Retatrutide is an new drug that has shown promise in the treatment of obesity and type 2 diabetes.

Retatrutide is a type of multi-receptor agonist that targets multiple hormonal pathways involved in blood sugar regulation, appetite control and metabolic health.

As clinical trials progress, retatrutide has garnered attention for its ability to significantly lower blood glucose levels and promote substantial weight loss.

What is Retatrutide?

Retatrutide is an investigational once-weekly injectable medication developed by Eli Lilly.

It is a triple receptor agonist meaning it activates three key hormone pathways that play a role in glucose metabolism and appetite regulation:

1. Glucagon-like peptide-1 (GLP-1) receptor – involved in insulin secretion, appetite suppression, and slowing digestion.
2. Glucose-dependent insulinotropic polypeptide (GIP) receptor – enhances insulin release in response to food intake and may contribute to weight loss.
3. Glucagon receptor – plays a role in energy expenditure and fat metabolism.

This multi-receptor action sets retatrutide apart from existing GLP-1 receptor agonists like semaglutide (Ozempic or Wegovy) and dual agonists like tirzepatide (Mounjaro or Zepbound).

How does Retatrutide work?

Retatrutide mimics the effects of naturally occurring gut hormones to improve metabolic health.

Lowering blood sugar

Stimulating insulin release when glucose levels are high while also reducing glucagon secretion to prevent excess sugar production by the liver.

Promoting weight loss

By targeting appetite regulation centers in the brain, retatrutide reduces hunger and increases feelings of fullness, leading to lower food intake.

Boosting metabolism

The glucagon component of retatrutide helps increase energy expenditure, potentially leading to greater fat loss compared to single or dual-receptor agonists.

History of Retatrutide

Eli Lilly developed retatrutide as part of its efforts to advance next-generation therapies. The drug builds on the success of earlier treatments such as GLP-1 receptor agonists such as liraglutide and semaglutide and the dual GIP/GLP-1 agonist tirzepatide.

Preclinical studies suggested that combining GLP-1, GIP and glucagon receptor activation could yield even greater metabolic benefits than previous therapies.

Retatrutide progressed through early-phase clinical trials, showing strong potential for both glycemic control and weight reduction.

Current evidence

Retatrutide has demonstrated remarkable results in clinical trials – particularly in weight loss and blood sugar control.

In the SURMOUNT-1 Trial (a study on obesity), participants lost up to 24.2% of their body weight over 48 weeks – the most significant weight reduction seen in an anti-obesity medication to date. Higher doses of retatrutide resulted in greater weight loss.

In type 2 diabetes trials, retatrutide significantly reduced HbA1c levels, with some participants achieving near-normal glucose levels. The combination of GLP-1, GIP and glucagon receptor activation provided superior glycemic control compared to existing GLP-1-based therapies.

While results are promising, long-term safety and efficacy studies are still ongoing.

What are the side effects?

Retatrutide has shown common side effects similar to other GLP-1 receptor agonists, including:

• Nausea
• Vomiting
• Diarrohea
• Constipation
• Abdominal discomfort or bloating

Some trial participants experienced a slight increase in resting heart rate, which has also been observed with other GLP-1 receptor agonists.

However, its unique action on glucagon receptors requires further research to assess long-term metabolic effects.

How Retatrutide compares

Retatrutide is shaping up to be a potentially more powerful option than existing medications.

Retatrutide’s triple action may lead to greater weight loss and potentially stronger glucose control when compared to Semaglutide.

Early results suggest retatrutide could offer even better metabolic benefits that tirzepatide, though direct comparison trials are needed.

Retatrutide works via a completely different mechanism to other weight loss drugs such as orlistat and phentermine focusing on hormonal regulation rather than just suppressing appetite or blocking fat absorption.

Potential uses

Beyond diabetes and obesity, researchers are exploring Retatrutide’s role in:

• Non-alcoholic fatty liver disease (NAFLD) where its impact on glucagon receptors suggests it may help reduce liver fat.
• Cardiovascular benefits as weight loss and improved metabolic markers could lower heart disease risk.
• Type 1 diabetes as although primarily studied in type 2 diabetes, there is potential for adjunctive use in type 1 diabetes management.

As new findings emerge, we’ll keep you updated on retatrutide’s progress:

• Retatrutide melts fat fast but at a cost warn experts

In the meantime, if you’re considering treatment options for diabetes or weight management, consult with a healthcare professional to explore the best approach for your needs.

It is most commonly used to treat wrinkles, scars, psoraisis and persistent wounds.

However, in recent years, researchers have started to explore its potential benefits for managing various health conditions including diabetes.

The exploration into red light therapy as a complementary treatment for diabetes is still in its early stages, but the initial findings are promising.

How does red light therapy work?

Red light therapy works by using low-wavelength red light to penetrate the skin to varying depths.

Light is absorbed by mitochondria, the energy-producing centres of cells and has been shown to stimulate cellular processes that can lead to various health benefits.

The primary mechanism of action behind red light therapy’s effectiveness is considered to be its ability to enhance mitochondrial function.

When cells absorb red light wavelengths around 600 to 700 nanometres, it stimulates the mitochondria to produce more adenosine triphosphate, also known as ATP.

ATP is the molecule that fuels cellular activity and increased ATP production can enhance cell regeneration and repair, reduce inflammation, and increase blood circulation.

The scientific name for red light therapy is photobiomodulation.

Red light therapy has gone by many names, including:

• Low level light therapy
• Low power laser therapy
• Photonic stimulation
•  Soft laser therapy

Red light therapy uses

Red light therapy has been used for its anti-inflammatory and regenerative properties to support skin health, reduce pain and inflammation.

Beyond dermatological applications, RLT is being researched for its effects on muscle recovery, mental health disorders like depression, and long-term health conditions such as diabetes.

Where can I get red light therapy?

