Diabetes

Welcome to the Affordable Drugs diabetes information page. The topic of diabetes can be confusing and overwhelming. There is diabetes mellitus, sugar diabetes, juvenile diabetes, gestational diabetes, type 1 diabetes, type 2 diabetes, etc. What are they and what do they all mean? You can start learning about diabetes here. We cover diabetes symptoms, diabetes treatments, diabetes diet, the causes of diabetes, etc. Educating yourself about diabetes is very important in obtaining positive health outcomes if you have been diagnosed with diabetes. Not only can you find great diabetes info but you can also find the best prices available on diabetes medications. The information contained on this page is not intended to replace the professional advice of your physician.

What is Diabetes?

Diabetes is a disorder in which the pancreas does not produce enough insulin or the insulin is not treated properly at the cellular level. Insulin is responsible for moving glucose through the bloodstream where it can be broken down for energy. However, diabetes keeps this natural process from occurring the way in which it was intended. Instead of being utilized for energy, the glucose builds up in the blood stream and wreaks havoc on the body.

What is Diabetes: The Types

There are two main types of diabetes:

Type 1 - Often referred to as juvenile diabetes, this type happens when the immune system destroys the pancreatic cells that produce insulin.

Type 2 - Caused by poor lifestyle habits and obesity, this type of diabetes occurs due to the inability of the pancreas to keep up with the processing of glucose.

Gestational diabetes occurs during pregnancy though it does not continue to cause a problem after the birth of a child. A woman with particular health issues may be at higher risk for gestational diabetes and will likely be tested for this issue at some point during pregnancy.

Diabetes insipidus is a different problem and must be handled in a separate manner altogether.

What is Diabetes - Prevention

It is unknown whether type 1 diabetes or "juvenile diabetes" may be prevented as the predisposition can be inherited or caused by other health conditions. It most often sets in by young adulthood.

It is possible to prevent type 2 diabetes. Excessive sugar in the diet and obesity are major contributing factors to this type. Keeping weight down with balanced eating and regular daily exercise can almost always insure you will not suffer from this type of diabetes.

What is Diabetes - The Symptoms

Following are some of the symptoms to watch for though not everyone who is diagnosed with diabetes experiences the same signs:

- Excessive thirst

- Excessive hunger 

- Weight loss without explanation 

- Frequent need to urinate

- A sweet smell to the urine

- Fatigue

- Blurred vision

- Dry mouth 

- Frequent yeast infections

- Cuts and scrapes that are slow to heal

What is Diabetes - Treatment

The treatment of diabetes depends on the type and severity of the problem. Some diabetics are able to control it with diet and exercise though for many, the right treatment is a combination of drugs and lifestyle changes. Insulin, supplements and new diabetic pharmaceuticals have come a long way toward treating the disease and keeping the lives of patients as normal as possible.

Left untreated, any type of diabetes can be extremely harmful and even deadly though with proper treatment, those who are diagnosed with the disease are capable of managing it and living full and satisfying lives.

Diabetes Symptoms

Type 1 and Type 2 diabetes share many symptoms in common. In both types of diabetes, there is excessive glucose present in the blood, while at the same time the cells of the body do not have enough glucose. In Type 1 diabetes, high glucose levels occur as a result of a lack of insulin due to the destruction of insulin producing cells. In Type 2 diabetes, the cells within the body become resistant to insulin. In both instances, the cells within the body do not receive the glucose that is needed, which can result in a variety of diabetes symptoms.

Symptoms of Diabetes

Frequent Urination

One of the most common symptoms of diabetes is frequent urination. When there is too much glucose present in the blood, the result is often an increase in urination due to the fact that the kidneys are not able to filter the glucose back into the blood. As a result, the kidneys become overwhelmed and begin to pull additional water from the blood in an effort to dilute the glucose. This causes frequent urination.

Excessive Thirst

Excessive thirst is also considered to be one of several diabetes symptoms. An individual with diabetes may feel as though they cannot drink enough water. Excessive thirst often arises as a result of the body drawing additional water from the blood in order to dilute the glucose. Excessive thirst in a diabetic can result in dehydration.

Unexplained Weight Loss

One of the more noticeable symptoms of diabetes is weight loss that occurs without even trying. This is more common in Type 2 diabetes. The pancreas ceases to make insulin. As a result, the body attempts to find another energy source because the cells are not able to receive glucose. Muscle tissue and fat is then broken down as a source for energy, which results in weight loss.

