you to be still be awake,i am halfway done and will attend to them afterwards.*
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: So in essence,Testing is multi dimensional and not just relying on only FBS.
Ok?
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: As i said earlier 2HPP is also Very Important.

The Values in mg/dl are;

90-126 (excellent)
126-180(good)
181-234(acceptable)
Above 235(High)

So if you test 2hrs Post Prandial(2 hrs after meal),you can determine how well controlled the glucose level is.

You just dont want to have a good FBS level and then upward spikes Post prandial levels.

The aim should be to maintain a relatively steady blood glucose level across the day.
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: Do you know that checking your blood glucose level at bedtime is also very important,especially if you are diabetic.
This is one of the reason why some people go to bed but dont wake up the next day.
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: *Blood Glucose Values*
There are two units of blood glucose measurement.
Mg/dl abd mMol/l.
Glucose monitors are in either of these two units,the common one being mMol/l

They are usually in a range of numbers.

For Fasting Blood Sugar

*30-70mg/dl OR 1.7-3.9mMol/L is Loe blood sugar*

*70-100mg/dl OR 3.9-5.5mMol/l is normal blood sugar*

*101-125mg/dl OR 5.6-6.9mMol/L is Pre diabetes*

*126-600mg/dl OR 7.0-33 3mMol/L is Diabetes*
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: 2HPP is important because your FBS may be good but your glucose levels 2hrs after meals might be high.If the 2HPP levels remain high they can lead to damage of the body’s organs.

[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: I just saw my notes..i forgot to add that the urine colour can also be used to differentiate between diabetes insipudus(D.I) and Diabetes Melitus(DM)

The urine colour in DM is usually yellow,pale and can also be cloudy.

In D.I,It is usually clear and transparent.
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: So in essence,Testing is multi dimensional and not just relying on only FBS.
Ok?
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: As i said earlier 2HPP is also Very Important.

The Values in mg/dl are;

90-126 (excellent)
126-180(good)
181-234(acceptable)
Above 235(High)

So if you test 2hrs Post Prandial(2 hrs after meal),you can determine how well controlled the glucose level is.

You just dont want to have a good FBS level and then upward spikes Post prandial levels.

The aim should be to maintain a relatively steady blood glucose level across the day.
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: Average peeing time for individuals is between 6-8times a day.
It could be less.
Some medications( e.g diuretics),excessive intake of water,body temperature can also increase urine output.

Just as being on some medications e.g steroids like prednisolone and dexamethasone can cause elevated blood glucose levels

Pls take note
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: *Blood Glucose Values*
There are two units of blood glucose measurement.
Mg/dl abd mMol/l.
Glucose monitors are in either of these two units,the common one being mMol/l

They are usually in a range of numbers.

For Fasting Blood Sugar

*30-70mg/dl OR 1.7-3.9mMol/L is Loe blood sugar*

*70-100mg/dl OR 3.9-5.5mMol/l is normal blood sugar*

*101-125mg/dl OR 5.6-6.9mMol/L is Pre diabetes*

*126-600mg/dl OR 7.0-33 3mMol/L is Diabetes*
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: *You can Send in your Questions if its getting late for you to be still be awake,i am halfway done and will attend to them afterwards.*
[14/11, 9:27 pm] Rx Online Pharmacy-Welnex: Do you know that checking your blood glucose level at bedtime is also very important,especially if you are diabetic.
This is one of the reason why some people go to bed but dont wake up the next day.
[14/11, 10:12 pm] Rx Online Pharmacy-Welnex: *complications of Diabetes Melitus*

Most people living with diabetes do not understand the complications that can arise from uncontrolled and persistently elevated blood glucose level. Some of them include;
-Irreversible kidney damage
-Retinopathy and blindness
-Peripheral Neuropathy (nerve Damage)
-Heart Attack
-Sleep apnea
– cerebrovascular disease
-Diabetic foot infections
-Diabeyic KetoAcidocis
[14/11, 10:12 pm] Rx Online Pharmacy-Welnex: I didnt want to bore you with the names since this ckess is not strictly for health professionals.
😁
[14/11, 10:12 pm] Rx Online Pharmacy-Welnex: *Treatment Of Diabetes Melitus*

Type 1 diabetes is primarily managed with Insulin Injections

Type 2 diabetes Melitus is managed with both insulin and Oral medications.
Both can be used together OR individually.

There are a lot of medication available for management of type 2 diabetes. Both the conventional ones we all know, newer molecules already in circulation and some still undergoing clinical trials.

Your Doctor or Pharmacist will discuss an appropriate individualised treatment protocol with you.