You can buy lamps, masks and panels which provide red light therapy.

These devices contain light emitting diodes (LED) on the device itself which emit red light.

Alternatively, you can choose to visit a red light therapy centre.

Red light therapy and diabetes

Recent studies have indicated promising results for the use of red light therapy in managing blood sugar levels in people with diabetes.

One particular study used a specific wavelength of 670 nm, applied to the skin, which showed a significant reduction in blood glucose levels and moderated peaks after glucose intake.

• Red light exposure can lower blood sugar levels in people with diabetes

It is thought that red light at 670 nm enhances the function of mitochondria, leading to an increase in ATP production and more efficient glucose metabolism.

This could potentially reduce blood glucose levels and support overall blood glucose control.

Red light therapy and weight loss

On top of its potential benefits for glucose management, red light therapy is being explored for its role in weight loss.

Studies have shown that exposure to certain wavelengths of red light can cause fat cells to release their lipid content – also known as lipolysis.

Released fat is then metabolised by the body leading to reduced fat mass and improved body composition.

The process is facilitated by the absorption of red light by mitochondria within the fat cells which can increase cellular metabolism and energy expenditure.

Enhanced mitochondrial activity might not only help in reducing the fat layers directly under the skin but also improve the overall metabolic rate which aids in weight management.

While research is promising, red light therapy should complement traditional weight loss methods such as diet and exercise and not replace them.

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Further research is needed to fully establish the parameters for safe and effective use such as optimal light wavelengths, exposure duration, and frequency of sessions to achieve the best results.

Combining RLT with a healthy lifestyle could potentially amplify the effects and contribute to more significant and sustainable weight loss outcomes.

How to use red light therapy safely

To ensure safe and effective use of red light therapy:

• Always consult with a healthcare provider before starting any new treatment
• Use RLT according to recommendations from a healthcare professional or qualified therapist
• Keep regular track of blood sugar levels to observe any changes or patterns that arise after starting RLT

Risks and contraindications

Red light therapy (RLT) is generally considered safe and well-tolerated when used appropriately.

However, it is not for everyone.

People with certain medical conditions such as skin cancer or photosensitivity disorders should avoid this treatment.

Direct exposure to the eyes should be avoided during the therapy.

As with any new treatment, individuals considering red light therapy should consult with healthcare team.

Hailed as the “King Kong” of weight loss injections, Mounjaro is unique in that the medication activates the receptors for these GLP-1 and GIP hormones in the body, enhancing insulin production, improving insulin sensitivity, and moderating blood sugar levels.

What is Mounjaro?

Mounjaro is an effective weight loss treatment shown in clinical trials to help people achieve significant weight loss.

Known in the US as Zepbound, it is the latest weight loss injection available in the UK.

Mounjaro contains the active compound tirzepatide, and is a trademark of Eli Lilly.

• Research shows Mounjaro achieves better weight loss results than Wegovy and Ozempic
• Mounjaro: new weight loss jab approved in the UK
• Warning that Ozempic and Mounjaro can trigger accelerated aging

How does Mounjaro work?

Mounjaro contains the active ingredient tirzepatide, a type of GLP-1 agonist.

GLP-1 agonists help regulate blood sugar post-meal by stimulating insulin secretion, suppressing glucagon secretion, and slowing gastric emptying.

GIP agonists complement this by not only boosting insulin secretion but also enhancing the body’s insulin sensitivity.

This approach addresses the underlying symptom of insulin resistance in type 2 diabetes, setting Mounjaro apart from other treatments like Semaglutide and liraglutide, which lack the additional benefit of GIP activation.

How does Mounjaro support weight loss?

Mounjaro supports weight loss through:

Reducing appetite

Mounjaro delays gastric emptying which promotes a sense of fullness, reduces appetite and naturally reduces calorie intake, and helps to regulate blood sugar levels by slowing down the absorption of glucose from food.

Increasing energy expenditure

Mounjaro activates receptors that boost metabolic rate and energy use, aiding in calorie burning.

Improving insulin sensitivity

The modulation of GIP receptors enhances glucose utilisation, contributing to sustained satiety and weight maintenance.

How effective is Mounjaro?

Clinical studies highlight Mounjaro’s effectiveness in weight reduction, showing participants losing up to 20% of their body weight over 72 weeks, particularly at higher doses.

These results underscore Mounjaro’s role as a potent option for weight loss, especially when coupled with lifestyle modifications.

Taking Mounjaro

Before initiating Mounjaro, patients should receive proper usage training from healthcare providers, discuss low blood sugar management, and consider alternative birth control methods due to potential interactions.

Regular monitoring and healthcare provider consultations are essential to optimise treatment outcomes and address any concerns.

Dosages

The recommended starting dosage of Mounjaro is 2.5mg injected once a week under the skin. This dosage is for treatment initiation and not intended for glycemic control.

After 4 weeks, the dosage is increased to 5mg injected once-a-week.

Some people achieve significant weight loss with low doses of Mounjaro (2.5mg-5mg), while others require higher doses (12.5mg-15mg) to see meaningful results.

Onset of action

Mounjaro begins to impact blood sugar levels immediately upon administration.

Achieving a healthy HbA1c level can take up to 12 weeks, with variations depending on individual health conditions and adherence to the prescribed regimen.

For weight loss, significant results are typically observed around the 28-week mark, emphasising the importance of a balanced diet and exercise in conjunction with Mounjaro therapy.

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What’s the difference betwen Mounjaro and Wegovy?

Mounjaro (tirzepatide) and Wegovy (semaglutide) are two medications used in the treatment of type 2 diabetes and for weight loss in individuals with obesity or overweight conditions.

However, both medications have distinct mechanisms and characteristics.

Wegovy (semaglutide) functions primarily as a GLP-1 receptor agonist that increases insulin production, decreases glucagon secretion, and slows down gastric emptying.

