Write a discussion research paper on the diabetes.

Write a discussion research paper on the diabetes.Anne Ayoyi
Initial Response
COLLAPSE
Introduction

Diabetes mellitus is a syndrome caused by a variety of etiologies and is characterized by a metabolic dysfunction with a degenerative potential that involves energetic sources due to changes in insulin production, secretion, and/or inability to adequately exercise its effects. It is a chronic condition that requires ongoing self-management of lifestyle choices and illness adaptation by those who are affected by it (Silva et al., 2018). Diabetes is characterized by persistent hyperglycemia caused by impaired glucose uptake by cells and increased glucose production (Rosenthal & Burchum, 2018, pg. 397).

Types of Diabetes

Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by pancreatic beta cell destruction, in which genetic susceptibility combined with environmental factors, primarily in childhood, play an important role. The destruction of beta cells results in hyperglycemia and a lifelong reliance on insulin (Primavera et al., 2020). The most prevalent metabolic disorder in children is type 1 diabetes, also referred to as insulin-dependent diabetes mellitus (IDDM) and juvenile onset diabetes mellitus (Gupta, 2018).

Insulin resistance and insufficiency are hallmarks of type 2 diabetes. Failure of -cells, combined with insulin resistance in the muscles and liver, forms a vicious triumvirate that is responsible for the core physiological defects (Borse et al., 2020) T2DM is caused by a combination of genetic and environmental factors. Insulin resistance and -cell dysfunction is heavily influenced by both genes and environment. T2DM is most common in people over the age of 45. Nonetheless, it is becoming more common in children, adolescents, and young adults because of rising levels of obesity, physical inactivity, and energy-dense diets (Bellou et al., 2018).

Gestational diabetes occurs in pregnant women. It is a serious pregnancy complication that affects women who have never had diabetes before. It is primarily caused by impaired glucose tolerance as a result of pancreatic cell dysfunction. Being overweight or obese, being of advanced maternal age, and having a family history of diabetes are all risk factors.Although gestational diabetes may resolve after birth, it can have long-term health consequences, including an increased risk of type 2 diabetes (T2DM) and cardiovascular disease (CVD) in the mother, as well as future obesity, CVD, T2DM, and/or GDM in the child (Plows et al., 2018).

Type 2 Diabetes, Metformin Drug Use and Dietary Considerations.

Type 2 diabetes has been selected. Metformin hydrochloride, a biguanide, is the most frequently prescribed oral glucose-lowering drug for type 2 diabetes. Its reputation stems from its effective glucose-lowering abilities, low cost, weight neutrality, overall good safety profile (particularly the absence of hypoglycemia as an adverse effect), and limited evidence for cardio protection (Sanchez-Rangel & Inzucchi, 2017). Metformin is available in 500, 850, and 1,000 mg tablet formulations, as well as immediate release (IR) and extended release (ER) formulations (Adegbola et al., 2017).

Metformin raises insulin sensitivity while reducing hepatic glucose synthesis and intestinal glucose absorption. Metformin is available as an immediate release (500 mg, 850 mg, or 1,000 mg) and extended release (500 mg, 750 mg, or 1,000mg) generic oral tablet on prescription. It is also available in combination with other diabetes medications. The maximum daily dose for adults is 2,000 mg for the immediate-release formulation and 2,550 mg for the extended-release formulation (Wong, 2017).

Metformin should be taken with a meal to reduce GI upset. The daily dose is frequently increased on a weekly basis in increments of 500 mg or 850 mg in order to lower this risk. 1 Metformin should be taken at the same time every day. Extended-release tablets should be swallowed with a full glass of water once daily with an evening meal. A starting dose of 500 mg or 1000 mg once daily is advised for extended-release oral formulation. 8 This daily dosage can be increased by 500 mg every week for a maximum of 6 weeks. Following that, for extended-release formulation, a maximum dose of 2000 mg once or twice daily is recommended. If your glomerular filtration rate is less than 30 mL/min/1.73 m2, don’t use it (Corcoran & Jacobs, 2022).

High sugar, fried food, and red meat consumption are all linked to insulin resistance and the emergence of T2DM. As a result, the intake must be reduced. Strict adherence to a controlled diet combined with adequate physical activity is strongly linked to a lower incidence of diabetes. Hence Incorporating a diet rich in lean meat, fish, fruits, and vegetables into diabetic patients’ daily routine results in a significant improvement in glucose handling. When taking metformin, a high-fiber diet can reduce the drug’s concentration, making it less effective. As a result, it is recommended that you consume no more than 30mg of fiber per day. Avoid alcohol, and sodium and saturated or trans fats. Stay away from alcohol, sodium, and saturated or trans fats. Long-term metformin use may impair the body’s ability to absorb vitamin B12 from food, potentially leading to anemia. When taking metformin for an extended period, it is therefore recommended to take vitamin B12 supplements (Borse et al., 2020).

