Overview And Pharmacology Of Diabetes Essay Paper
Overview And Pharmacology Of Diabetes Essay Paper
Diabetes is a chronic disease that results from the pancreas’s impairment from producing adequate insulin or when there is poor body uptake of insulin despite production by the pancreatic cells. Insulin hormones produced by the pancreas beta cells are crucial in regulating blood sugar levels. Hypoglycemia refers to a situation with a decreased sugar level in the bloodstream, while hyperglycemia is an increased blood sugar level circulating in the bloodstream. Possession of either hyperglycemia or hypoglycemia indicates a common effect of uncontrolled diabetes, predisposing a client to severe complications of body system damage. For instance, the kidney, nerves, and blood vessels are affected most. Diabetes has three types, namely, diabetes mellitus, diabetes insipidus, and gestational diabetes. Diabetes is a non-communicable disease ranked after cardiovascular disease and cancer as killer diseases. Diabetes leads an individual to develop kidney failure, shock, and death (Galicia et al., 2020)Overview And Pharmacology Of Diabetes Essay Paper. Diabetes is known for increasing premature mortality among low-income countries and developed states.
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Diabetes mellitus
Diabetes mellitus exist in two forms; type 1 diabetes mellitus and type 2 diabetes mellitus. Type 1 diabetes mellitus is a chronic disease characterized by the pancreatic cells’ inability to produce insulin due to the destruction of the autoimmune. A child can be born with type 1 diabetes mellitus but often may also develop during adulthood.
Pathophysiology
Autoimmune destruction of the beta cells of the islets of Langerhans in pancreases characterizes type 1 diabetes mellitus. Autoimmune destruction of the pancreatic cells occurs from the degenerations of the axons and axonal segmentation demyelination, thus impairing impulse transmission from the central nervous system to coordinate the pancreatic cells to produce insulin. With the decline of the beta cells, insulin secretion is decreased until the cells of the pancreas no longer produce insulin hormone to maintain the standard blood glucose level circulating in the bloodstream. Destruction of beta cells of islet of Langerhans leads to no longer production of insulin, thus resulting in Type 1 DM (Paschou et al., 2018)Overview And Pharmacology Of Diabetes Essay Paper. Patients diagnosed with type 1 diabetes mellitus will require complete dependence on exogenous insulin to reverse this catabolic condition hence normalizing lipid and protein metabolism.
Clinical manifestations of type 1 diabetes mellitus include; constant exhaustion or fatigue, polyuria, polydipsia, retinopathy, weight loss, and content complaints of hunger by the patient. The diagnosis is usually made by taking a test of the fasting blood sugar (fasting plasma glucose) and random blood sugar level. FPB exceeding 7.0 mmol/L and RPB exceeding 11.1mmol/L are indicative of type 1 DM. a strict test of HBA1C for one month give an accurate diagnosis of ruing out type 1 diabetes mellitus.
Pharmacologic management
Type 1 DM solely relies on lifelong insulin therapy, diet control, self-monitoring, and self-administration of insulin therapy. The management of type 1DM involves rapid-acting, intermediate, and short-acting insulin therapy. The American Diabetic Association stipulates tight glycemic evaluation and control to institute effective treatment. Rapid-acting includes aspart insulin, glulisine, and lispro. Lispro is regular insulin that acts by reversing the amino acids lysine in the beta cells of the pancreasOverview And Pharmacology Of Diabetes Essay Paper.
NPH, a crystalline suspension of human insulin containing protamine, is intermediate insulin essential in managing diabetes type 1 Dm because it is equivalent to extended insulin and rapid insulin. However, long-acting insulin such as insulin glargine and insulin detemir are commonly used to control Diabetes type1 Mellitus because it produces good stability of basal serum insulin concentration after a single injection. Low doses are often administered twice a day.
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Key considerations that aid advanced nursing practice in the management of type 1 diabetes management entail education of clients possessing the condition to continue taking their insulin and close self-monitoring of their blood sugar levels. Since they depend on lifetime insulin injection, self-insulin administration techniques should be emphasized for them to have the requisite knowledge. Clients should be taught to avoid consuming heavy carbohydrates to avoid a hyperglycemic crisis. Eating healthily and exercising regularly are significant in maintaining a healthy weight. Aiming at reasonable glycemic control and exploring psychological issues within the patient boundaries is significant for maintaining the welfare of a client with type 1 diabetic Mellitus Overview And Pharmacology Of Diabetes Essay Paper.
Diabetes type 2 Mellitus
Diabetic type 2 Mellitus entails a chronic condition described as the resistance of the uptake of insulin despite secretion of insulin by the beta cells of the pancreas, productions of excessive glucagon, or inadequate secretion of insulin to enable control of blood sugar levels circulating in the blood stream (Galicia et al., 2020). Clinical manifestations of type 2 Mellitus include unexplained weight loss, blurred vision, polyuria, polyphagia, and weakness of lower extremities (paresthesia). Type 2DM is also known as no dependent. Clients with type 2 diabetes mellitus gain excess body and inability to participate in physical activities.
