Diabetes and Drug Treatment

Diabetesand Drug Treatment

Diabetesand Drug Treatment

Diabetesis a medicaltermthat is usedto denotea disorderof metabolism. Metabolism is theprocessthrough which thehumanbodyconvertsingested foodinto energyforgrowthanddevelopment(CDCP, 2012). Diabetic personssufferfrom themalfunctionof thepancreatic gland,and,forthis reason,noinsulin orinadequateamountof insulin is secreted into thebody.Insomecasesthehumancellsfailto reactto thetypeof insulin that is producedby theglandsandwhenthishappensthelevel of glucose mounts upandis removedfrom thebodyin urine (NIDDK &amp NHI, 2014).

Classificationsof Diabetes

Type1 diabetes (T1D): This crops up as an effectof thedamagetothecellsin thepancreatic glandthat secretesinsulin. Typically,itbeginsin childhood,andsometimesin earlyadulthood. Type1 diabetes can alsocrop up at anyage.In theU.S, T1D accountsforabout 5% of all thediagnosed casesof diabetes (America Diabetes Association, 2013). Morethan 8,000 youngadultsare diagnosed with thistypeof diabetes annually.Managementandtreatmentof type1 diabetes entail injectionorconstantinfusionof insulin by theuseof insulin pump into thebloodstream (CDCP, 2014).

Type2 diabetes (T2D): Crops up dueto failureof thebodyto usethesecreted insulin secreted by thepancreatic cells.Itcan alsooccurdueto thereductionin thequantitiesof insulin secreted into thebloodstream(American Diabetes Association, 2012). Usually,T2D can developat anyagebutin mostcasesitdevelopsafter 40 years.T2D is preventable by a changein lifestyle to avoidriskfactors.In theU.S at leastone in everythree peoplewill developtype2 diabetes in their lifetime.There are morethan 5000 youngadultsdiagnosed with type2 diabetes everyyear(American Diabetes Association, 2012).

About80% of theindividualsdiagnosed with T2D are overweight orobese(CDCP, 2014).In theyear,2012 morethan 1.7 million individualsagedabove 20 werediagnosed with T2D. Someof theotherriskfactorsincludehavinga familyhistoryanddevelopingdiabetes whenpregnant,whatisreferredto as gestational diabetes (American Diabetes Association, 2012).

GestationalDiabetes: This is diabetes that crops up during pregnancy.Gestational diabetes disappearsimmediatelyafter deliverybutwomenthatexhibitthistypeof diabetes during pregnancyare at moresusceptibleto developingT2D one ortwo decades later(CDCP, 2014). In theU. S, 13% pregnantwomendevelopgestational diabetes (CDCP, 2014). Itdevelopsmoreoftenin womenwhocomefrom familieswith a historyof diabetes, obeseandoverweight mothersandwomenfrom someethnic groups.Thistypeof diabetes cropsup as a consequenceof inhibitory effectsof hormones that supportpregnancyandthatreducetheamountof insulin secreted into thebloodstream(American Diabetes Association, 2012).

Pre-diabetes:This is a conditionherethebloodsugar level is above thenormalthoughitis not elevatedenoughto bedescribedas diabetes. In theU.S, 86 million people,which translatesinto one in everythree adultshavepre-diabetes. Surprisingly nine out ten individualswith pre-diabetes are not awareof their healthcondition(CDCP, 2014). Between15-30% of allpersonswith pre-diabetes will developT2D within a spanof 5 years.

RiskFactors

  • Physical inactivity high risk ethnicity and race, for example, Latino, Asian Americans, African American and Native Americans

  • Family history, that is first degree relative with diabetes

  • Women with PCOS

  • Hypertension (therapy of hypertension or blood sugar level above 140/90 mmHg

  • History of CVD

  • Women diagnosed with GDM or those who deliver babies weighing more than 9 lb

  • HDL cholesterol level less than 0.90 mmol/L

  • A1C ≥5.7%, IGT

  • Other clinical conditions related to insulin resistance such as obesity and acanthosis nigricans.

Testingto detecttype2 diabetes andevaluation of riskforfuturediabetes in pre-diabetic individualsshould be donein adultsof allagesandwhoare obese,overweight andthosewhoindicatea signof theriskfactorsfordiabetes.Individualswith noriskfactorsshould undergothetestat theageof 45 (American Diabetes Association, 2012).

AICtestthat isalsoreferredto as glycohemoglobintestshowstheaveragelevel of thebloodsugar in thelast90 days.Thistypeof testistermedas one of theaptestandreliabletestforpre-diabetes. Evensoin patientswith somehealthconditionsitmay misspre-diabetes butotherglucose tests can catch this.Whentestsare normalthetestis repeatedafter three years(NIDDK &amp NHI, 2014).