In clinical studies, semaglutide has demonstrated substantial weight loss outcomes with patients experiencing an average weight loss of around 15-18% of their body weight over 68 weeks.

Mounjaro (tirzepatide), on the other hand, is unique as it acts as both a GLP-1 and GIP receptor agonist enhancing the body’s insulin production in response to meals, improves insulin sensitivity and slows gastric emptying.

Clinical trials have shown that tirzepatide can lead to significant weight loss with patients potentially losing up to 20% of their body weight.

Both medications are administered through subcutaneous injections.

Mounjaro is typically injected once a week, and Wegovy is also a once-weekly injection.

Mounjaro side effects

Mounjaro’s use is accompanied by critical side effect warnings, including potential risks for:

• Thyroid tumours
• Pancreatitis
• Hypoglycemia
• Severe allergic reactions
• Kidney failure
• Gallbladder problems

Mounjarois not suitable for individuals with a history of medullary thyroid carcinoma (MTC), Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or those allergic to its ingredients.

Common side effects

Mounjaro can cause side effects such as:

• Nausea
• Diarrhoea
• Decreased appetite
• Abdominal pain

Monitor and report any adverse effects to your healthcare provider is crucial for managing and adjusting treatment as necessary.

Summary

• Price: From £179 per month
• Function: Appetite suppression
• Effectiveness: Average loss of 15-20% body weight
• Common side effects: Fatigue, dizziness, insomnia, gastrointestinal discomfort
• Dosage: Begins at 2.5mg weekly, with possible titration to 15mg

Insulin helps the body control blood sugar levels. For people with type 2 diabetes, their body either does not make enough insulin or it does not respond to insulin the way it should, which causes high blood sugar levels. Metformin tackles both issues to lower blood sugar levels. It controls how much glucose is released into the blood and helps the body respond to the insulin.

Some people with type 1 diabetes may also be prescribed metformin.

When taking medication, you should always be conscious of how it interacts with other substances, such as alcohol.

Although experiencing harmful effects when taking metformin and drinking alcohol is rare, drinking in excess increases this risk.

Low blood sugar levels

Continuous heavy drinking and binge drinking when on metformin can result in very low blood sugar levels. However, this unhealthy drinking habit when on sulfonylureas, another type 2 diabetes drug, results in a greater risk of hypoglycemia, life-threatening low blood sugar.

When a person with diabetes is drinking alcohol, it is important that those around them know what to do for hypoglycemia and what the symptoms look like. If any symptoms appear, it is important to stop drinking alcohol and to eat or drink something that will quickly increase blood sugar levels.

Symptoms include:

• Dizziness
• Confusion
• Blurred vision
• Headache and
• Drowsiness

Some people with diabetes may carry glucose tablets that can raise their blood sugar quickly. Alternatively juice or soda is commonly used. After 15 minutes, they should then check their blood sugars and then repeat the steps if needed.

• How to treat a hypo

Some people with diabetes have a glucagon hypoglycaemia rescue kit which includes human glucagon, a syringe to inject the glucagon and instructions for when the person cannot eat food or eating food does not help during severe hypoglycaemia. If the hypoglycaemia is severe, such as the person with diabetes becoming unconscious, and they do not have a glucagon hypoglycaemia rescue kit, someone will need to call 999.

You should ask a doctor if you are interested in getting a rescue kit. You are likely to be recommended one if you take metformin with other diabetes medications or if you have experienced severe hypoglycaemia before.

Lactic acidosis

Another life-threatening side effect of drinking alcohol when on metformin is lactic acidosis, a build-up of lactic acid in your blood which is rare but a serious side effect.

As your body uses energy, it produces lactic acid and taking metformin results in your body producing more lactic acid than usual. Alcohol causes your body to take longer to get rid of lactic acid and causes a build-up, especially if you take metformin, which causes kidney, lung, heart and blood vessel damage.

It is a medical emergency and can cause organs to shut down and lead to death if it is not treated immediately.

Symptoms of lactic acidosis include:

• Weakness
• Tiredness
• Dizziness
• Breathing difficulties
• Muscle pain and
• Fast heart rate

If you are drinking alcohol and experience any symptoms, seek medical assistance immediately.

Although alcohol interacts with metformin, it also affects diabetes by lowering blood sugar levels for up to 24 hours after consuming it.

The best approach? Moderation

People with diabetes should follow simple guidance when drinking alcohol; do not drink on an empty stomach, do not drink if you have low blood sugar, eat before or after drinking, drink plenty of water throughout and check blood sugar levels before drinking, whilst drinking, before bed and for 24 hours after you stop drinking.

Although alcohol and metformin can have negative effects on the body, everyone reacts differently to alcohol and only your doctor knows your medical history and diabetes well enough to advise you.

If they tell you that it is safe, take appropriate precautions and remember that moderation is crucial.

Read our guide to learn everything about semaglutide including how it works, dosage, side effects, and cost of semaglutide.

What is semaglutide?

Semaglutide is a relatively new drug that has been shown to be just as effective at reducing body weight as certain weight loss surgeries. The drug’s effects were uncovered during a clinical trial led by Professor Rachel Batterham at University College London (UCL) to evaluate the efficacy of this drug in weight management.

The trial consisted of nearly 2000 people, across multiple countries. Each participant was either given a 2.4mg dose of semaglutide or a placebo on a weekly basis. They were also provided with counselling sessions from dietitians to help them stick to a reduced-calorie diet and exercise more.

The study reported an average weight loss of around 2.4 stone or 15.3kg was lost in the group of participants taking the drug, while those receiving the placebo (dummy drug) only lost an average of 0.4 stone or 2.6kg.

Moreover, within the group taking Semaglutide, 75% of those in the Semaglutide group lost over 10% of their body weight and more than 30% lost over 20% of their body weight. The findings indicate that this may indeed represent a major breakthrough in improving the health of those living with obesity.

