Diabetes and Drug Treatments

Introduction

Diabetes mellitus is an umbrella term for a number of conditions that stem from body insulin deficiency or inadequate cell reaction to its action (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Under the general term, researchers identify type 1, type 2, gestational, and secondary diabetes that emerge as comorbidity. Combined, diabetes mellitus is a highly widespread condition that affects about 10% of the population in the United States alone (CDC, 2017). In addition, there are 57 million people who are on the verge of developing the condition (Arcangelo et al., 2017). The typical symptoms of diabetes include hyperglycemia, hunger and thirst, blurred vision, fatigue, and frequent urination. Patients are diagnosed with diabetes when the sampled plasma glucose level exceeds or equals 200 milligrams per deciliter. Those who have glucose levels between 140 and 200 are called pre-diabetes patients. Due to the high prevalence and mortality rates of diabetes, it is paramount to review the possible drug treatments and major differences between the types of diabetes.

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Differences between the Types of Diabetes

Diabetes type 1 is also known as juvenile diabetes is believed to be a chronic autoimmune disease, which is characterized by the vulnerability of pancreatic beta cells responsible for insulin production. Type 1 usually occurs before the age of 30, which distinguishes it from other types, and specifically, type 2. The latter develops as adipose or muscular cells become less responsive to the action of insulin. It could also emerge due to the deterioration of beta-cell function. Majorly, diabetes of the second type is developed in people older than 45 (Arcangelo et al., 2017). Gestational diabetes develops in women during pregnancy presumably due to the anti-insulin effects of progesterone, cortisol, and human placental lactogen (Arcangelo et al., 2017). This type of diabetes is characterized by higher blood sugar levels that subside after the baby is delivered. Yet, there is an increased incidence of diabetes in such women.

Diabetes Type 2

Diabetes of the second type is believed to be caused by a variety of reasons. Genetics seem to contribute to the susceptibility to the disease. Family history is, therefore, named one of the risk factors (Arcangelo et al., 2017). In addition, excess fatty tissue is also a factor that increases resistance to insulin action. Diabetes type 2, similar to other types, is identified through blood testing and an oral glucose tolerance test. Once diagnosed, the disease requires strict adherence to management techniques and a medication plan (Ley, Hamdy, Mohan, & Hu, 2014). Due to the fact that the second type is the most widespread as opposed to other types, it is paramount to review the pharmacological treatment for it.

Pharmacological Intervention for Diabetes Type 2

Prior to initiation of the drug therapy, patients are required to be taught the mechanisms of self-treatment, general knowledge of the disease, and administration of drugs. Preparation also includes instruction on self-monitoring of glucose level, the importance of regular exercising, dosage and administration, and healthy nutrition practices. The preferred type of medication is selected based on the actual level of glucose, the presence of comorbidities, and patient preferences. If the glucose levels are less than 250 milligrams per deciliter, then the first-line treatment option would be biguanides such as metformin (Rojas & Gomes, 2013). It is also recommended to consume medications with food to reduce adverse effects. Their advantage is that they do not cause hypoglycemia or hyperinsulinemia (Arcangelo et al., 2017). The drug is administered orally, twice a day with an initial dosage of 500 milligrams. An increase in dosage is decided upon based on the weekly or biweekly results of the treatment.

Usually, the effect of the intake lasts for 24 to 28 hours. The maximum dosage of metformin is estimated at 2000 milligrams per day. The drug is not recommended for children, those aged 80 and above, regular alcohol consumers, and those suffering from dehydration. Heart diseases and pregnancy are also listed among contraindications for biguanides. Among the common adverse effects, there are diarrhea, vomiting, flatulence, etc. Yet the side effects usually decrease in frequency as the treatment continues (Arcangelo et al., 2017). Lactic acidosis can become an issue if the patient does not conform to alcohol abstinence recommendations.

Dietary considerations for patients with diabetes of the second type include complex carbohydrates, foods with a low glycemic index, protein-rich foods (Ley et al., 2014). Also, people with the second type are advised to consume more vegetables. Foods to avoid include those with high glycemic index, sugar, sweets, simple carbohydrates such as pasta, white bread, pastries, etc. (Ley et al., 2014). Generally, the nutritional strategy should pursue the goal of having enough energy, vitamins, proteins, and microelements with the lowest possible effects on blood sugar levels.

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Short-Term and Long-Term Impact of Diabetes Type 2

Short-term effects of type 2 diabetes mellitus include low blood glucose level, which results in dizziness, headaches, fatigue, paleness, etc. Additionally, patients with this condition may experience the hyperosmolar hyperglycemic nonketotic syndrome. Long-term issues list diabetic retinopathy, kidney dysfunction, elevated risk of strokes due to increased blood vessels, nerve damage, and other complications (Victoria’s Hub for Health Services and Business, 2017). Drug therapy-induced complications may include renal function deterioration, ketoacidosis, metabolic acidosis, etc.

Conclusion

All in all, diabetes is a widespread condition that requires further study as even more people are at risk of developing this condition. Diabetes type 2 significantly undermines the quality of life and slowly diminishes health reserves. Current treatment and nutrition advice are able only to offer short-term relief of the symptoms. The cure is yet to be developed.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins

Center for Disease Control and Prevention (CDC). National diabetes statistics report, 2017. Web.

Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2014). Prevention and management of type 2 diabetes: Dietary components and nutritional strategies. The Lancet, 383(9933), 1999-2007.

Rojas, L. B. A., & Gomes, M. B. (2013). Metformin: An old but still the best treatment for type 2 diabetes. Diabetology & Metabolic Syndrome, 5(6), 1-15.

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Victoria’s Hub for Health Services and Business. (2017). Diabetes – Long-term effects. Web.

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