Do not recommend your medications to someone else.
[14/11, 10:12 pm] Rx Online Pharmacy-Welnex: *Diabetic ketoAcidosis (especially in type 1)
[14/11, 10:12 pm] Rx Online Pharmacy-Welnex: *class
[14/11, 10:14 pm] Rx Online Pharmacy-Welnex: These complications occur mostly due to the persistently elevated blood glucose levels causing injuries to the blood vessels in these organs (as in the case of the kidney) or damage to the walls of the blood vessel that nourish the nerves(as in the case of the legs and eyes).
[14/11, 10:31 pm] Rx Online Pharmacy-Welnex: Type 2 diabetes can also lead to eye conditions such as cataract and glaucoma
[14/11, 10:31 pm] Rx Online Pharmacy-Welnex: Diabetic foot infections occur when peripheral neuropathy is worsened or

in thd case of a slow healing wound. This conditions if not well treated ultimately results in amputation of the affected limb.
[14/11, 10:31 pm] Rx Online Pharmacy-Welnex: Peripheral Neuropathy is a common occurence in people living with type 2 diabetes.
The symptoms include numbness,tingling sensation,hotness of the foot.

This happens due to the reason just mentioned earlier(persistent elevated blood sugar damaging the blood vessels supplying the nerves).

Another reason is due to the side effects of the anti diabetic medications.
Most of these medications cause increase in the body’s excretion of important vitamins (esp the b vitamins) and elements.
[14/11, 10:44 pm] Rx Online Pharmacy-Welnex: Diabetic Ketoacidosis (DKA) is a common occurence in type 1 diabetes.

In DKA,the body produces high level of acids in the blood calked ketones.
This ketones are produced because there is no insulin to take up glucose into the cells. The body then break down fats to get energy.
As the level of these ketones rise,it leads to a dangerous condition called Diabetic Ketoacidosis.

The Early symptoms include;
-Polydypsia(excessive thirst)
-polyuria (excessive urination)
-High blood glucose levels
–high ketone levels in the urine

More severe symptoms include;
— dry /flaky skin
–difficulty in breathing
–weakness
—constantly feeling sleepy
–Fruity Smelling breath

This is actually a very dangerous condition.
[14/11, 10:58 pm] Rx Online Pharmacy-Welnex: Looking at the symptoms, there are some similarities,therefore more focus should be on the unique factors when confronted with it.
[14/11, 10:58 pm] Rx Online Pharmacy-Welnex: *1)hyperglycaemia*
This simply refers to elevated blood glucose level.
Symptoms include;

Headache
Blurred vision
Highly Irritable
Polydypsia(excessive thirst)
Frequent urination
Weight loss
Fatigue (weakness)

*2)Hypoglycaemia*
Polyphagia (excessive hunger)
Dizziness
Sweating
Dizziness
Trembling
Pale look
Blurred vision
Tiredness
Difficulty in concentrating
Confusion
Palpitation

Extreme of both conditions can lead to coma
[14/11, 11:26 pm] Rx Online Pharmacy-Welnex: Please can you throw more light on this
[14/11, 11:26 pm] Rx Online Pharmacy-Welnex: Lifestyle modification with respect to meals is very important in prevention and management of type 2 diabetes.
If you are in lagos,you can walk into any of our outlets and pick up a *free copy* of healthy portion food chart.
It is very informative and relatable.
[14/11, 11:57 pm] Rx Online Pharmacy-Welnex: *Myths and Realities*
A lot of myths and realities surround this Disease condition,one of which we just talked about -Boring food.
*So now you know better.*

Some feel it is a death sentence.
*It isnt dear Friend,if well managed,you can live a long and healthy life*

Some are just tired of taking pills everyday
*Well,you might be able to avert this if you are focused and meet your required blood glucose target.Thay way you _might_ be on alternate day treatment with strict monitoring*

If tbe blood glucose level drops,they can stop their pills and return to unhealthy eating habits.

*No,No,No*

The Reality of Diabetes type 2 is that it cannot be cured.
It can only be managed effectively. When this is done,the individual is able to live a very normal and healthy life.

Are you living with this condition or you know someone who is?

*Do not let it define you*

*Take charge of the disease condition,set a goal for your blood sugar level and work towards it*

*work closely with your doctor or Pharmacist to guide you in making the right decisions and also providing you with new/relevant information*
[14/11, 11:57 pm] Rx Online Pharmacy-Welnex: For Anyone on anti diabetic medication,it is very important to add a supplement to your medication.

This helps to mitigate those complications mentioned earlier.
Look out for supplements containning,Alpha Lipoic Acid,B-Vitamins,chromium,Zinc,cinnamon,varnadium,
amongst others.
A good number of them are available in most Pharmacies including WELNEX PHARMACY.
[14/11, 11:57 pm] Rx Online Pharmacy-Welnex: The floor is now o

pen for questions
[14/11, 11:57 pm] Rx Online Pharmacy-Welnex: Having covered the outline,we will draw the curtain on today’s Live class.

I want to appreciate everyone who joinned in,and who helped spread the news.

I hope its been interesting and informative as i intended it would.

Above all,let’s change the narrative..

Diabetes is not life imprisonment.

Together we can,and we will!

Thanks
Pharm Chioma

For Audios parts
Click on this TELEGRAM LINK

https://t.me/joinchat/GOR8E1e2nzyfmUIdwuoitQ