Medication And Treatment Of Diabetes Discussion

Medication And Treatment Of Diabetes Discussion

Diabetes mellitus is a metabolic disorder typified by chronic hyperglycemia with disturbances in the metabolism of fat, protein, and carbohydrates. Diabetes can be categorized into three general groups: type 1 diabetes, type 2 diabetes, and gestational diabetes.  According to American Diabetes Association (2019), type 1diabetes,  previously known as juvenile-onset diabetes or insulin-dependent insulin accounts for 5 to 10 percent of all diabetes and is a  result of autoimmune destruction of bet cells in the pancreas. Type 2 diabetes, previously referred to as adult-onset diabetes or non-insulin dependent diabetes accounts for 90-95 percent of all diabetes.   It occurs as a result of the progressive loss of insulin secretion by the beta cells frequently due to insulin resistance.  Gestational diabetes mellitus is diabetes diagnosed in the last or second trimester of pregnancy that was not present before gestation Medication And Treatment Of Diabetes Discussion.

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Metformin is used as the first-line medication in treating type 2 diabetes mellitus. It is an effective monotherapy and with other medications used for lowering blood glucose.  It is affordable and is well-tolerated with minimum side effects. According to Baker et al. (2021), metformin improves glycemic control via numerous mechanisms including inhibiting hepatic gluconeogenesis, increasing uptake of glucose by tissue, and reducing the absorption of intestinal glucose. 500 mg daily is the minimum dose essential to produce a significant reduction in glycated hemoglobin.

Abdominal discomfort, diarrhea, and nausea are the most common adverse effects of metformin.  And these side effects occur in 20 to 30 percent of patients.  To make the gastrointestinal side effects less impactful, the dose should be titrated gradually and the medication taken with a meal.  Metformin therapy can be started at a low dose of 500 mg two times a day and increased by 500mg daily every one to two weeks until the patient arrives at a maximum tolerated dose (Baker et al., 2021)Medication And Treatment Of Diabetes Discussion.

Strict control of glucose can prevent or delay type 2 diabetes diabetes-related complications. There is ample evidence that leading a healthy lifestyle, including performing physical exercise, attaining modest weight loss, and adhering to a healthy diet can maintain healthy levels of blood glucose and l minimize the risk of type 2 diabetes complications. Chong et al. (2017), posit that regular physical activity can assist in preventing type two diabetes onset, minimize the risk of complications and improve control of blood pressure in type 2 diabetes patients. Dietary modifications and weight management such as adopting a low-glycerin index or eating pattern or Mediterranean diet effectively improve markers for the risk of cardiovascular disease Medication And Treatment Of Diabetes Discussion.

References

American Diabetes Association. (2019). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care, 42(Suppl 1),  S13–S28). doi: 10.2337/dc19-S002.

Baker, C., Retzik-Stahr, C., Singh, V., Plomondon, R., Andreson, V., & Rasouli, N. (2021). Should metformin remain the first-line therapy for treatment of type 2 diabetes?  Therapeutic Advances in Endocrinology and Metabolism, 12, 1-13. https://doi.org/10.1177/2042018820980225

Chong, S., Ding, D., Byun, R., Comino, E., Bauman, A., & Jalaludin, B. (2017). Lifestyle Changes After a Diagnosis of Type 2 Diabetes. Diabetes Spectrum, 30(1), 43-50. doi: 10.2337/ds15-0044 Medication And Treatment Of Diabetes Discussion

Lena Chung
Week 5 Discussion
COLLAPSE
There are growing number of diabetes which accounted for 37.3 million, 11.3% of the US population, (CDC 2022). Type 1 diabetes is usually diagnosed in young age due to insufficient insulin in blood, also called juvenile diabetes when happens in young age. Type 2 diabetes is a metabolic disease causing hyperglycemia in blood that can affect quality of life and lead to circulatory, nervous, and immune system disorders. Gestational diabetes occurs during pregnancy without preexisting diabetes diagnosis, but usually resolves after baby is born Medication And Treatment Of Diabetes Discussion.

Majority of patients are classified in type 2 diabetes which belong to insulin resistance group (Blaslov et al., 2018). Type 2 diabetes requires healthy diet, regular exercise, maintain healthy weight, monitor blood sugar, and medication therapy. If blood sugar cannot reach the optimal level, medications like metformin can be prescribed. Metformin was approved by FDA in 1995, designated as first line drugs for type 2 diabetes, and it works by decreasing intestinal glucose absorption and diminishing hepatic gluconeogenesis, (Manu, Rogozea, & Cernea, 2021).

Metformin is available in table, suspension, solution, and extended-release forms. Special diet plan may have been prescribed by primary care physician or dietitian along with the medication therapy. Diet plan may include high fat, low-calorie, and low carbohydrates, (Blaslov et al., 2018). Metformin should be taken with meal and full glass of water, should not be crushed, broken, or chewed, Medication should be stored in designated container at room temperature. Some of the side effects include abdominal discomfort, cough, hoarseness, decreased appetite, diarrhea, low back pain, muscle cramping, and sleepiness, (Mayo Clinic, n.d.)Medication And Treatment Of Diabetes Discussion.

Type 2 diabetes will require lifelong treatment with balanced diet, physical activity, and medication therapy as needed. In short term, Metformin improved body weight and glycemic control. In long term, metformin reduced the risk of macrovascular disease, (Kooy et al., 2009). Although there are many treatment options available for diabetes, it is important for patients with diabetes to live quality living style and be happy. It is imperative to focus on prevention and promoting healthy lifestyle through continued patient education, (Blaslov et al., 2018)Medication And Treatment Of Diabetes Discussion.

References

Blaslov, K., Naranđa, F. S., Kruljac, I., & Renar, I. P. (2018). Treatment approach to type 2 diabetes: Past, present and future. World journal of diabetes, 9(12), 209–219. https://doi.org/10.4239/wjd.v9.i12.209

CDC (2022). National Diabetes Statistics Report. Diabetes. Retrieved from https://www.cdc.gov/diabetes/data/statistics-report/index.html

Kooy, A., de Jager, J., Lehert, P., Bets, D., Wulffelé, M. G., Donker, A. J., & Stehouwer, C. D. (2009). Long-term effects of metformin on metabolism and microvascular and macrovascular disease in patients with type 2 diabetes mellitus. Archives of internal medicine, 169(6), 616–625. https://doi.org/10.1001/archinternmed.2009.20

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Manu, P., Rogozea, L. M., & Cernea, S. (2021). Pharmacological management of diabetes mellitus: a century of expert opinions in cecil textbook of medicine. American Journal of Therapeutics, 28(4), e397-e410.

Mayo Clinic (n.d.). Metformin (Oral Route). Drugs and Supplements. Retrieved from https://www.mayoclinic.org/drugs-supplements/metformin-oral-route/proper-use/drg-20067074 Medication And Treatment Of Diabetes Discussion