Fatigue and Weakness

Other diabetes symptoms may include fatigue and weakness. The cells within the body use glucose in order to produce necessary energy. When there is no glucose present or when the cells become immune to glucose, the glucose is not able to reach the cells. As a result, the cells become deficient in energy, which results in a feeling of tiredness or lethargy.

Numbness or Tingling in the Hands, Feet or Legs

A sensation of tingling or numbness in the extremities can also be included in the symptoms of diabetes. This is known as neuropathy. It may occur gradually over time as the nervous system becomes damaged by the high levels of glucose in the blood. This symptom can sometimes be improved with glucose management.

Other Diabetes Symptoms

Other symptoms of diabetes that may be experienced include dry or itchy skin, blurred vision, bruises or cuts that seem to take longer to heal and frequent infections. All of these symptoms are related to high levels of glucose present within the body. If you notice any of the symptoms mentioned above, it is important to schedule an appointment with your physician.

Diabetes Complications

Complications of Diabetes:

People with diabetes are at risk of developing a number of complications throughout the body. Complications of diabetes include eye disease, kidney disease, nerve damage, and heart disease, among others. Chances of developing diabetes complications decrease with proper diagnosis and treatment.

Diabetic Eye Disease
Diabetics are at high risk of developing eye disease, leading to a loss of vision, or in severe cases, even blindness. The most common diabetic eye disease is retinopathy. Retinopathy affects the blood vessels in the retina, sometimes causing swelling and the leakage of fluid. This condition could result in decreased vision or blindness. Diabetics are also at a higher risk of developing cataracts and glaucoma.

Diabetic Kidney Disease
Diabetes is the number one cause of kidney failure. Kidneys damaged by diabetes progressively lose the ability to remove waste from the blood. In the early stages of kidney disease, or nephropathy, small amounts of the protein albumin begin to leak into the urine. Progression of the disease results in larger amounts of albumin leaking into the kidneys. As the disease continues to progress, the kidney's ability to filter out waste decreases and eventually stops. In the last stages of kidney disease, a patient must either undergo dialysis or have a kidney transplant.

Diabetic Neuropathies
Diabetes can cause a number of nerve disorders, or neuropaties, throughout the body over a prolonged period of time. There are four types of neuropathy, including peripheral neuropathy, autonomic neuropathy, focal neuropathy and proximal neuropathy. Peripheral is the most common type of neuropathy, affecting the long nerves of the body. Symptoms of peripheral neuropathy may include tingling, numbness, burning and pain in the feet and lower legs. Around 60%-70% of people with diabetes develop some type of nerve disorder or neuropathy, especially those who have a difficult time controlling their blood glucose.

Diabetes and Heart Disease
Another of several complications of diabetes includes heart disease. According to statistics, people with diabetes are twice as likely to develop heart disease than those without diabetes. Two out of three people with diabetes die from heart disease and stroke. Diabetes affects blood vessels, causing them to narrow, or in some cases, become completely clogged with plaque. This process, called atherosclerosis, hinders blood flow, resulting in possible hemorrhage or the development of a blood clot. If the whole artery becomes blocked, a person is at great risk of suffering a heart attack or stroke, due to the oxygen supply being cut off or significantly reduced.

Diabetes Causes

Diabetes is a widespread problem that afflicts millions of people, and in some cases has serious consequences. The disease impairs sugar metabolism in our body. The causes of diabetes are not precisely known but there are risk factors that have been identified. There are two types of diabetes: Type 1 and Type 2 diabetes , and each is believed to have different risk factors.

Type 1 diabetes causes
There are believed to be different Type 1 diabetes causes -- a disease that is thought to afflict the autoimmune system. In this form of diabetes, the body produces no insulin. Some believe that genes may be one of the causes of diabetes of this type, so checking family history may identify risk. Type 1 diabetes is more common in people of northern European descent and rarest among people of Asian descent.

Virus infections are considered to be possible causes of diabetes. In particular, viruses that infect the pancreas can reduce that organ's ability to produce insulin.

Type 2 diabetes causes
With this type of diabetes the body produces insulin, but only in insufficient quantities, or the insulin does not function properly. Heredity is implicated as one of the Type 2 diabetes causes. There is a significantly higher chance of having Type 2 diabetes if a person has a close relative with the disease. People of African, Asian and American Indian descent appear to be more susceptible to this form of diabetes.

