The Diabetes Disorder Discussion Paper

The Diabetes Disorder Discussion Paper

Shoshana Moss

Diabetes is a set of disorders that causes increased amounts of blood glucose to remain in the blood due to either poor insulin production or improper response of cells to insulin. There are multiple types of diabetes: Type 1 Diabetes is a chronic condition in which little to no insulin is produced by the body due to immune-mediated destruction of pancreatic beta cells (Simmons & Michels, 2015). Type 1 Diabetes in children is referred to as juvenile diabetes. Juvenile diabetes has various etiologies including genetics, environmental factors, drugs or infection (Pasi et al., 2022). Type 2 Diabetes usually results from a combination of insulin resistance and impaired insulin secretion. In contrast to type 1 diabetes, those with type 2 diabetes are capable of producing insulin. However, the major target tissues of insulin (the liver, muscles and adipose tissue) become insulin resistant. Over time, hyperglycemia leads to decreased pancreatic beta cell function and decreased insulin production and secretion (Rosenthal & Burchum, 2021). Gestational Diabetes is a condition in which a woman develops diabetes during pregnancy (and usually disappears after birth). It is caused by hormones produced by the placenta that cause insulin resistance in the mother (Johns Hopkins Medicine, 2019)The Diabetes Disorder Discussion Paper.

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One of the most common medications prescribed for prevention and treatment of type 2 diabetes is Metformin. Metformin is a biguanide that inhibits hepatic gluconeogenesis and targets cells to increase glucose uptake (Correia et al., 2008). This drug has been shown to reduce complications and mortality from diabetes by 30% compared to other medication options (Nasri & Rafieian-Kopaei, 2014). Metformin is administered orally as either an immediate-release or extended-release tablet or oral suspension. The immediate-release and extended-release tablets should be given with meals. It is also important to note that the extended-release tablets should never be crushed or chewed (IBM Micromedex, 2022)The Diabetes Disorder Discussion Paper.

Short-term effects of Type 2 diabetes include fatigue, irritability, blurred vision, slow-healing wounds and frequent infection. Other more serious complications may develop including diabetic ketoacidosis and hyperosmolar hyperglycemic state (Hess-Fischl & Leontis, 2019). Furthermore, if one takes too much insulin or too much medication, or if one doesn’t have enough to eat or exercises more than usual it can put them at risk for hypoglycemia. Long-term complications from diabetes develop gradually and are caused by poor blood glucose control. Possible complications include cardiovascular disease, stroke, neuropathy, nephropathy, retinopathy, foot damage/poor healing of wounds, bacterial and fungal infections and hearing impairments among others (Hess-Fischl & Leontis, 2019)The Diabetes Disorder Discussion Paper.

Short-term effects of Metformin include dizziness, nausea, vomiting, diarrhea, weakness or metallic taste in the mouth. These short-term side effects may have a great impact on a patient’s willingness to comply with medication adherence. It is important to ask patients about side effects they are experiencing to ensure that any barriers to medication compliance can be overcome. Long-term effects of Metformin include vitamin B-12 deficiency and anemia. Furthermore, low vitamin B-12 levels may also contribute to peripheral neuropathy in patients (Aungst, 2019). The greatest adverse effect of this drug is lactic acidosis, which occurs due to overdose or in some patients in which this medication is contraindicated, such as those with serious infections, liver or kidney disease, recent surgery, heavy alcohol use, dehydration, and those who have received iodine contrast among others. It is important to note, however, that lactic acidosis is quite rare. It has been shown that diabetic patients who are considered at risk have received Metformin with no increased risk of lactic acidosis (Nasri & Rafieian-Kopaei, 2014)The Diabetes Disorder Discussion Paper.

References

Aungst, T. (2019, July 31). Long-Term Side Effects of Metformin: What Are the Risks? GoodRx. https://www.goodrx.com/metformin/long-term-side-effects-of-metformin-what-are-the-risks

Correia, S., Carvalho, C., Santos, M., Seica, R., Oliveira, C., & Moreira, P. (2008). Mechanisms of Action of Metformin in Type 2 Diabetes and Associated Complications: An Overview. Mini-Reviews in Medicinal Chemistry, 8(13), 1343–1354. https://doi.org/10.2174/138955708786369546

Hess-Fischl, A., & Leontis, L. (2009). Type 2 Diabetes Complications. EndocrineWeb. https://www.endocrineweb.com/conditions/type-2-diabetes/type-2-diabetes-complications

IBM Micromedex. (2022). Metformin (Oral Route) Proper Use – Mayo Clinic. Www.mayoclinic.org. https://www.mayoclinic.org/drugs-supplements/metformin-oral-route/proper-use/drg-20067074The Diabetes Disorder Discussion Paper

Johns Hopkins Medicine. (2019). Gestational Diabetes Mellitus (GDM). JOHNS HOPKINS Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/gestational-diabetes

Nasri, H., & Rafieian-Kopaei, M. (2014a). Metformin: Current knowledge. Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 19(7), 658–664. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214027/

Ravi, K., & Pasi, R. (2022). Type 1 diabetes mellitus in pediatric age group: A rising endemic. Journal of Family Medicine and Primary Care, 11(1), 27. https://doi.org/10.4103/jfmpc.jfmpc_975_21

Rosenthal, L., & Burchum, J. (2021). Lehne’s pharmacotherapeutics for advanced practice providers. (2nd ed.). Saunders.

Simmons, K. M. (2015). Type 1 diabetes: A predictable disease. World Journal of Diabetes, 6(3), 380. https://doi.org/10.4239/wjd.v6.i3.380 The Diabetes Disorder Discussion Paper

A clear definition has been made of what diabetes disorder is, two different types (Type 1 and Type 2 diabetes), and the impact it has on young children (juvenile diabetes). You have offered the view that different etiologies, for type 1, could lead to diabetes and some of the ones mentioned are genetic, environmental, and use of drugs (Nasri & Rafieian-Kopaei, 2020). A strong point made is that while Type 1 is chronic in the sense that zero, or almost zero, insulin is produced by the body, type 2 is less so and is associated with certain organs becoming resistant to insulin. In both cases, the body experiences low sugar levels leading to diabetes. You have discussed the various treatments available and elaborated on the benefits of each and their scope.

This is important because it makes patients and their guardians aware of the importance of the various dosages given and how failures to stick to the prescribed medications could impact their health (Lee, 2018). I also laud the fact that you have succinctly detailed the side effects of each of these diabetes strains to help patients and their loved ones be aware of them and how to respond. I think that something that could have been added along these lines is the need to constantly monitor diabetes medication and diet as these two help alleviate the health outcomes for the patients. The incidence of hypoglycemia has been mentioned when the patient takes too much insulin and fails to engage in recommended physical exercise and diet (Simmons, K. M., & Michels, A. W. (2021)The Diabetes Disorder Discussion Paper. Simply put, once an individual is diagnosed with any of the two types of diabetes, they should change their lifestyles to accommodate the appropriate diet and physical exercises.

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References

Lee, G. (2018). Lehne’s Pharmacotherapeutics for Advanced Practice Providers, Laura D. Rosenthal, Jacqueline Rosenjack Burchum, Elsevier, eBook ISBN: 9780323376631, Paperback ISBN: 978-0-323-44,783-6.

Nasri, H., & Rafieian-Kopaei, M. (2020). Metformin: current knowledge. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 19(7), 658. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214027/

Simmons, K. M., & Michels, A. W. (2021). Type 1 diabetes: A predictable disease. World journal of diabetes, 6(3), 380. https://doi.org/10.4239/wjd.v6.i3.380  The Diabetes Disorder Discussion Paper