Diabetes mellitus (DM) is a metabolic disorder of the heterogeneous type characterized by a higher concentration of glucose in the bloodstream. Several categories exist, including type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), gestational diabetes mellitus (GDM), and juvenile diabetes mellitus (JDM). Substantial differences exist between the categories. Approximately the age of onset of T1DM is before the age of 25, whereas T2DM is older than 25 years. Obesity is over 90% of the T2DM population, with T1DM generally thin; however, with the rate of obesity today, T1DM can also be overweight. Insulin production occurs in every form of DM except for T1DM, making diabetic ketoacidosis (DKA) more common than other forms. Family history in T1DM is rough between 5%-10%, and the incidence rate in T2DM is 75%-90% (Punthakee et al., 2018). GDM is a terrible pregnancy complication where women without any previous DM history develop hyperglycemia. Unlike the other DM forms, little treatment is available, making hypertrophy and hyperplasia of pancreatic cells the compensation mechanism (Plows et al., 2018). JDM patients are diagnosed with the most common metabolic disorder when the body attacks pancreatic beta cells. The dangers of new-onset T1DM in children create a sense of urgency of awareness for parents (Gupta, 2018).
T2DM is the most prevalent form of diabetes, and the condition I am going to discuss is drug therapy, dietary, short-term impact, and long-term impact. Metformin is approved as the first-line drug in T2DM when HbA1c is uncontrolled by non-pharmacological methods. Metformin’s mechanism of action involves reducing the hepatic glucose output. Preparation is simple in tablet form drugs, making oral administration easy. Lifestyle and dietary changes have a substantial impact on managing T2DM. Physical activity and dietician consultation help the patient manage their obesity. Low carb diets are the most common change in nutritional therapy. Short-term impacts of T2DM include weight loss, and long-term effects include cardiovascular disease, renal impairment, neuropathy, and blindness. Metformin carries several short-term consequences like weight loss, nausea, anorexia, abdominal cramps, bloating, and diarrhea. Long-term impacts require caution in patients: lactic acidosis, renal impairment with contrast dye, and vitamin B-12 deficiency. Metformin positively impacts cardiovascular and stroke risk associated with T2DM (Keresztes & Peacock-Johnson, 2019).3 APA ref
Diabetes metabolic disease characterized by hyperglycemia which can be attributed to a dysfunction of insulin action or secretion. The four most common symptoms of diabetic patients include polyuria, polyphagia, polydipsia, and rapid weight changes. Type 1 DM, also called juvenile diabetes, is autoimmune or cell-mediated destruction of beta cells in the pancreas that result in insulin deficiency, according to McCance & Huether (2019). The study by Claessens et al. (2020) aimed to identify the specific autoimmune response contributing to juvenile diabetes and noted the T cells to proliferate in large numbers destroying beta cells. Type 2 DM is the most common gradual destruction of beta cells of time due to defect, environment, lifestyle, and other risk factors. These patients can make lifestyle modifications, including diet, exercise programs as management, and some may require insulin supplementation (Rosenthal & Burchum,2018). Gestational Diabetes occurred during pregnancy and is diagnosed with standard antenatal testing with a glucose tolerance test. Pharmacologic treatment for diabetes includes insulin replacement and glucose monitoring.
Insulin is replaced with oral or subcutaneous medication dependent on patients’ glycemic control HA1c and daily glucose monitoring. Oral biguanide or sulfonylureas such as metformin and glipizide are the first drugs prescribes for people with type 2 diabetes with extensive education on lifestyle modifications (Rosenthal & Burchum 2018). Subcutaneous insulins include rapid acting, short acting, intermediate, long, and ultra-long acting with different peak times and half-life.3APA refrences