Obesity is often cited as one of the causes of diabetes of the Type 2 variant. The excess fat in some individuals, especially of older age, seems to interfere with the normal functioning of insulin in the body. As many as 80 percent of people with Type 2 diabetes are either overweight or obese. The fat cells do not absorb insulin as readily as muscle cells, and fatty acids released by fat cells inhibit metabolism of glucose. Because the used glucose is stored as fat itself, a vicious cycle occurs that promotes fat build-up.

Diet is also thought to be one of the major causes of diabetes. In particular eating too much fat and carbohydrates is believed to interfere with glucose metabolism and possibly to hamper the secretion of insulin from the pancreas. Both of these factors lead to a build up of sugar in the blood. A bad diet can also lead to a poor cholesterol profile with not enough good HDL cholesterol. This leads to an environment in the blood that interferes with insulin absorption.

Lack of exercise and physical activity is another one of the causes of diabetes -- one that can be rather easily avoided. Experts recommend that people should exercise at least three times a week. A sedentary lifestyle can contribute to getting overweight and to high blood fat levels - two other risk factors for Type 2 diabetes.

Other factors considered as diabetes causes include age (over 65), emotional stress, smoking, alcohol intake, and high blood pressure (140/90 mm or higher). Giving birth to large baby of more than 9 pounds can lead to a Type 2 form known as gestational diabetes.

There is additionally a condition called prediabetes, or impaired glucose tolerance, that is implicated as a cause of Type 2 diabetes. This condition afflicts a large percentage of the population of people between the ages of 40 to 74. If prediabetes is treated early, the chances of contracting Type 2 diabetes later on is significantly reduced.

By knowing the various diabetes causes, people can take measures to prevent this serious infliction from occurring including watching their diet and getting plenty of exercise.

What Causes Diabetes?

While medical scientists have no definitive answer as to what causes diabetes, there are several risk factors that are known to contribute to the disease. Taking note of what causes diabetes is an important step to fighting the disease.

Researchers believe that there is a genetic element to the development diabetes and that because of certain genes that pass from generation to generation, a person can inherit the disease. It is thought that a child is more likely to inherit diabetes if the father has the disease than if the mother does, and is significantly more likely to inherit the disease if both parents are diabetic.

An astonishing majority of people that suffer from diabetes is overweight. Being overweight leads to an increased insulin resistance in the muscle and tissue cells. Without proper insulin function in the body, sugar is unable to move from the blood to the muscle and tissue cells, leading to high blood sugar levels and ultimately diabetes.

Diet is a major factor in defining what causes diabetes. The body needs a balanced diet to sustain vital functions, so consuming an imbalance of carbohydrates, fats or proteins can be harmful to the body. It is believed that a high intake of refined products, improper nutrition and low protein and fiber intake all contribute to the development of diabetes. Eating too much food in general also hinders the pancreas from producing and secreting insulin, which is a principle factor contributing to what causes diabetes.

Level of physical activity is also thought to contribute to diabetes. People who have a sedentary lifestyle tend to be more prone to developing diabetes when compared with those who have a regular weekly exercise routine.

Age is also an important factor when considering what causes diabetes. While diabetes can occur at any age, the overwhelming majority of cases occur after the age of fifty. However, it is important to note that in many cases, increased age correlates with a change in lifestyle that can often include decreased physical activity and weight gain, both known to contribute to diabetes.

Stress is also thought to cause diabetes due to the increase in certain chemical levels in the body that emotional stress or physical injury can cause. These imbalances can affect the functionality of the pancreas, which influences metabolism and has been linked to the initial stages of diabetes.

Hypertension is considered to be one of the potential causes of diabetes as medical scientists have established a direct relation between high systolic pressure and diabetes.

High triglyceride and cholesterol levels in the blood have also been linked to high blood sugar and can be considered possible causes of diabetes.

There are certain sex-linked factors that are thought to contribute to diabetes. Elderly males are particularly susceptible to developing the disease, as are women with multiple pregnances as well as women suffering from Polycystatic Ovarian Syndrome.

In some cases, certain pharmaceutical drugs are known to induce the onset of diabetes, including clozapine, olanzapine, risperidone, quetiapine and ziprasidone.