Mechanism of action

Something you may be wondering is how this new drug may work to assist with weight management.

Semaglutide is something called a GLP-1 (or glucagon-like peptide-1) agonist.

This means that it binds to the GLP-1 receptor in the brain and increases its activity, which has a number of favourable downstream effects. For instance, when activated, this receptor can trigger an increase in hormones called ‘incretins’, which work to:

• Help the body produce insulin, but only when needed
• Reduce the amount of unnecessary glucose (sugar) being released by the liver
• Slow the rate at which the stomach digests and empties food
• Reduce appetite, resulting in a reduced food intake

Dosage and administration

The first thing to be aware of is that you may know Semaglutide by its trade name – Ozempic.

With respect to dosage, the National Institute for Healthcare and Excellence (NICE) recommends 0.25mg once a week for 4 weeks. This can then be followed by 0.5mg once a week for at least 4 weeks and then increased to 1mg a week if necessary.

These recommendations may differ between individuals and between different administration methods. Speaking to your regular healthcare provider for further information is always best.

Your doctor will also be able to provide you with more detailed information on how to take this drug. Typically, this is self-administered and can be taken via subcutaneous injection or an oral tablet. Usually, if you are having injections, this occurs in the thigh, abdomen or upper arm, and you may be advised to rotate between these injection sites each week.

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Semaglutide side effects

As with any medical therapy, there are some potential side effects that users can experience.

Side effects that are most common can include:

• Reduced appetite
• Burping
• Constipation
• Diarrhoea
• Dizziness
• Fatigue
• Gastrointestinal discomfort
• Gastrointestinal disorders
• Hypoglycaemia (when used in combination with insulin or sulfonylureas)
• Nausea
• Vomiting
• Reduced body weight

Other less common side effects that can be experienced may include pancreatitis and altered taste. If you begin to note symptoms of acute pancreatitis, such as severe abdominal pain, you should stop taking the medication.

If symptoms persist or become severe, it is crucial that you reach out to your healthcare provider for further assistance.

Different medications can also interact and impact each other’s function or endanger your health. If one medication may negatively impact another, this is referred to as a contraindication.

For instance, there have been reports of diabetic ketoacidosis in patients with type 2 diabetes when taking GLP-1 receptor agonists alongside insulin.

Hence, it is incredibly important that you seek further guidance on if Semaglutide is an appropriate and safe medication for you by speaking with your doctor.

You can find more information regarding the contraindications and adverse effects of Semaglutide via the NICE website, but this does not replace a conversation with your doctor.

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There is also guidance that Semaglutide may not be appropriate for those who are pregnant, breastfeeding or have existing liver or kidney impairment.

What is the cost of semaglutide?

One semaglutide pen contains 4 x once weekly doses of semaglutide and costs £73.25.

Drug shortages

The social media platform TikTok has been at the centre of a number of controversies where semaglutide is marketed to people without type 2 diabetes or obesity as a quick-fix weight loss drug:

• TikTok trends are causing another shortage of diabetes drug Ozempic
• TikTok trend causes a shortage of diabetes medication Ozempic

Summary

Semaglutide is a promising and safe medication that is accessible to certain patients through their doctor.

Due to the mechanism of action, this drug may elicit significant weight loss, though there are a number of side effects to be aware of.

Insulin resistance is the name given to when cells of the body don’t respond properly to the hormone insulin.

Insulin resistance is the driving factor that leads to

type 2 diabetes, gestational diabetes and

prediabetes

Insulin resistance is closely associated with obesity; however, it is possible to be insulin resistant without being overweight or obese.

Modern research has shown that insulin resistance can be combatted by treatment methods that reduce how much

insulin
the body is producing or taking via insulin injections or insulin pumps.

Reducing insulin resistance can be achieved by following

low-carbohydrate
and

ketogenic
diets.

What is insulin resistance?

The role of insulin is to allow cells of the body to take in glucose to be used as fuel or stored as body fat.


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It also means that glucose is more likely to build up in the blood and this can lead to

too high blood sugar levels

When the body becomes resistant to insulin, it tries to cope by producing more insulin. People with insulin resistance are often producing too more insulin than healthy people.

Producing too much insulin is known as

hyperinsulinemia

Symptoms of insulin resistance

Initially, insulin resistance presents no symptoms. The symptoms only start to appear once it leads to secondary effects such as higher blood sugar levels. When this happens, the symptoms may include:

• Lethargy (tiredness)
• Hunger
• Difficulty concentrating (brain fog)

Other signs that often appear in people with insulin resistance include:

• Weight gain around the middle (belly fat)
• 
  High blood pressure
• High cholesterol levels

If insulin resistance develops into prediabetes or type 2 diabetes, the symptoms will include increased

blood glucose levels
and more of the classic

symptoms of type 2 diabetes

Causes of insulin resistance

Whilst the exact cause of insulin resistance is still not fully understood, it is well-known which factors can lead to insulin resistance developing.

Insulin resistance can commonly develop if one or more of the following factors apply:

• If you are overweight or
  
  obese
• Having a high-calorie diet, high-carbohydrate or high-sugar diet
• Sedentary lifestyle – taking little physical activity
• Taking high doses of steroids over an extended period of time
• Having
  
  chronic stress
• Having
  
  Cushing’s disease
  or
  
  polycystic ovary disease

In terms of what is happening inside the body that causes insulin resistance, researchers have observed that insulin resistance occurs in people that have:

• High levels of insulin circulating in their blood
• Excessive fat stored in the liver and pancreas
• High levels of inflammation

Can insulin resistance be reduced or reversed?

It is certainly possible to reduce the effects of insulin resistance and there are a number of effective ways to do this.

