DIABETES
Diabetes mellitus is a disorder in which the pancreas cannot create sufficient insulin (type 1 or insulin-dependent diabetes) or in which insulin is not effective (type 2 or non–insulin-dependent diabetes). Insulin allows the body to use and store sugar; in the diabetic state, the victim suffers from high blood sugar and an array of physiological derangements (kidney failure, skin ulcers, bleeding into the vitreous of the eye) associated with deterioration of small blood vessels. Many diabetics need to take insulin by injection or inhalation to manage the disease; others can control their blood sugar by diet, oral medications (hypoglycemic agents), or both. Oral medications include drugs that stimulate pancreatic cells to produce more insulin (e.g., glipizide [Glucotrol]), reduce sugar production in the liver (e.g., metformin [Glucophage]), reduce carbohydrate absorption and sugar “peaks” after eating (e.g., acarbose [Precose]), or reduce insulin resistance in the body (e.g., pioglitazone). Exenatide (Byetta) injection is used as a supplemental drug for certain patients with type 2 diabetes. Insulin analogues, such as insulin lispro, are rapidly acting and when used in conjunction with standard insulins, which have longer onset and duration of action, can allow the outdoor enthusiast who suffers from diabetes to have greater flexibility in the timing of meals, snacks, and exercise. One product is the Humalog KwikPen. Insulin is available in an inhaled form (Exubera).