Diabetes Diet

If you have diabetes, you probably have questions about the proper diet for managing your blood sugar levels. A special diabetes diet can certainly help control your blood sugar, sometimes eliminating the need for insulin injections. (Consult your doctor before changing your diet or reducing your insulin.)

Your diabetes diet does not have to be a complicated, time-consuming process. It simply needs to follow a few key points. A healthy diabetes diet is healthy for anyone because it stresses fruits, vegetables, and whole grains. You will also need to be consistent to keep your body from causing an unsafe increase in blood sugar when faced with an excess of fat or calories.

The first thing to understand is how your body uses food. Everything you eat eventually turns into sugar. If you eat sugary foods, this hits your bloodstream right away. After about an hour, it's followed by carbs, then by proteins at around four hours, and finally fats around six to eight hours.

The key to using this information is to eat a balanced meal which allows an even flow of sugars to your bloodstream as each of these food types breaks down. If you eat small servings from each category at every meal, your body will be able to process each one slowly rather than processing a large amount of sugar at one time, such as if you eat only carbs. It can be helpful to eat a small meal every two to three hours during the day. Light exercise after each meal can also stimulate your digestion, avoiding a spike in your blood sugar. Another important part of your diabetes diet is to drink two glasses of water with each meal.

The ideal diabetes diet contains a combination of foods. A sample meal might include one serving each of whole grain bread or pasta, lean protein, dairy, vegetables, and fruit, plus a small amount of unsaturated fats such as dressing or margarine. Avoid fatty red meat and organ meat, highly processed food, fried foods, and foods high in saturated fat or cholesterol.

There are also many "free" snacks and drinks to get you through the day. A free food or drink is one with 20 calories or less, and less than 5 grams of carbs. Examples include club soda, coffee, tea, broth, diet soft drinks, sugar-free drink mixes, sugar-free candy or gum, and sugar free gelatin

If you follow your diet plan, you will eat a fairly consistent amount of carbs and calories each day, which helps your body maintain both your weight and your blood sugar. A diabetes diet plan does not have to be restrictive, and your entire family can benefit from this healthy diet.

Type one Diabetes

What is Type I Diabetes?
Type One Diabetes, or Diabetes Mellitus type one, is a form of diabetes that affected 5 to 10% of people with diabetes. Type one Diabetes is an autoimmune disease that basically reduces and destroys insulin producing cells from the pancreas. This lack of insulin then causes an increase in blood glucose levels.  Glucose then begins to appear in the urinary tract and urine when blood glucose levels are above the renal glucose filtering threshold. Basically, high glucose levels caused by diabetes destroys cells that are essential to making the urinary tract function correctly.

Type one diabetes can be deadly, as the body cannot function without insulin. The only way to avoid death as a result of diabetes type one is the regular injection of exogenous insulin which restores blood insulin levels, which helps the body to use the glucose and regulate blood sugar levels. Though injection is the main form of the administration of insulin, there are other ways to do this such as inhaled solutions of insulin, catheters, and indwelling. However, the use of these products rarely accomplishes the same thing that directly injected insulin does. The latter three options are still in the experimental stage and are only administered if needles are not an option for one reason or another.

Type one diabetes is typically known as childhood diabetes or juvenile diabetes because it is most common in adolescents or children under the age of 17. In fact, the small percentage of adults that are diagnosed with type 2 diabetes are misdiagnosed and actually have type one, though because of the rarity of type 1 appearing in adults, this is often overlooked. Though there are some experimental vaccinations for type one diabetes, however, none of them have been approved thus far. Most people with type one diabetes are otherwise very healthy and can even lose weight more easily than others. However, if type one is not treated, then this can end in dangerous results. Because the actual cause of diabetes type one is unknown, it can be a very spontaneous and unforeseen ailment for any range of person.