Effective methods include:

• 
  Low-carbohydrate
  and
  
  ketogenic
  diets
• Very-low-calorie diets
• Weight loss surgery
• Taking a lot of exercise in combination with a healthy diet

These methods share a similar way of working in that they all help to reduce the body’s need for insulin and help people to lose weight.

Read more on

reversing the effects of diabetes

Levemir is a type of long-acting insulin used to treat patients with diabetes by keeping blood sugar levels under control.

Produced by Novo Nordisk Limited, Levemir is the trade name for insulin detemir, a man-made form of insulin that is used as a substitute for the body’s natural insulin in diabetic patients.

Once injected, it has a long duration of action – up to 24 hours.

Who is Levemir suitable for?

Levemir is used to treat adults and children over the age of two with

type 1 diabetes

It is also prescribed for adult patients with

type 2 diabetes

who are unable to achieve good

glycemic control on oral hypoglycemics alone

Before using Levemir

Before prescribing Levemir your doctor will assess any
prescription medicines
you are taking to ensure insulin detemir can safely be taken in conjunction.

Levemir can potentially interfere with many other medications, so it is important you inform your doctor of any over-the-counter medications you use – this includes over-the-counter, vitami, and

herbal products

– as well as any medical conditions they may not be aware of.

You should not use Levemir if you are allergic to insulin detemir, or if you are in a

state of diabetic ketoacidosis

How do I take Levemir?

Like all insulins, Levemir is designed for use as a subcutaneous injection.

In other words, it should be injected into the fatty tissue beneath the skin, usually once daily at the same time each day (preferably at your evening meal or at bedtime).

Your healthcare team

should show you how to inject the medicine yourself, as well as how to properly dispose of

used needles

and syringes.

When starting your regimen, you must follow the instructions on your prescription label. This means avoiding using larger or smaller amounts of the insulin or for longer than recommended.

If you miss a dose, follow your doctor’s directions.

Benefits of Levemir

The main benefit of Levemir is its duration of action, with a single injection of the medicine working for up to 24 hours to

keep blood sugar levels stable

Side effects of Levemir

As with all insulin products,

hypoglycemia

(low blood sugar) is the most common side effect, and left untreated can lead to

loss of consciousness and coma

Other serious adverse effects of Levemir can include:

• Itching rash, swelling, or redness at injection sites
• Breathing difficulties
• Rapid heart rate
• Sweating
• Light headedness or feeling faint

These are signs of insulin allergy and you should seek emergency medical help if you experience any of these.

Other side effects can include:

• Swelling in your hands or feet
• 
  Extreme thirst or hunger
  
• 
  Increased urination
  
• 
  Lumpy skin at injection sites
  
• Weight gain
• Mild headache
• Back or stomach pain
• Unusual tiredness or weakness

Please note this is not a full list of side effects and others may occur.

Some of the above may not require medical attention as they might just be an initial reaction to the medicine and may start to subside once your body adjusts to the insulin.

If, however, any of these side effects continue and start to become problematic, or if you have any questions about them, talk with your doctor or healthcare team. They may decide to change the dose of your medicine or

switch you to another type of insulin

Insulin is a hormone which plays a key role in the regulation of blood glucose levels. A lack of insulin, or an inability to adequately respond to insulin, can each lead to the development of the symptoms of diabetes.

In addition to its role in controlling blood sugar levels, insulin is also involved in the storage of fat.

The role of insulin in the body

Insulin is a hormone which plays a number of roles in the body’s metabolism.

Insulin regulates how the body uses and stores glucose and fat. Many of the body’s cells rely on insulin to take glucose from the blood for energy.

Insulin and blood glucose levels

Insulin helps control blood glucose levels by signaling the liver and muscle and fat cells to take in glucose from the blood. Insulin therefore helps cells to take in glucose to be used for energy.

If the body has sufficient energy, insulin signals the liver to take up glucose and store it as glycogen.

The liver can store up to around 5% of its mass as glycogen.

Some cells in the body can take glucose from the blood without insulin, but most cells do require insulin to be present.

Insulin and type 1 diabetes

In type 1 diabetes, the body produces insufficient insulin to regulate blood glucose levels.

Without the presence of insulin, many of the body’s cells cannot take glucose from the blood and therefore the body uses other sources of energy.

Ketones are produced by the liver as an alternative source of energy, however, high levels of the ketones can lead to a dangerous condition called ketoacidosis.

People with type 1 diabetes will need to inject insulin to compensate for their body’s lack of insulin.

Insulin and type 2 diabetes

Type 2 diabetes is characterised by the body not responding effectively to insulin. This is termed insulin resistance. As a result the body is less able to take up glucose from the blood. In the earlier stages of type 2 diabetes, the body responds by producing more insulin than it would normally need to.

If type 2 diabetes develops over a number of years, the extra demands on the pancreas to produce insulin can lead to a loss of insulin producing cells (known as pancreatic beta cells) as they wear out.

Depending on their level of insulin resistance, people with type 2 diabetes  may also need to take insulin injections to manage their blood sugar levels.

Insulin and fat storage

As well as being involved in the regulation of blood glucose, insulin is also involved in how fat is used by the body. When the liver is has taken up its capacity of glycoge, insulin signals fat cells to take up glucose to be stored as triglycerides.

An additional effect of insulin is in inhibiting the breakdown of fats.

Synthetic insulin

People with type 1 diabetes and a proportion of people with type 2 diabetes will need to take exogenous insulin (insulin that is not produced by one’s own body). Insulin is usually injected but can also be delivered by an insulin pump which continually infuses insulin through the day and night.

Synthetic insulin is made in laboratories and is the most commonly prescribed form of insulin for medication purposes. Non-synthetic animal insulin is also available in the UK if preferred.

Product:

EasyTouch Lancing Device

Manufacturer:

Abbott

Alternative site testing cap

You can also get and an

alternative site testing

cap to fit to the device to aid testing on forearms or other appropriate areas other than fingertips.

