Posted: February 19th, 2022
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Diabetes and Drug Treatments
Diabetes and Drug Treatments
According to the American Diabetes Association (2018), approximately 1.5 million Americans are diagnosed with diabetes every year. When not treated, patients with this condition are susceptible to multiple alterations, including stroke, kidney failure, and heart disease. Multiple recent studies conclude that there are multiple diabetes treatment methods, most of which are in the form of drug therapy. However, the patient’s behavioural factors and the type of diabetes impacts diabetes treatment recommendations.
Rosenthal and Burchum (2021) contend that though type 1 diabetes often presents during childhood or adolescence, the condition can also develop during adulthood. This type of diabetes is caused by an autoimmune reaction that destroys the beta cells responsible for synthesizing insulin. The clinical manifestation of this condition includes high blood sugar, excessive urination and thirst and weight loss.
Approximately 90 to 95% of diagnosed diabetes cases are diabetes type 2 diabetes. Rosenthal and Burchum (2021) espouse that type 2 diabetes is non-insulin-dependent diabetes that develops in genetically predisposed individuals due to advancing age, obesity, and inactivity. Though patients with this condition still produce insulin, its secretion is not tightly coupled with plasma glucose, delaying insulin release while the peak output is subnormal.
Gestational diabetes appears during pregnancy and subsides after delivery (Rosenthal and Burchum, 2021). On the same note, the American Diabetes Association (2018) advises that women with gestational diabetes tend to have undiagnosed pre-existing diabetes, thus requiring them to be diagnosed with type 1 or type 2 diabetes.
Furthermore, juvenile diabetes is an autoimmune disease characterized by the pancreas stopping to produce insulin. Rosenthal and Burchum (2021) find that the early signs of this condition include urination and thirst.
According to the U.S. Food and Drug (2017), Metformin, a Biguanide drug class, is the first type 2 diabetes therapy line. Rosenthal and Burchum (2021) argue that this drug is an oral agent that minimizes the production of glucose by the liver and increases tissue response to insulin. This drug comes in two oral preparations with the first initial adult 500 mg dose taken orally twice or once daily with a meal to minimize gastrointestinal upset and the second 500mg to 1 gram taken once daily with the evening meal alongside a gradual titration dose to reduce gastrointestinal effects. The authors contend that some of the side effects of this drug include diarrhoea, nausea, and reduced appetite. On the same note, the U.S. Food and Drug (2017) recommends that patients under this medication not take alcohol since it potentiates the drug’s effects on lactate metabolism and can result in low blood sugar when patients fail to eat enough.
The short-term impacts of type 2 diabetes include hypoglycemia, particularly among patients taking secretagogues including sulfonylurea agents and exogenous insulin-requiring immediate replacement of glucose intravenously or by mouth. Other short term impacts include hyperosmolar hyperglycemic nonketotic syndrome (Rosenthal and Burchum, 2021). On the other hand, the authors contend that long-term impacts include microvascular complications damaging the small blood vessels resulting in renal failure, retinopathy resulting in blindness and neuropathy resulting in foot disorders and impotence. In addition, long-term macrovascular complications include damages to the major blood vessels resulting in cardiovascular diseases.
American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes2018. Diabetes Care, 41(Supplement 1), S73 S85.
Rosenthal, L. D., & Burchum, J. R. (2021). Lehnes pharmacotherapeutics for advanced practice nurses and physician assistants. St. Louis, MO: Elsevier.
U.S. Food & Drug. (2017). FDA Drug Safety Communication: FDA revises warnings regarding use of the diabetes medicine metformin in certain patients with reduced kidney function.
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