Diabetes is a group of deases in which the body doesn’t make any insulin or the body cannot make good use of insulin it produces. When any of these things happens, the body is unable to get sugar from the blood into cells. That lead to high blood sugar levels.
There are three main types of diabetes:
Type 1 Diabetes
Type 1 diabetes often develops more quickly and cause symptoms like weight loss, it can develop at any age. but occurs most frequently in children and adolescents. When you have type 1 diabetes, your body produces very little or no insulin, which means that you need daily insulin injections to maintain blood glucose levels under control.
Type 2 Diabetes
Type 2 diabetes is more common in adults and accounts for around 90% of all diabetes cases.it start as insulin resistance. This means your body does not make good use of the insulin that it produces. The cornerstone of type 2 diabetes treatment is healthy lifestyle, including increased physical activity and healthy diet. However, over time most people with type 2 diabetes will require oral drugs or insulin to keep their blood glucose levels under control.
Gestational Diabetes is a type of diabetes that can develop during pregnancy.it is usually diagnosed from a blood test 24 to 28 weeks into pregnancy. That means you have high blood glucose and its associated with complications to both of mother and fetus. this type of diabetes usually disappears after pregnancy but women affected and their children are at increased risk of developing type 2 diabetes later in life.
Types of diabetes treated
For all types of diabetes, you’ll need to work closely with your doctor to keep it under control. The main goal is to keep blood glucose levels within your target range. Your doctor will let you know what your target range should be. Targets vary with the type of diabetes, age, and presence of complications. If you have gestational diabetes, you blood glucoses targets will be lower than people with other types of diabetes. Physical activity is an important part of diabetes management. Ask your doctor how many minutes per week you should devote to exercise. Diet is also crucial to good control.
Treating type 1
All people with type 1 diabetes must take insulin to live because damage to the pancreas is permanent. There are different types of insulin available with different times of onset, peak, and duration. Insulin is injected just under the skin. Your doctor will show you how to properly inject and rotate injection sites. You can also use an insulin pump, which is a device worn outside your body that can be programmed to release a specific dose. There are now continuous blood glucose monitors as well that check your sugar 24 hours a day.
Treating type 2
Type 2 diabetes is managed with diet and exercise, and can also be treated with a variety of medications to help control blood sugar. The most common tablet is metformin but if metformin doesn’t work, your doctor can add other medications or try something different.
Treatment for gestational diabetes
Controlling your blood sugar level is essential to keeping your baby healthy and avoiding complications during delivery. In addition to maintaining a healthy diet and exercising, your treatment plan may include monitoring your blood sugar and, in some cases, using insulin or oral medications. Your doctor also will monitor your blood sugar level during labor. If your blood sugar rises, your baby may release high levels of insulin which can lead to low blood sugar right after birth
- At a glance 2016: Diabetes. (2016).
- Diabetic neuropathy. (n.d.).
- Diabetes UK https://www.diabetes.org.uk/diabetes-the-basics/diabetes-treatments
- Mayo Clinic Staff. (2017). Type 1 diabetes.
Parallel trade or parallel import in pharmaceutical market simply refers to buy medicinal products in a country that sells them at a reasonable price and then to distribute such products outside the distribution channels set up by the drug manufacturer or its recognized distributor in one’s own country of origin. It is named ‘parallel’ as it takes place beside and usually in parallel to the producer’s distribution networks.
The EU Commission’s policy position is that parallel imports increased price competition, and that this in turn increases consumer welfare as the import of goods from a country with lower prices forces sellers in the country of destination to reduce prices. The commission’s overall approach is based on two principles (Competition Policy Newsletter 1, 2007):
- The single market in pharmaceuticals requires the unhindered free movement of products – private companies cannot erect barriers to undermine this without distorting intra-brand competition.
- The efficiency claims defence advanced by the research based pharmaceutical industry is unsubstantiated – i.e. there is no evidence that partitioning the common market would spur on global investment in inter-brand competition.
Parallel Trade in the Pharmaceutical Sector
The Reasons for Parallel Trade in the Pharmaceutical Sector The pharmaceutical industry is a special sector in two respects: Firstly, innovative pharmaceutical companies incur high research and development costs for novel medicines. Secondly, in many cases, the buyer of a pharmaceutical product does not directly pay for it but is reimbursed by a national health system. Prices and reimbursement schemes vary considerably between countries in Europe: Price differentiation allows companies to allocate contributions to research and development costs efficiently among different payers, which improves cost recovery.