PreventiveMeasures

Type2diabetes is preventable through diet,andthatis eatinghealthyfood,losingweightandbeingmoreactiveto preventobesity. Individualscan alsomanagetype2 diabetes through workingwith healthprofessionalwhocontinuously monitortheir condition,eatinghealthyfoodandstayingactive(American Diabetes Association, 2012). Evenso,after a particularperiodindividualswhohavedevelopedtype2 diabetes will stillneedto ingest insulin in their bloodstream to controlbloodsugar level especiallyin agingpopulation.

Thereare varioustypesof drugsthat performdiversefunctionsin thebodyin orderto ensurethatbloodsugar level is in check(America Diabetes Association, 2013). Theseinclude,

  • Meglitinides

  • Alpha-glucosidase inhibitors

  • Bile Acid Sequestrants

  • Sulfonylureas

Meglitinides

Thisclassof drugsthatstimulatethebeta cells(cellsof thepancreas) in productionof insulin. Normallytheyare injectedinto thebodybefore a meal.Meglitinides facilitatereleaseof insulin andforthisreasontheycan causehypoglycemia (America Diabetes Association, 2013).Biguanides

Thisclassof drugslowerstheamountof glucose in thebloodby decreasingthelevel of glucose producedby theliver.Theyalsoaidin reducingbloodsugar level by promptingthemuscletissuemoreresponsiveto insulin andas a resultglucose is absorbed.Biguanides areinjectedtwicea day(America Diabetes Association, 2013).

CDCPindicatethattheriskof deathforadultswith T1DandT2Dis 50% higherthan forindividualswithout diabetes. In thesamevein,medicalcostsforindividualshavingdiabetes are twiceas highas forindividualswithout diabetes. In addition,individualswith diabetes are moresusceptibleto serioushealthcomplications(CDCP, 2014). Thediagrambelow displaysthisscenario

Source:CDCP, 2014

PrimaryPrevention

Theprimarypreventionof diabetes strives to stoptheprogressionof type2 diabetes by persuadingindividualsto practicehealthylifestyle, participatein moderatephysicalactivitiesandensuretheyeatwellbalanceddiet(NIDDK &amp NHI, 2014).Recentstudieshaveindicatedthatearlyscreening forpre-diabetes anddiabetes may be costeffectivesince earlyinterventionin individualswith diabetes producesconsiderablelongtermsavingsin medicalcosts(American Diabetes Association, 2012). Earlyinterventionin peoplewith pre-diabetes producessignificantlong-term savingsin healthcarecosts.

Exhaustivelifestyle changesin individualswith pre-diabetes which may entaildailyphysicalactivitiesforabout30 minutes,andlossof 5-7% of bodyweighthas beenfoundto reducethemedicalcostsfordiabetic individuals(American Diabetes Association , 2012).Individualswith pre-diabetes can lowertheir riskof developingtype2 diabetes by usingmedicationandpracticinghealthylifestyle. Eventhough,healthylifestyle andoralmedicationcan considerably diminishtheriskofdevelopingT2D,there is noknownpreventionforT1D(NIDDK&amp NHI, 2014).

Secondaryprevention

Secondarypreventionmeasuresare formulatedto haltcostlydiabetes complicationsandencompassa blendof earlydetectionof diabetes, encouraginglifestyle changeandsupportingenhancedtreatmentof bothdiabetes (American Diabetes Association, 2012).Theprogressof thebothtypeof diabetes is monitoredto preventtheonsetof complications.Researchhas showed convincingly thattreatmentof type2 diabetes can significantly reducediabetes healthcomplicationssuchas stroke,deteriorationof visionandheartattack(NIDDK &amp NHI, 2014). Effectivescreening andmonitoringentail constantevaluation of thebloodsugar level, bloodlipids, andpressure.Inthecaseof diabetes type1 maintainstherightquantitiesof glucose in thebloodthrough injectionshavebeenshownto lowertheriskof chroniccomplicationsof diabetes.Evenso,diabetes is a progressivecondition,andthismeansthatevenwith effectivetreatmentandmanagementof thediseaseprogressfrom one yearto anothernecessitating alterationof treatmentandmanagementregimens. Whilethework,of searchingfortherightcurefordiabetes, continues,itis possibleto lowerthehealtheffectsandcostsof diabetes (American Diabetes Association, 2012).

References

AmericaDiabetes Association (2013). EconomicCosts of Diabetes in the U.S. in2012.Retreivedfrom:http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.htmlAmericanDiabetes Association (2012). Standardsof Medical Care in Diabetes—2012.Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632172/CDCP(2012). NationalDiabetes Fact Sheet: National Estimates and General Information onDiabetes and Prediabetes in the United States.Nationaldiabetes statistics report. (2014). CDCP website.www.cdc.gov/diabeteS/pubs/statsreport14.htm.Accessed January 23, 2015.NationalInstitute of Diabetes and Digestive and Kidney Diseases (NIDDK)&amp NationalInstitutes of Health (NIH).(2014). InsulinResistance and Prediabetes.The NIDDK Clearinghouses Publication. Retrieved from:http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/

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