The biggest difference between type one and type two diabetes is the degree to which insulin production is hampered.  In type 1 diabetes insulin production is very minimal or non-existant whereas in type 2 diabetes insulin production still occurs but may not be produced in sufficient amounts for the body to regulate blood sugar levels or the body may not be reacting to the insulin being produced.  A C-peptide assay can help with diagnosis of diabetes and the type of diabetes.  A C-peptide test is basically a type of measurement of how much insulin is being produced in the body.  C-peptide is a byproduct of insulin production, usually by the pancreas. The level of C-peptide is a gauge of how much insulin is being produced in the body.  In type one diabetes C-peptide levels will be low due to the fact that no insulin or less insulin is being produced.  Type two diabetes may show a normal C-peptide assay, which indicates normal insulin production but the body is resistant, or you may get a lower C-peptide reading which indicates insulin production is impaired. Another difference between type 1 and type 2 diabetes is the manner of treatment; in type one, injection of insulin is the only option; however, type 2 can often be treated with diet and exercise and oral medications.

Type 2 Diabetes

Type 2 diabetes is the most common type of diabetes. It is also known as non-insulin dependant diabetes and affects 90% to 95% of diabetics. Type 2 diabetes is a chronic disease that is distinguished by high levels of sugar in the blood. People that have type 2 diabetes produce insulin, unlike those who have type 1 diabetes. Type 2 diabetics either do not produce enough insulin or their bodies are unable to use the insulin sufficiently. This is known as insulin resistance. Insulin is needed by the body to use glucose or blood sugar for energy. Insulin carries glucose from the blood to cells in the body. If glucose levels increase in the blood instead of moving into the cells, the cells will not be able to function correctly. The build-up of glucose in the blood can also cause dehydration and damage to the heart, kidneys, and eyes.

Type 2 diabetes, or non-insulin dependant diabetes, will typically occur gradually over time. Overweight people possess a greater risk of insulin resistance, because the excess fat hinders the ability of the body to use insulin. This is why most people with diabetes are overweight when diagnosed. However, people who are thin or elderly can also develop type 2 diabetes. People who have a high risk of developing type 2 diabetes include:

* Those who are 45 years and older.
* Those that possess excess body weight (particularly at the waist).
* Those that eat a poor diet.
* Those who are not very physically active.
* Those who have a family history of type 2 diabetes.
* Those who have high blood pressure.
* Those who are of a certain race or ethnicity (Native Americans, Hispanic Americans, and African Americans have high occurrences of diabetes).
* Those who have an HDL cholesterol less than 35 mg/dL
* Those who have a triglyceride level more than 250 mg/dL

The symptoms of type 2 diabetes differ between each person. Some people will not display any symptoms. These symptoms may include:

* Increased urination.
* Increased hunger (particularly after eating).
* Frequent tiredness or weakness
* Erectile dysfunction
* Blurred vision
* Increased Thirst
* Dry mouth
* Tingling or numbness of the feet or hands
* Reoccurring infections of the skin, vagina, or urinary tract.
* Nausea

To diagnose Type 2 diabetes, or non-insulin dependant diabetes, a doctor will look for high glucose levels in the blood by doing a random blood test. He or she may also do a screening test or examine the person's urine for ketone bodies or glucose. The person will also have to regularly check their blood sugar levels.

Treatment of non-insulin dependant diabetes involves exercising, eating right, regularly testing your blood sugar levels, and taking certain medications. Dieting and exercise are usually the first steps taken to control type 2 diabetes. They are very important because they help manage weight and control the glucose levels in the blood. People with type 2 diabetes should see their doctor every 3 months. If type 2 diabetes is not controlled it could lead to serious life-threatening health problems.

Diabetes Treatments

While diabetes may, in part, be well-controlled by diet and exercise, the medications prescribed by your doctor are vital to your well-being. Following your physician's instructions closely, and taking the correct doses at the appropriate time during the day, can go a long way towards keeping your blood sugar under control. This, in turn, can make all the difference in the world to your long-term health as a diabetic.

For decades, the only oral drugs available to treat Type 2 diabetes were the drugs in a class called sulfonylureas. There are now six classes of oral medications to treat diabetes. They are sulfonylureas, biguanides, thiazolidinediones, meglitinides, alpha-glucosidase inhibitors, and DPP-4 Inhibitors. Each of these primarily works with one of the body's organs or systems.

Sulfonylureas work by stimulating insulin production in the pancreas. Gliburide and Glimepride are common examples of sulfonylureas, which work well in combination with other diabetic medications. Gliburide (brand name Glucotrol) is a fairly low-priced medication, but may cause the blood sugar to drop too low, and can cause weight gain. Similar in effect and price is Glimepiride (brand name Amaryl). It is also low-cost, and works well with other diabetic medications, but can cause weight gain.

