Pharmacologic Approaches to Glycemic Treatment Essay

Types of diabetes Type 1 diabetes is characterized by the destruction of pancreatic beta cells resulting in the body becoming incapable of producing insulin. It is no longer referred to as juvenile diabetes because the number of juveniles and children who have developed type 2 diabetes has grown substantially. In type 2 diabetes, cells in the body become insulin resistant, release of insulin is delayed and peak output of insulin less than normal. Gestational diabetes happens when the body does not produce enough insulin during pregnancy and this usually resolves with the birth of the child. Metformin Type 2 diabetes accounts for 90-95% of all diabetes diagnosed in the United States, (Rosenthal and Burchum, 2021) and Metformin is the first-line pharmacologic treatment for type 2 diabetes (American Diabetes Association 2018). Therefore, it is logical to understand why this medication is the most prescribed anti-diabetic agent. Considering its high efficacy, and low risk (except in impaired kidney function), it is understandable why it is the gold standard treatment. Proper preparation of this drug includes storage in a cool, dry place and the most important aspect of administration is to take with food to minimize GI side effects. Of particular note is the importance of the inclusion of diet and exercise to maximize the benefits of this medication.  Pharmacologic Approaches to Glycemic Treatment Essay

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One way the mechanism of action supports managing hyperglycemia is by increasing glucose uptake into skeletal muscle. Therefore, when paired with exercise, muscle use of glucose is maximized. Short-term and long-term impacts The short-term impacts of Type 2 Diabetes are minuscule when compared to the long-term health consequences. In the short term, clinical manifestations include polydipsia, polyuria, fatigue, and other non-specific symptoms. However, the long-term impacts (especially poorly controlled hyperglycemia) have significant health implications and lead to incredible suffering. According to McCance, Huether, and Rote (Figure 22.13, 2019) long-term consequences include: retinopathy, cataracts, neuropathy, HTN, PVD, CVD, biliary disease, gastroparesis, nephropathy, glomerulosclerosis, chronic kidney disease, decreased cognition, oxidative stress, immunosuppression, infection, and cancer. The most important short-term effect of Metformin is to limit hyperglycemia. Furthermore, because it does not actually lower blood sugar, it removes the risk of hypoglycemic events in the case that meals are skipped.  Pharmacologic Approaches to Glycemic Treatment Essay The long-term consequences of Metformin include impaired absorption of vitamin B12 and folic acid. Because metformin is excreted by the kidneys without being metabolized by the liver, those with CHF or renal impairment must utilize a different pharmacological agent. If not, metformin can accumulate in the body and cause metabolic acidosis. Conclusion All of the above information emphasizes the importance of patient education on the disease process and medication usage. In a recent study assessing the knowledge of diabetics taking Oral Hypoglycemic Agents (OHA), Kusturica, Maričić, Petrović, Dugandžija, Crnobrnja, and Horvat (2020) found, “More than half of participants considered their knowledge of OHAs insufficient.” As a health care provider, it is vitally important to correct this phenomenon in order to work as a true interdisciplinary team and successfully manage this disease. Pharmacologic Approaches to Glycemic Treatment Essay

American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes—2018. Diabetes Care, 41(Supplement 1), S73–S85. Retrieved from http://care.diabetesjournals.org/content/41/supplement_1/s73.full-text.pdf

McCance, K. L., Huether, S. E., & Rote, N. S. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby.

Milica Paut Kusturica, Mina Maričić, Ana Tomas Petrović, Tihomir Dugandžija, Veljko Crnobrnja, & Olga Horvat. (2020). Assessment of Type 2 Diabetes Patients’ Knowledge of Oral Hypoglycemic Agents. Journal of Health Science and Medical Research (JHSMR), 38(1), 35–42. https://doi.org/10.31584/jhsmr.202075

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurse Pharmacologic Approaches to Glycemic Treatment Essay