1) This results in considerable price differences between Member States. A price comparison of pharmaceuticals in 16 EU Member States in 2013 shows differences between 25% and 100% for two thirds and between 100% and 251% for one third.
2) Such price differences are a strong incentive for parallel trade: An importer, usually a wholesaler, purchases pharmaceuticals in a low-price country and then sells them in a high-price country.
Parallel Trade of Pharmaceuticals and its Problems in the EU
Parallel trade, on the one hand, lowers expenditure on pharmaceuticals for high-price countries which is, of course, welcomed by them. The larger the share of parallel imported medicines, the greater this effect is. On the other hand, parallel trade adds to the non-transparency of price structures and may cause certain difficulties for pharmaceutical companies regarding cost calculations.
1) Shortages of Medicines
Parallel trade is exports of pharmaceuticals from low-price countries to high-price countries, may lead to shortages in the former unless the manufacturer is willing to make up for it and supply higher quantities of the product.
2) Risk to the safety of pharmaceuticals
Parallel trade can increase the potential risk of falsified pharmaceuticals because extra steps are added to the supply chain through parallel imports. Complex supply chains, routes of transport, changes of outer packaging and relabeling make it difficult for national authorities to trace the history of pharmaceuticals bought and sold by intermediaries in different EU Member States. The EU has taken measures against falsified medicines through the Falsified Medicines Directive. So far, however, this has not eliminated the problem completely.
3) Lack of transparency and calculation problems
Prices in the pharmaceutical sector are not transparent. The negotiated prices that health insurers pay are generally not published. Such lack of transparency protects the producers by blocking price signals to other insurers and other countries.
Parallel trade is a form of arbitrage: A product, sold by the manufacturer in country A at a lower price than in country B, is bought by a dealer in country A and sold in country B. It is particularly relevant for pharmaceuticals in the internal market of the EU.
Parallel trade may lead to pharmaceutical shortages in low-price countries and increase the potential risk of falsified pharmaceuticals. It adds to the non-transparency of pricing of pharmaceuticals and can lead to calculation problems for manufacturers.
There are three basic options for addressing parallel trade: the exclusion of pharmaceuticals from the internal market rules, open redistribution among the national health systems by a subsidisation fund, and a unitary price that has to be paid everywhere in the EU.
Adverse drug effects are especially problematic in the elderly because they have slowed metabolism and excretion of medications. Often such adverse reactions are caused by the use of unnecessary medications, or the use of medications in excessive doses. Adverse drug effects are a widespread problem and can lead to significant injury and even death in the elderly. Physicians, nurses, and pharmacists are all responsible for the medication regimen in the nursing home setting.
The statistics regarding adverse drug effects are shocking. In the November 2006 issue of Clinical Geriatrics, a publication of the American Geriatric Society, the following was noted:
30% more money is spent in the United States on treating adverse drug effects than on all pharmaceuticals combined.
31% of older adults use more than one pharmacy, creating challenges for a comprehensive drug review.
50% of older adults receive prescriptions from more than one prescribing clinician.
One in 12 physician visits for the elderly result in a prescription of medication that is not recommended for them.
6,900,000 elderly persons are currently taking medications not recommended for the elderly.
10.3% of all prescriptions in the United States generate an electronic safety alert to the dispensing pharmacists. Of these alerts, 88% are overridden by the dispensing pharmacist. When interviewed, some pharmacists stated they did not believe the alert was important, was not real, or that they already knew about it.
The Centers for Medicare and Medicaid Services (CMS) have taken note of the high risk of injury related to adverse drug effects. In December 2006, CMS clarified federal mandates to state surveyors regarding the appropriate use of medications in the nursing home setting under F329 of the OBRA regulations. The rules are not new, but facilities are receiving clarification as to what medications should be reduced or eliminated from residents’ medication regimens. The clarification makes facilities responsible for the medication regimen, more so than the physician, nurse practitioner, or physician’s assistant who ordered the medication. State surveyors evaluate compliance with such rulings, and will, in essence, question the facility when rules are not followed. This clarification by CMS should be referred to when questioning whether therapy is recommended for the elderly population.
