Diabetes and Drug Treatments Essay
Differences between Type 1, Type 2, Juvenile, and Gestational Diabetes
Diabetes results from defects in insulin action, insulin secretion, or both (McCance & Huether, 2019). The two major types of diabetes are type 1 and type 2, but there is a type that arises during pregnancy called gestational diabetes. Type 1 used to be called juvenile-onset diabetes but is no longer called that since more cases of type 2 diabetes are arising in children than they have in the past (Burchum & Rosenthal, 2021). Type 1 is typically an autoimmune etiology where it attacks the beta cells in the pancreas that are responsible for insulin synthesis and secretion (Burchum & Rosenthal, 2021). Type 2 diabetes has an unknown etiology, but genetic factors seem to play an important role (Burchum & Rosenthal, 2021). There are many differences between the two major types, but management goals are the same with each and will use the same types of medications in treatment Diabetes and Drug Treatments Essay. Type 1, unlike type 2, has a rapid onset with more definitive presenting symptoms such as polydipsia, polyphagia, and polyuria; whereas in type 2 the onset is gradual, and symptoms may take not be present initially (Burchum & Rosenthal, 2021). Once diagnosed with either one of these two major types they are going to need life-long treatment and management, unlike gestational diabetes which is usually relieved once the baby is delivered (Burchum & Rosenthal, 2021). According to the CDC (2021), “during pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively, a condition called insulin resistance.” Gestational diabetes is also managed similarly to the other two types of diabetes (Burchum & Rosenthal, 2021) Diabetes and Drug Treatments Essay.
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Insulin Lispro (Humalog) and Type 1 Management
This type of insulin is short-acting and great for covering the postprandial rise caused by meals due to its rapid onset of 15-30 minutes (Burchum & Rosenthal, 2021). This can be given either before meals or after meals due to this rapid onset as well (Burchum & Rosenthal, 2021). This insulin is usually administered via subcutaneous injection but can be administered through I.V. as well (Burchum & Rosenthal, 2021). Diabetes and Drug Treatments Essay Insulin lispro is very similar to natural insulin and the only real difference is the amino acids places are switched (Burchum & Rosenthal, 2021). This medication can be used for all types of diabetes.
When treating type 1 diabetes, there is a basal/bolus strategy used in the management of the disease (Burchum & Rosenthal, 2021). This means that there is the use of longer-acting insulin covering the basal insulin needs and a short-acting, such as lispro, that covers the increased glucose levels due to meals, snacks, and any other spike in blood glucose. This strategy in management usually has great success in keeping blood glucose ranges in a safe effective zone.
Dietary Considerations
Along with the management of type 1 diabetes with insulin, there needs to be strict dietary control as well (Burchum & Rosenthal, 2021). Diabetes and Drug Treatments Essay Carbohydrates are the big key to managing and keeping consistent with intake from day to day to avoid major fluctuations in blood glucose levels making it difficult to manage (Diabetes Institute University of Florida, n.d.). It is also important to pick foods that are fiber-dense carbohydrates (Diabetes Institute University of Florida, n.d.). Everybody has different unique needs to meet with their foods and that is especially true for diabetics.
References
CDC. (2021). Gestational diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/gestational.html#:~:text=What%20Causes%20Gestational%20Diabetes%3F,body%20for%20use%20as%20energy.
Diabetes Institute University of Florida. (n.d.). Type 1 diabetes nutrition. Retrieved from https://diabetes.ufl.edu/outreach/resources/nutrition/type-1-diabetes/
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier Diabetes and Drug Treatments Essay.
Discussion: Diabetes and Drug Treatments
Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations.
For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.
Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/
To Prepare
- Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
- Select one type of diabetes to focus on for this Discussion.
- Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
- Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.
By Day 3 of Week 5
Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.
By Day 6 of Week 5
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.