Abbot Thin Lancets

The EasyTouch Lancing Device uses Abbott Thin Lancets which are available from the Abbott site or from your local healthcare centre.

Product guide written by Diabetes Expert:

Sue Marshall

Product:

Microlet 2

Manufacturer:

Ascensia Diabetes Care

As well as its range of blood test meters including the Contour NEXT, Contour NEXT Link, and

Contour NEXT USB

, Ascensia Diabetes Care’s Microlet 2 lancing device is a neat way to get that little drop of blood needed to make those meters work.

The Microlet 2 has an ergonomic and compact design for simple, smooth testing and allows for easy one handed lancing with an easy to grip surface and large button.

Microlet lancets

It uses Microlet lancets, which are not only silicone coated (so they are virtually pain-free) but are coloured – which makes the whole lancet-changing thing just a little more fun!

Available on prescription

These are available on prescription in a pack of 200: PIP Code 280-0050, GMS Code 85055.

Product:

OneTouch Delica

Manufacturer:

LifeScan

Lancing devices are an important part of testing and so it’s important to have a lancing device that is easy to use and minimises unnecessary pain.

The OneTouch Delica from LifeScan is designed to be kind to fingers, featuring seven depth settings to choose from and Advanced Glide® Control System, which guides the lancet in a straight motio, reduces vibration and allows more precise lancing.

Features of the OneTouch Delica

• Advanced Glide® Control System guides the lancet for smooth lancing
• Seven depth settings to choose from to minimise pain
• Ejection Control removes the lancet without needing to touch the lancet, reducing risk of accidental finger stick injuries
• Quiet and easy to use
• Small and easy to fit in blood glucose testing wallets
• Takes OneTouch Delica thin 30 gauge lancets
• Lancets have a cap to cover the used sharp tip

In a clinical study, 96% of patients found the Delica system easy to use and 76% thought it was quiet.

Product:

Vitrix Sterilance Press

Manufacturer:

Vitrix

Delphis Medical Limited specialise in blood lancets and have a range of

blood lancet products

in the UK. Vitrex Sterilance Press is the newest.

It comes pre-loaded, button operated and has high-speed penetratio, all of which ensure a good blood sample every time.

Sterilised using gamma radiation

There are a number of variations of Sterilance Press, including the Vitrex Sterilance Lite which has been sterilised using gamma radiation.

The

needle

is fully shielded before and after use (so it can’t be re-used and there are no accidental finger-pricks), and being extremely sharp it’s comfortable to use with minimum pain.

Vitrex Steriheel Baby is a blood safety lancet especially designed for neo-natal and premature babies.

However, it can also be recommended for other applications where short penetration depth and/or minimal compression of tissue is required.

Product guide written by Diabetes Expert:

Sue Marshall

Diabetes medications are a common form of treatment for people with diabetes.

There are many different types of diabetes medicines, or anti-diabetic drugs, and this includes

insulin, which has its own area within the site.

Whilst each drug is unique in the way it works to help patients with diabetes keep their condition under control, some act similarly to one other and are grouped in the same class of drugs.

The way in which they are administered can also differ, with some medicines taken orally and others injected directly into the blood.

Are diabetes drugs suitable for all diabetics?

Most diabetes drugs are designed for people with

type 2 diabetes
who are unable to control their blood sugar levels through strict diet and exercise alone. But somen, such as metformin, are sometimes taken alongside insulin treatment for people with

type 1 diabetes

What are the side effects of anti-diabetic medicines?

As with any type of medication, blood glucose-lowering drugs can have a number of side effects. These potentially harmful effects are listed in the patient information leaflet that accompanies the medication, so make sure you check this before starting your drug treatment.

You may not experience any of the adverse effects listed, but if you do, consult your

doctor
and/or diabetes

care team
as they may be able to suggest another suitable medication for your condition. They will also be help with any questions or concerns you have regarding your medicine.

Can more than one drug be taken at the same time?

Depending on individual circumstances, a GP may prescribe more than one

anti-diabetic drug
to help treat a patient’s diabetes.

MEDICATION GUIDES:

Alpha Glucosidase Inhibitors

Amylin Analogues

Biguanides

Gliptins

GLP-1 Agonists

Glinides

Gliflozins

Sulphonylureas

Glitazones

Watch the video below for more information on the types of diabetes medication available.

Important information

• Make sure you’re prescribed diabetes medication is safe to take with your other medicines.
• Before starting your course, read the manufacturer’s printed information leaflet from inside the pack.
• Stick to the drug dosage prescribed by your doctor. If you think you’ve taken an overdose of this medicine, get yourself to A&E department of your local hospital as quick as you can, and remember to take the container with you.
• Never give your medication to other people, even if their condition appears to be the same as yours.
• Take any out-of-date or unwanted medicines to your local pharmacy for disposal.

*Disclaimer: This article on diabetes medication is for information only.

Studies have showed that Actos (pioglitazone) is linked statistically with an increased risk of bladder cancer – suggesting Actos could double the risk of getting bladder cancer.

Studies indicate that people with bladder cancer amongst people with

type 2 diabetes
not taking Actos were 0.07% and 0.15% amongst those taking Actos.

Should I keep taking Actos?

The advice from the European Medicines Agency is to keep taking Actos unless your doctor suggests otherwise.

Whilst the risks of developing bladder cancer are increased, the EMA believes the increased risks do not necessarily outweigh the benefits of taking Actos.

People with an increased risk of bladder cancer, such as people who smoke, have had a career that has seen them exposed to industrial chemicals or are over 60 would be advised to discuss the risks with their doctor.

Has Actos been banned in France and Germany?

France has taken the precautionary measure of suspending the use of Actos.