Pathophysiology.
Diabetes type 2 is explained by two factors; the dysfunction of the beta cell of the pancreas and resistance to insulin production. Beta cell dysfunctions inhibit the typical stages of insulin production, thus causing inadequate production of insulin or failure to produce insulin at all. Insulin resistance can be attributed to overweight individuals due to increased glucagon production (Oguntibeju, 2019)Overview And Pharmacology Of Diabetes Essay Paper. Insulin resistance also results from physical inactivity, a high intake of calories, and the administration of steroid medications.
Pharmacological management.
The pharmacologic treatment of diabetes type 2 Mellitus I is to relieve symptoms and prevent the development of complications such as diabetic neuropathy that affects the eyes and kidney failure. Increases in glycemic within the blood streams cause havoc for the kidney to ultra-filtrate the large sugar particle, thus impairing the kidney’s workload. The pharmacologic treatment also targets reducing excess body weight and reducing cardiovascular conditions such as hypertension and neuralgic deficits.
The pharmacologic treatment entails using drugs in the class of biguanides, alpha-glucosidase inhibitors, sulfonylureas, dopamine agonists, insulins, selective sodium-glucose transporter inhibitors, and meglitinide derivatives. Metformin is the most clinical biguanide that is mainly used. The pharma kinetic and pharma dynamic of metformin has proved safe and effective to use. It is significant for lowering postprandial blood glucose and decreasing hepatic gluconeogenesis. The use treats insulin resistance of sulfonylureas and meglitinide derivatives. Sulfonylureas such as glimepiride, glipizide, and glyburide counteract insulin resistance by stimulating the beta cells of the pancreas to release insulin. It also proved effective among adults as an adjunct to diet and exercise. Use meglitinide derivatives such as repaglinide in crisis where there is prolonged resistance of insulin secretion by the beta cells of the pancreas. Meglitinide is a short-acting insulin secretagogue that enables the physiologic release of insulin (Cole & Florez, 2020)Overview And Pharmacology Of Diabetes Essay Paper. Meglitinide derivatives achieve effective glycemic control and are more expensive than sulfonylureas derivatives.
Gestational diabetes
Gestational diabetes refers to diabetes that was recognized during the pregnancy period. Gestational diabetes predominantly accounts for the diabetes mellitus found during the pregnancy period. The pharmacologic management of gestational diabetes revolves around; monitoring diet intake, insulin administration, metformin, and glyburide medications (McIntyre et al., 2019). The goals of insulin administration enable the achievement of optimum glucose profiles. Oral agents such as metformin and glyburide prove safe and effective in pregnancy. Average blood sugars level and ultrasonic monitoring of the welfare of the neonate are effective in constituting the management of gestational diabetes.
Advanced nursing practice requires requisite knowledge in the management of diabetes. Management of diabetic clients requires detailed assessment, instituting effective interventions with a rationale that will lead to positive evaluations. Articulating profound education therapy of diet observation is vital for diabetic patients. One should know how to explain what a diabetic plate should be like when explaining to clients. Advanced nurse practice should be skillfully competent in demonstrating the technique of self-administration of insulin. Clients with lifelong dependence on insulin must effectively demonstrate the technique of self-injection. Advanced nurse practitioners should be able to promote self-care by encouraging patients to use their personalized care plans regarding activities of daily living, diet, and exercise. Assessment of mental status is vital. Patients tend to demonstrate psychological symptoms, for instance, depression and stress secondary to lifelong dependence on insulin self-injections. Monitoring input and input are essential to identify polyuria and polydipsia hence evaluation of the workload of kidneys. They are documenting changes in urine passage. Regular blood glucose monitoring enables to determination and enhances glycemic control. The advanced practicing nurse should recognize and follow infection prevention techniques when exposing sharps after measuring plasma glucose levels. The advanced practicing nurse should be able to recognize complications accruing from diabetes. Adequate knowledge about the complication of diabetes allows for effective management in case of an emergency Overview And Pharmacology Of Diabetes Essay Paper.
References
McIntyre, H. D., Catalano, P., Zhang, C., Desoye, G., Mathiesen, E. R., & Damm, P. (2019). Gestational diabetes mellitus. Nature reviews Disease primers, 5(1), 1-19.
Oguntibeju, O. O. (2019). Type 2 diabetes mellitus, oxidative stress and inflammation: examining the links. International journal of physiology, pathophysiology and pharmacology, 11(3), 45.
Paschou, S. A., Papadopoulou-Marketou, N., Chrousos, G. P., & Kanaka-Gantenbein, C. (2018). On type 1 diabetes mellitus pathogenesis. Endocrine connections, 7(1), R38-R46.
Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature reviews nephrology, 16(7), 377-390.
Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., … & Martín, C. (2020). Pathophysiology of type 2 diabetes mellitus. International journal of molecular sciences, 21(17), 6275. Overview And Pharmacology Of Diabetes Essay Paper
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