Diabetes and Drug Treatments Essay sample 2
There are three main types of diabetes. The first is Type 1, The second is Type 2 and the third is gestational diabetes. Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. It was once known as juvenile diabetes or insulin-dependent diabetes Diabetes and Drug Treatments Essay. Type 1 diabetes is most often diagnosed in children, teens, and young adults. Its symptoms usually develop quickly and there is currently no known measure for preventing it. Type 1 diabetics will require insulin daily for survival. Thus, insulin levels in type 1 diabetes patients severely decrease and eventually fall to zero (Rosenthal & Burchum, 2021). Whereas with type 2 diabetes, the body is unable to use insulin well to keep blood sugar levels at the normal range. Type 2 diabetes is mostly diagnosed in adults though becoming more common in children and young adults. It develops over time, and about 90-95 % of people with diabetes have type 2 (CDC, 2021). People with type 2 diabetes may not have symptoms which therefore makes it important for those at high risk to get tested since it can be delayed or prevented with healthy lifestyle changes (e.g eating healthy, being active, and weight loss). Gestational diabetes develops during pregnancy with an unknown cause and usually goes away after the baby is born but increases the woman’s chances of developing type 2 diabetes later in life. Every year, gestational diabetes affects nearly ten % of pregnancies in the U.S (ADA, 2022). By working with your doctor closely, you can have a healthy pregnancy and a healthy baby Diabetes and Drug Treatments Essay.
There has been considerable progress toward diabetes management within the past twenty years. Even with such progress, fewer than half of diabetic patients are unable to reach their target blood sugar goals (Harvard Health Publishing, 2020). When it comes to medications for managing type 2 diabetes, Metformin has been the number 1 drug of choice that has been used for many decades to manage type 2 diabetes. Metformin is a tried and tested drug, recommended by many experts as 1st line therapy which is safe, affordable, effective, and well-tolerated by most people (Harvard Health Publishing, 2020)). Metformin works by lowering glucose production in the liver while improving the body’s sensitivity to insulin. This helps the body to use insulin more effectively. Possible side effects of metformin are nausea, bloating, diarrhea, and abdominal pain which may get better as time goes by. Vit. B-12 deficiency may be experienced by some patients, thus needing supplements (ADA,2022). Another medication must be added if metformin alone cannot adequately control blood sugar levels.
Type 2 diabetes can be well managed by following a healthy meal plan, exercising, losing weight, and taking the necessary prescribed medications to avoid short and long-term complications associated with it. Hypoglycemia and hyperosmolar hyperglycemic nonketotic syndrome (HHNS) are examples of short-term complications associated with type 2 diabetes (Rosenthal & Burchum, 2021). Long-term complications may develop over time causing damage to both tiny and large blood vessels. The complications from damage to blood vessels include eyes, kidneys, nerve disease, the heart, and brain.
With type 2 diabetes, it is important to work hard and stay consistent in keeping your blood glucose level under control by practicing healthy eating habits, exercising, and keeping a healthy weight as well as taking prescribed medications. This will help prevent the above-mentioned complications or help prevent them from getting worse if they already exist.
References
American Diabetes Association (ADA), (2022). What Are My Options? https://www.diabetes.org/healthy-living/medication-treatments/oral-medication/what-are-my-options
Centers for Disease Control and Prevention (CDC), (2021). What is Diabetes? https://www.cdc.gov/diabetes/basics/diabetes.html
Harvard Health Publishing (2020). Type 2 Diabetes: Which Medication is Best for Me. https://www.health.harvard.edu/blog/type-2-diabetes-which-medication-is-best-for-me-2020110521256#:~:text=Metformin%20is%20a%20tried%20and,well%20tolerated%20by%20most%20people.
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Diabetes and Drug Treatments Essay sample 3
Differences in Types of Diabetes
As we intake carbohydrates our blood glucose levels rise. The pancreatic β cells secrete insulin in response to rising glucose levels to allow cells to take in glucose and convert it into energy or to be stored as fat. When people have impairments in their body’s ability to make insulin, respond to insulin, and generally regulate their blood glucose levels they are considered Diabetic. Type one diabetics make up the smallest group and often people develop this type as juveniles. Adults can also abruptly get this type of diabetes and thus it is no longer referred to as juvenile diabetes. This autoimmune disease attacks the β cells of the pancreas impairing their ability to make insulin Diabetes and Drug Treatments Essay. Type two diabetes is characterized by insulin resistance and insulin secretion from the pancreas not coupled with increased glucose levels in the blood. Like type one diabetes, type two usually gets to the point that there is no insulin secretion by the pancreas. Gestational diabetes occurs due to placental hormones such as estrogen and cortisol increasing glucose levels and blocking insulin. Another way it occurs is due to the mother having hyperglycemia which increases fetal glucose levels resulting in hyperinsulinemia in the fetus. For all of these types tight glycemic control is important and occurs with frequent monitoring, medication, and lifestyle changes.