In Germany and Luxembourg, doctors are not prescribing Actos whilst further investigations are taking place.

In the rest of Europe and the USA, doctors have been urged to be cautious in prescribing Actos, particularly in older patients.

How can bladder cancer be spotted?

The most common symptom of bladder cancer is the presence of blood in the urine, which may be noticed as red or brown coloured urine or as clots or streaks of blood.

Other symptoms of bladder include pain whilst urinating and an urgent need to urinate.

The symptoms are not a definite sign of bladder cancer, but you are advised to report the symptoms to your doctor immediately you recognise them.

Doctors are being advised to discuss treatment options for patients taking Actos at their next treatment review.

• Read more on
  
  bladder cancer and diabetes

Statins have attracted controversy in the past for their potentially dangerous side effects. Statins side effects usually fall into one of 4 categories.

The side effects categories are:

• Easy to diagnose
• Mild
• Reversible
• Rarely dangerous

Statins side effects and indeed the drugs themselves have been studied in detail, and are known to be safe.

Your GP or healthcare professional will be able to help you if you experience any statins side effects symptoms.

Used alongside

blood glucose control

, statins are medically proven to cut cholesterol levels and decrease the likelihood of a cardiovascular event.

Statins will commonly be prescribed to people that have already had a heart attack,

stroke

or

peripheral artery disease

What are the side effects of statins?

Statins side effects may include the following:

• Some studies have shown statins increase risk of
  
  depression
  
  and impair cognitive ability
• One statin, simvastatin, could lead to a rare kidney problem
• The FDA has warned that patients on statins are more likely to develop myopathy, including rhabdomyolysis in rare and serious cases
• Liver function can sometimes be affected

Do statins increase risk of Parkinson’s or Alzheimer’s?

There is currently no evidence of a link between statins and Parkinson’s or Alzheimer’s.

Statins and blood glucose levels

Studies have indicated slightly higher fasting blood glucose levels in people with diabetes taking statins.

The effect may be more pronounced in people taking larger statins doses.

How are statins side effects influenced by the liver?

Statins target liver cells where

cholesterol

is produced by the body.

When your doctor is considering whether to put you on statins, you will have a

blood test

to check how well your liver functions.

If your liver is affected, your doctor may change your medication or reduce your dose.

I’m on statins, should I change my diet to lower the risk of side effects?

Your doctor should be able to advise you

regarding your diet

in relation to statins. The British Heart Foundation advises avoiding grapefruit and grapefruit juice as they can increase the risk of statin side effects.

Traditional Chinese Medicine (TCM) is an ancient form of treatment that aims to maintain harmony and balance within the body.

A number of therapeutic methods may be combined to produce a holistic effect.

Whilst some aspects of TCM may result in benefits, there is little in the way of scientific proof to show that the theory behind TCM is valid.

How does Chinese medicine work?

Chinese medicine works to benefit the mind and body overall.

Techniques used in Chinese medicine include:

• Chinese herbal medicine
• Acupuncture
• Diet therapy
• Mind body exercises such as qigong and t’ai chi
• Chinese
  
  massage
  (tui na)

Chinese herbal medicine

Chinese herbal medicine is centred on the use of plants, but also some minerals and animal products. These herbs are often combined in formulas and administered as capsules, powders or teas.

Different herbs are chosen based on the person’s symptoms. These may be single herbs or a combination, with the different herbs playing different roles.


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Acupuncture

Acupuncture is the practise of inserting needles (4-25mm long) into specific areas of the body to stimulate sensory

nerves.

The stimulation of nerves can result in the release of chemicals in the body including endorphins.

Research studies have demonstrated that acupuncture therapy may benefit peripheral

diabetic neuropathy
and reduce

nerve pain.


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Evidence showing a positive effect of acupuncture on blood glucose levels are limited to animal studies.

Diet therapy

Diet therapy in Chinese medicine is based around eating natural whole foods. Chinese

diet
therapy puts forward the idea that diabetes is down to excess internal heat.

The remedy is to have cooling foods. Many

fruits
and vegetables, tofun, certain grains and certain seafood are defined as being cooling foods.


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Whilst eating natural, whole foods is a good step, care should be taken about choice of foods as Chinese diet therapy lacks a strong scientific basis.

Note that grains and most fruits are relatively high in carbohydrate. Too much carbohydrate in the diet is linked with high blood glucose levels and poor blood glucose control.

Qigong and t’ai chi

T’ai chi and Qigong are martial arts that have evolved into different forms including low impact exercise. In this form, they are characterised by controlled breathing, stretching, balance and slow, flowing movements.

T’ai chi and Qigong are recognised as being particularly useful for some

elderly people
as research suggests that they may improve psychological wellbeing and balance to prevent falls.


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Tui na massage therapy

Tui na is a form of massage therapy that uses techniques such as kneading, pull and pushing of the flesh at acupressure points.

Whilst research has found positive results for tui na in a number of areas of health, such as lower back pain and

high blood pressure, however, stronger and more reliable research is needed to qualify the benefits.


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Colour, music and art are sensory or creative therapies. A number of studies have been run to test the benefit of these therapies on different aspects of diabetes.

There is some evidence that art and music therapy can have some benefits for certain people but the

research
to date is limited to small studies, therefore the reliability of the findings is not guaranteed.

In this guide, we review which studies have been run and what they can tell us.

Art therapy

Art therapy can help someone with diabetes regain a sense of control and maintain a feeling of independence.

The therapy could help people move towards gaining acceptance of diabetes which is an important hurdle to cross. Accepting diabetes can lead people towards taking ownership of their diabetes which in turn can lead to improvement in

diabetes management

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A 2013 study into art therapy for children with uncontrolled

type 1 diabetes
showed evidence of benefits for diabetes management.