Biguanides lower blood glucose levels by reducing glucose production in the liver. The cells of a diabetic person often resist insulin which is needed to absorb glucose into the cells and out of the bloodstream. Biguanides makes the muscle cells more sensitive. In other words they are more interested in, or hungry for, the glucose.  Metformin (brand name Glucophage) is a biguanide. During the nineties, metformin was made available in the USA, which gave doctors another tool for treating diabetes. Metformin is now one of the most common drugs to be prescribed to newly diagnosed diabetics. This medication works well in combination with the sulfonylureas. The advantages of metformin are that it does not cause weight gain, it may actually decrease "bad" cholesterol (LDL) and triglycerides, and it is also one of the less expensive drugs. On the other hand, it does cause nausea and diarrhea in many patients. When taken with food, however, the diarrhea is usually lessened.

Alpha-Glucosidase Inhibitors work by slowing absorption of carbohydrates in the intestine Acarbose (brand name Precose) and meglitol (brand name Glyset) are alpha-glucosidase inhibitors. When taken with the first bite of food, medications in this class block the breakdown of starches from foods such as bread, pasta, or potatoes in the intestine. They also slow the breakdown of some simple sugars, such as granulated sugar. In this way they prevent a spike in blood glucose levels after a meal. Side effects include gas and diarrhea.

The fourth class is the Thiazolidinediones. These medications work by increasing the body's sensitivity to insulin, and by helping insulin work more effectively in the fat and muscles. Like the biguanides, it also lessens glucose production in the liver.  Rosiglitazone (brand name Avandia) may slightly increase "good" cholesterol (HDL), but can have bad side effects, as well as being one of the more expensive medications. It may cause weight gain or swelling, which can worsen or even cause heart failure. It may also increase "bad" cholesterol (LDL) and triglycerides, and occasionally has been known to cause liver problems.  Pioglitazone (brand name Actos) is one of the newer oral medications for Type 2 diabetes. It's benefits include that it may lower triglycerides, but like Avandia, it can cause increased "bad" cholesterol, and can cause weight gain or swelling which can lead to or worsen heart failure. It is also quite expensive.

Meglitinides, like the sulfonylureas, stimulate the pancreas to make more insulin, although they use a different mechanism, which more accurately reflects the body's normal reaction to high glucose in a non-diabetic person. Repaglinide (brand name Prandin) and nateglinide (brand name Starlix) are meglinitides. They are rapid-insulin releasers. Advantages are that they work quickly, but have a short life, thus lessening the risk of hypoglycemia.

The DPP-4 inhibitors are the newest class of medications on the market. They help improve a patient's A1C without causing hypoglycemia. There is a naturally-occurring compound in the body called GLP-1. This compound reduces blood glucose levels, but is itself broken down very quickly. The DPP-4 inhibitors interfere in this breaking-down process, allowing the GLP-1 to stay active in the patient's system for a longer period of time. Also, these inhibitors only affect the glucose levels when they are high. The advantages of this class of medications are that it does not tend to cause increased weight gain, and has only a positive or neutral effect on the HDL and LDL cholesterol levels. Sitagliptin phosphate (brand name Januvia) is the only currently available DPP-4 inhibitor. Side effects are possible sore throats or respiratory infection, and it is very expensive.

There are two new drugs which have been cleared by the FDA for treating diabetes. These drugs, although not insulin, are injectable. One of them, Pramlintide (brand name Symlin) is a synthetic hormone. This hormone, amylin, is produced by beta cells in the pancreas, just as insulin is. There are three hormones--insulin, amylin, and glucagon�which work together to sustain normal blood glucose levels. When injections of Pramlintide are taken with meals, A1C levels have shown improvement without causing weight gain, or low blood sugar. Nausea is a side effect, although this diminishes over time as patients find their optimum dose.



The other new injectable drug is actually the first in a new and seventh class of medications for type 2 diabetes. This class is called incretin mimitics, and the drug is Exenatide (brand name Byetta). It is also a synthetic, although not a human hormone. It was first extracted from the saliva of a Gila monster, a poisonous lizard. Exenatide lowers blood glucose levels by increasing insulin secretion. Like the DPP-4 inhibitors, it only lowers blood glucose when the levels are too high, so does not cause hyperglycemia. Like the Pramlintide, nausea is the primary side effect, which again, tends to diminish over time.