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Drug Therapy for Type 1 Diabetics
All type one diabetics are treated with insulin. To help maintain tight glycemic control a long acting insulin is helpful for basal coverage during times of fasting (Retnakaran & Zinman, 2021). Our liver continues to send out glucose when we are not eating and long acting insulin can help keep glucose levels in a safe range. A common long acting insulin type one diabetics use is insulin glargine (U-100) which is generally only needed once a day. It has no peak and lasts 18-24 hrs. Some people may need to administer twice a day (Rosenthal & Burchum, 2021). Patients should administer this insulin with a subcutaneous injection at the same time each day, rotate sites of administration, and use a new needle each time. Prior to using an insulin vial or pen it should be stored in a refrigerator and then used within 28 days after being kept at room temperature. The insulin should be kept out of direct light and away from heat Diabetes and Drug Treatments Essay.
To cover glucose spikes during prandial times regular or fast acting insulin injections can be given. Regular short-acting insulin should be given one hour prior to eating, whereas fast acting insulin can be given within 15 mins before or after eating. As with long acting insulin, doses are given through subcutaneous injections rotated to different sites. It is important for patients to check their blood sugar levels prior to administering insulin to properly dose it. The dose is also dependent on the number of carbohydrates expected to be consumed. This close matching of insulin to carbohydrate intake helps maintain tight glycemic control. Lifestyle and dietary choices greatly affect glucose control as well.
Dietary Considerations
Since carbohydrates increase blood glucose rates it is important for individuals to know what foods contain them and to monitor the amount they consume. In addition to carbs, proteins have a correlating effect on postprandial glycemic spikes (Paterson et al., 2019). The American Diabetes Association (2019) recommends the Diabetes Plate Method for choosing meals- fill one half of the plate with non-starchy vegetables, one quarter with lean proteins, and one quarter with carbohydrate foods. They recommend using this method to increase compliance without all the hassle of counting each carb and protein. Working with a registered dietician can help get patients started in the right direction.
Short and Long-Term Impact
The short term impact of type one diabetes is hypoglycemia and hyperglycemia. Both are very dangerous and thus people need to not fast for very long, but eat small meals throughout the day to maintain adequate blood glucose levels. Patients need to properly dose their insulin so that they do not cause hypoglycemia as well. By following a diabetic diet hyperglycemia and diabetic ketoacidosis can be prevented Diabetes and Drug Treatments Essay. When individuals with type one diabetes do not have dramatic spikes and lows in their glucose levels they decrease the long-term impacts of diabetes.
High blood glucose levels are bad for our arteries and over time cause damage to the walls of them. Many people develop diabetic retinopathy which can cause loss of vision. These vessels are so tiny and are often the first ones affected by hyperglycemia. The kidneys can also be affected and people often get nephropathy which will affect the body’s ability to eliminate waste and regulate blood pressure. Cardiovascular disease needs to be treated in diabetic patients with the recommended angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker (Rosenthal & Burchum, 2021). With so many possible complications as a result of this autoimmune disease if is important to work closely with a provider who can monitor the various body systems affected by it Diabetes and Drug Treatments Essay.
Conclusion
The various types of diabetes require different treatment approaches. They all require tight glucose control to help reduce the risk of sometimes life threatening complications. Type one diabetics need to inject themselves with insulin to make up for what their pancreas is no longer able to do. Through constant monitoring of levels, making healthy lifestyle choices, diabetic patients can live good lives and avoid many of the adverse effects that can happen. Genetics plays a big role in who gets diabetes, but through modifiable factors it is no longer a death sentence. Medications continue to be developed and studied that can mimic our body’s own natural release of insulin. These new findings are helping more and more people be compliant and in control of this disease. It is exciting to see what more we can learn as we educate and treat the millions of diabetics in this country.
Resources
American Diabetes Association. (2019). What is the diabetes plate method? https://www.diabetesfoodhub.org/articles/what-is-the-diabetes-plate-method.html#:~:text=The%20Diabetes%20Plate%20Method%20is,you%20need%20is%20a%20plate!
Paterson, M. A., King, B. R., Smart, C. E., Smith, T., & Lopez, R. (2019, August 27). Impact of dietary protein on postprandial glycaemic control and insulin requirements in type 1 diabetes: A systematic review. Diabetic Medicine, 36 (12), 1585-1599. https://doi.org/10.1111/dme.14119
Retnakaran, R., & Zinman, B. (2021, September 16). The ongoing evolution of basal insulin therapy over 100 years and its promise for the future. Diabetes, Obesity and Metabolism: A Journal of Pharmacology and Therapeutics, 24(51). https://doi.org/10.1111/dom.14552
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier Diabetes and Drug Treatments Essay.