The following are questions you should ask the nursing home staff or medical provider of your loved one if you suspect medications are unnecessary or causing adverse effects:
Is this medication necessary?
Is the drug contraindicated in the elderly population?
Is the resident taking the lowest effective dose of the drug?
Are medications being used to treat the side effects of other medications? For example, medications for constipation are often given to treat the side effects of certain pain medications.
Can the drug regimen be simplified?
What are the potential drug interactions of the medications currently prescribed?
American Medical Director’s Association
Centers for Medicare and Medicaid Services
Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. Cancer can start almost anywhere in the human body, which is made up of trillions of cells
Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy.
Common Cancer Treatment Options
Marrow Stem Cell Transplantation
A bone marrow transplant is a procedure that implants healthy blood-making stem cells into the body to replace damaged or diseased bone marrow. In cases where the bone marrow is not functioning or cannot produce enough healthy blood cells, a bone marrow transplant is required. Bone marrow transplants are of two types, autologous and allogeneic. Transplants in which cells from the human body are used are called autologous, and transplants from a donor or donor are called allogeneic transplants.
Chemotherapy is a drug-based therapies. Chemotherapy is a special form of drug therapy that aims to stop or destroy the growth and proliferation of cancer cells that cause uncontrolled growth in the human body and damage healthy tissues.
Immunotherapy is a new dimension of drug therapy in cancer. Millions of cancer cells are born in our bodies every day. There are cells in the human immune system to defeat cancer cells. When the immune (immune) system recognizes cancer cells, it immediately takes action and destroys the cell. T cells (T lymphocytes) in the immune system fight these cancer cells and try to destroy them.
Interventional Radiology is a field of radiology that includes techniques applied for diagnosis and treatment in many areas of medicine. The patient is usually administered local anesthesia; Interventional radiology, which includes the diagnosis and treatment methods performed by entering the body with very small means (in the size of a pinhole), enables diseases to be treated with much simpler interventions than before, without the need for open operations and diagnostic surgical applications, and to obtain clearer information about the disease.
Radiotherapy, that is, beam therapy, aims to destroy cancer cells to a large extent by emitting radiation beams on cancer cells and to treat cancer with this process. Radiotherapy procedures are in the field of specialization in the medical science called radiation oncology.
Diabetes is a metabolic disease that develops when the secretory gland called the pancreas does not produce enough insulin hormone in your body or the insulin hormone it produces cannot be used effectively.
Our digestive system breaks down the eating into nutrients. Carbohydrates or various sugars are broken down into glucose for use by the body and absorbed. Glucose is an important fuel source for many organs in our body. However, in order to use glucose as a fuel, the glucose molecule must enter the cell. For this reason, we need a special hormone. Beta cells in the pancreas produce a hormone called insulin.
Insulin is the chemical messenger necessary for the entry of glucose into the cell to regulate blood sugar levels that rise after a meal. Insulin is released into the bloodstream to trigger blood glucose to enter cells. Insulin lowers your blood sugar level, allowing glucose to enter the cell.
Not only insulin but also glucagon which has an effect on blood sugar levels. If your blood sugar levels are too low or you haven’t eaten for too long, glucagon inform the liver to release stored sugar.
The other active hormone in diabetes is GLP-1 which helps the pancreas for production of the right amount of insulin to move sugar from the blood into the cells. When blood sugar gets too high, GLP-1 stimulates beta cells to increase insulin production and also helps lower the amount of sugar converted by the liver. When blood sugar gets too high, insulin production increases. Metabolic disorders in these systems lead to diabetes.
These days, autumn makes itself felt, unpredictable weather causes an increase in flu cases. It is possible to protect against influenza, which can be seen more frequently in crowded environments, by vaccination.
Influenza is an infectious disease which is disease that enters the body through the respiratory tract with viruses called “influenza”. Influenza can cause epidemics, especially in late autumn, winter, and early spring.
Healthy individuals injected with flu viruses usually heal spontaneously in one week. However, it can cause serious and fatal complications especially in the elderly, children, and people with chronic diseases
Influenza, which is a contagious virus infection, is a much more severe disease than the common cold. The flu virus, which can survive for weeks, especially in the winter, is very easy to transmit. One of the most important ways to protect against the flu is the flu vaccine.