Short-term and Long-term Impact Type 2 Diabetes

Diabetes is linked to the development of complications, which can impair health-related quality of life and increase mortality risk. Two immediate side effects of type 2 diabetes are hypoglycemia and hyperosmolar hyperglycemic nonketotic syndrome (HHNS). Hypoglycemia occurs when SGLT2 inhibitors, GLP-1 receptor agonists, and exogenous insulin, sulfonylureas, and thiazolidine are used together and the patient experiences headache, dizziness, blurred vision, fatigue, and irritability. The hyperosmolar hyperglycemic nonketotic syndrome (HHNS), which is characterized by extremely high blood glucose levels, is uncommon in type 2 diabetes and is associated with a high overall mortality rate (McCance & Huether, 2019).

Long-term complications can be macrovascular (like stroke, coronary artery disease, and peripheral vascular disease) or microvascular (such as retinopathy, nephropathy, and neuropathy).T2DM treatment strategies should take into account the effects of treatment on HRQoL as well as outcomes such as microvascular and macrovascular complications and hypoglycemia, which have a significant impact on HRQoL and HCRU (Cannon et al., 2018).Regular monitoring of vitamin B12 levels should be taken into consideration, especially if anemia or peripheral neuropathy are present, as long-term metformin use may lead to vitamin B12 deficiency. For screening vitamin B12 deficiency, an annual complete blood count with mean corpuscular volume may be more cost effective (Rosenthal & Burchum, 2018).

Conclusion

Metformin is the first-line treatment for many T2DM patients. It reduces fasting blood glucose by about 20% and HbA1c by about 1.5 percent. It can be used in conjunction with sulfonylureas, glinides, alpha-glucosidase inhibitors, insulin, thiazolidinediones (TZD), glucagon-like peptide-1 receptor agonists (RA-GLP1), dipeptidyl peptidase 4 inhibitors (iDPP4), and sodium-glucose co-transporter 2 inhibitors (iSGLT2) (Marn- Metformin reduces fasting and postprandial blood glucose levels when used alone. It lowers blood sugar more effectively when combined with other agents. It is ideal for patients who tend to skip meals because it lowers blood sugar levels below a healthy level (Rosenthal & Burchum, 2018).

References

Adegbola, A. J., Awobusuyi, O. J., Adeagbo, B. A., Oladokun, B. S., Owolabi, A. R., & Soyinka, J. O. (2017). Bioequivalence study of generic metformin hydrochloride in healthy Nigerian volunteers. Journal of Exploratory Research in Pharmacology, 2(3), 7581. https://doi.org/10.14218/jerp.2017.00010

Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E. (2018). Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of Meta-analyses. PLOS ONE, 13(3). https://doi.org/10.1371/journal.pone.0194127

Borse, S. P., Chhipa, A. S., Sharma, V., Singh, D. P., & Nivsarkar, M. (2020). Management of type 2 diabetes: Current strategies, unfocussed aspects, challenges, and alternatives. Medical Principles and Practice, 30(2), 109121. https://doi.org/10.1159/000511002

Cannon, A., Handelsman, Y., Heile, M., & Shannon, M. (2018). Burden of illness in type 2 diabetes mellitus. Journal of Managed Care & Specialty Pharmacy, 24(9-a Suppl). https://doi.org/10.18553/jmcp.2018.24.9-a.s5

Corcoran, C., & Jacobs, T. F. (2022). Metformin. National Center for Biotechnology Information. Retrieved June 26, 2022, from https://pubmed.ncbi.nlm.nih.gov/30085525

Gupta, R. (2018). An update on juvenile diabetes mellitus. Journal of Childhood & Developmental Disorders, 04(01). https://doi.org/10.4172/2472-1786.100065

Marn-Pealver, J. J., Martn-Timn, I., Sevillano-Collantes, C., & Caizo-Gmez, F. J. (2016). Update on the treatment of type 2 diabetes mellitus. World Journal of Diabetes, 7(17), 354. https://doi.org/10.4239/wjd.v7.i17.354

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

Plows, J., Stanley, J., Baker, P., Reynolds, C., & Vickers, M. (2018). The pathophysiology of gestational diabetes mellitus. International Journal of Molecular Sciences, 19(11), 3342. https://doi.org/10.3390/ijms19113342

Primavera, M., Giannini, C., & Chiarelli, F. (2020). Prediction and prevention of type 1 diabetes. Frontiers in Endocrinology, 11. https://doi.org/10.3389/fendo.2020.00248

Sanchez-Rangel, E., & Inzucchi, S. E. (2017). Metformin: Clinical use in type 2 diabetes. Diabetologia, 60(9), 15861593. https://doi.org/10.1007/s00125-017-4336-x

Silva, J. A., Souza, E. C., Echaz Bschemeier, A. G., Costa, C. C., Bezerra, H. S., & Feitosa, E. E. (2018). Diagnosis of diabetes mellitus and living with a chronic condition: Participatory study. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-5637-9

Wong, E. (2017). Metformin: Its history, safety, and updated labeling recommendations. The Journal for Nurse Practitioners, 13(9), 643644. https://doi.org/10.1016/j.nurpra.2017.06.008

Last Completed Projects