The children chosen to take part had been struggling with self-management. Needle phobia and difficulty adhering to a good diet and taking injections were some of the main issues encountered by the

children.
Art therapy was maintained for an average of about 9 months in the intervention group of children.

The study showed that those taking part in art therapy improved their

HbA1c
by 9 mmol/mol (0.8%) on average compared with the control group.


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Music therapy

Most of us find music can be useful for relaxing and motivation. Research has also tested music therapy and shown that it may have some short-term benefits in certain areas.

A 2013 study found evidence that music therapy could help lower systolic blood pressure of patients with diabetes and

high blood pressure

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Listening to pleasant music could help reduce feelings of pain, according to a study from 2008. This effect could, for example, have short-term benefits for people with a degree of

neuropathy pain

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Colour therapy

Colour therapy, also known as chromotherapy, is based on the idea that different colours can help with physical and

mental health

However, there is little evidence to demonstrate that the therapy has treatment potential in diabetes.

Homeopathy treatment is based on the use of highly diluted substances. Scientific research has shown homeopathic medicine to have no evidence of benefit beyond a placebo effect.

Homeopathy should not be used to treat any

type of diabetes
or diabetes related complications. It must not replace any prescription medication you are currently taking.

What is homeopathy?

Homeopathy was developed in Germany and has been used for more than 200 years.

A homeopath will select the most appropriate medicines for you based on your symptoms, then heavily dilute and shake these substances in water.

Whilst practitioners claim these substances can be used to treat a wide variety of illnesses, research shows no scientific evidence that the treatments are any better than using a placebo.

A placebo effect is when people experience a benefit that is psychological and not brought on by any therapeutic effect of the medication.

Does homeopathy work?

There is no evidence to support the use of homeopathy for treating medical conditions.

In the UK, the House of Commons’ Science and Technology Committee called for the

NHS
to withdraw funding of homeopathy; concluding that there was no evidence that homeopathy works beyond a placebo effect.

The British Medical Association supports the view that homeopathy is not supported by evidence and therefore should not be funded on the NHS.


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It is not only the UK that has found no scientific basis for homeopathy. The Australian Government’s National Health and Medical Research Council states in a 2015 review:

“Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective.

“Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay

treatments
for which there is good evidence for safety and effectiveness.”


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Availability

Despite the lack of evidence for the effectiveness of homeopathy, many health shops and pharmacies sell homeopathic tablets or other remedies.

There is no legal regulation of homeopathic practitioners in the UK, and no qualifications or experience is needed to practice homeopathy.

If you are considering homeopathy for your diabetes, you should first consult your healthcare team. Do not stop taking any

diabetes medication
as this can put you in danger.

Massage therapy can have several relaxing effects on the body, some of which could be particularly useful for people with diabetes.

Studies have shown that massage therapy may help lower anxiety,

stress
and possibly blood pressure, all of which can increase your well-being.

Note that massage therapy should not replace any

medications
you are taking for these conditions.

If you are considering massage therapy for health reasons, it is advisable to consult your doctor first.

Types of massage therapy

Different types of massage therapy include:

• Swedish massage – also known as classic massage
• Thai massage – combines acupressure techniques with yoga poses
• Reflexology – involves applying pressure to the feet
• Shiatsu massage – massage is provided by specialist machines

These each work in different ways and will therefore have different benefits and precautions to consider.

Massage therapy benefits

Massage therapy is known to have benefits on lowering

anxiety
and stress and the effects are likely to extend to people with diabetes to some extent.

Stress is known to negatively affect

diabetes control
and therefore reductions in stress may result in improved blood glucose levels. However, there have been no well-run studies to show whether this applies in practice.


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Massage may also help

lower blood pressure, however, there is a lack of good quality studies to confirm this.


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There is some evidence that indicates that massage may improve glucose levels in children with

type 1 diabetes
but again more research is this needed in this area to confirm.


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Massage therapy and diabetic neuropathy

Whilst research into massage for neuropathy treatment is scarce, one study from 1973 showed potential for massage to relieve symptoms of

diabetic neuropathy

The study used a mechanical leg massage technique called syncardial massage. This involves wearing an inflatable cuff, similar to the cuffs used for taking blood pressure. The cuff was worn on the legs and delivers waves of pressure which is thought to aid blood flow.

The majority of participants noted improvement in symptoms, however, the trial was not randomly controlled and therefore researchers cannot rule out that the benefits may have been a placebo effect.

Precautions

A review from 2001, by Ezzo et al. noted that massage may present some risks if care is not taken by the masseuse (the practitioner giving the massage).

In people on insulin, massage may increase the risk of

hypoglycemia
(too low blood sugar).

In people with neuropathy, the masseuse should know the correct ways to apply pressure so as not to damage blood vessels and tissues.


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Relaxation therapy can take many forms. Learning how to manage stress and relax the body and mind can have benefits towards managing chronic diseases such as diabetes.

Guided imagery, sometimes called visualisatio, can profoundly affect the state of a patient’s mind. It is thought that those people who have an optimistic, bright outlook on life will also remain in

better health

Guided imagery teaches the patient the skill of creating a mental image. In the case of diabetes, this mental image may reflect the patient’s own perception of his or her diabetes.

The reactions to this image are then explored and discussed with a therapist who helps to change the image of the disease for the better.

Guided imagery can be used to treat a number of other conditions such as stress and depression

To date, there is lack of strong research available to help evaluate the benefits of guided imagery specifically for people with diabetes.

Research into guided imagery and diabetes

A research study published in 2015 investigated the effects of listening to a guided imagery recording on blood glucose control in children with type 1 diabetes.

13 children took part in the study. One group listened to the guided imagery recording along with background music twice a week for 12 weeks. Another group listened to the background music only.

The results showed that the guided imagery group achieved a significant reduction in HbA1c.

The study is small and further research would help to demonstrate how effective guided imagery is for lowering blood sugar across a larger population.


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