The flu vaccine is inactive and is prepared each year according to the World Health Organization’s recommendations. After the flu vaccine is administered, the protective antibody level is formed on average, 10-15 days. It can prevent 70-90% of flu symptoms in healthy young adults.
Who can have the flu vaccine?
Flu vaccines are suitable for most people with rare exceptions
- people 50 years and older
- People with chronic diseases in a nursing home
- People with chronic diseases such as chronic obstructive pulmonary disease (asthma, chronic bronchitis, etc.), heart patients, diabetics, chronic liver and kidney patients,
- Those with immunologic diseases.
- Those with immune-suppressed diseases suppressed immune system (HIV/AIDS patients, cancer patients, organ and bone marrow transplant recipients, chemotherapy, radiotherapy patients, steroids)
- Between 6 months and 18 months and taking long-term aspirin therapy (to reduce the risk of developing Reye’s syndrome),
- Pregnant women (within the knowledge of the patient’s physician),
- Babies older than six months (trivalent inactivated flu vaccine), older than thirty-six months (3 years old) (trivalent or quadrivalent flu vaccine can be administered),
- Health workers,
- All healthy individuals who want to be protected by vaccination can get vaccinated.
Unfortunately, Coronavirus does not affect only adults, children can also develop COVID-19.
Most of the cases are not showing the symptoms and Covid-19 in children usually have milder symptoms when compared to adults. However, some children might develop severe complications and need to hospitalize.
The symptoms of Covid in children are similar and we list few main Covid-19 symptoms;
If you are suspicious that your kid might have a Covid-19 infection, you should get a PCR test and isolate the kid from family members and visitors. And of course, the kid should stay home until receiving the result of the PCR test. If the symptoms get any worse, you should call your doctor or admit to the closest ER.
Getting Covid-19 again seems to be rare but you have a still possible to get Covid-19 again after the recovery of it.
It is called reinfection. According to the knowledge from similar viruses, reinfections are expected.
This situation is also valid for vaccinated people. If you got the shot of Covid Vaccine and still virus can infect you again and thanks to the vaccine, the risk of severe illness and death decrease significantly.
There is a study called SARS-CoV-2 Immunity and Reinfection Evaluation (SIREN) which was conducted by the Department of Health and Social Care and Public Health in England. The study showed that the possibility of reinfection is decreased by 83% for at least five months due to the responses of the immune from the previous infection.
The results from the same study suggested that cases of reinfection are rare and the ratio of occurrence is fewer than 1% of about 6.600 participants who had already been infected by the COVID-19 virus.
Reinfection is a rare situation but it is significant to take precautions such as wearing masks, handwashing, and social distancing.
The pandemic of Covid-19 continues to affect our lives and thankfully vaccines are coming with hope to fight this pandemic. However, new versions of the Covid-19 virus are reported and put us in a stressful place again.
Let’s see what is the variant Of Covid-19 and how does it affect us?
The mutation is responsible for the formation of new variants of the virus and some of these variants continue to spread and some of them are disappeared.
As we know, new variants of Covid-19 are reported. One of them is detected in the UK and called B.1.1.7. It is more contagious when compared to their variants.
Last October, in South Africa, named with B.1.351 variant was determined and lastly, P.1 variant was detected passenger from Brasil at the airport in Japan.
Easily and fast spreading of these variants cause the number of infected people, a requirement of the health services, hospital admission, and finally to death.
Therefore, protective strategies such as physical distance, mask, hand hygiene, isolation, and quarantine limit the spreading of the Covid-19 virus and protect public health.
Current vaccines were based on the previous version of the virus. However, scientists believe that they would be effective for new types of viruses.
The first result of BioNTech/Pfizer vaccines provides protection but less effective to new variants.
Two new vaccines (from Novavax and Jannsen) to be approved sooner would provide the protection as well. Experts from Oxford-AstraZeneca explained that their vaccine is protective against to new English variant.
Experts state that although this vaccine still provides protection against severe Covid-19 diseases, it is less effective against the South African variant.
Preliminary results from Moderna also show that the vaccine is effective against the South African variant. However, experts point out that the immune response may not be strong and long-lasting in this variant.
Experts say that many different variants may emerge in the future, but even in the worst-case scenario, vaccines can be redesigned or modified within a few weeks or months.
It is stated that the flu vaccine is updated to cover new strains every year, as well as the coronavirus vaccines, can be renewed.