The American Diabetes Association, ADA (2016) describes diabetes as one of the most common endocrine diseases, with its prevalence continuing to rise, despite the efforts that the healthcare industry is undertaking to stem its incidence. CDC (2016) reports that as of 2014, there were 29.1 people living with diabetes, both diagnosed and undiagnosed. 21million cases are diagnosed, while the rest are undiagnosed. The burden of the condition on the US population and healthcare system continues to increase, with an estimated 245 billion being spent annually for treatment and management of diabetes. Additionally, diabetes is associated with reduced cost of life for the affected, in addition to fatalities. This paper will explore the different types of diabetes, and the treatment methods available.
Pathophysiology
Type1 diabetes is characterized by the destruction of insulin-producing cells, the beta cells, consequently causing an insufficient supply of insulin in the body (Arcangelo & Peterson, 2013). Insulin facilitates the metabolism of glucose, and its insufficiency implies that glucose is not metabolized, hence increasing its amount in the blood. Onset of type1 diabetes mostly occurs at the age of 30 years and below. Type2 diabetes is characterized by insensitivity of the cells membranes to insulin activity, inhibiting the absorption of insulin into the body cells (Arcangelo & Peterson, 2013). As a result, glucose builds up in the body cells because it is not metabolized into energy due to lack of insulin. Its onset occurs at 30 years and above.
Gestational diabetes is characterized by intolerance to glucose during pregnancy (TA, 2014). It occurs when the placenta of the mother produces hormones that destroy or inhibit the secretion or functioning of insulin, consequently inhibiting or impeding the process of metabolism of glucose in the body (Arcangelo & Peterson, 2013). It is prevalent in pregnant women, and usually presents in the later stages of pregnancy, i.e., 2nd and 3rd trimesters. Gestational diabetes, however, disappears after pregnancy.
Drug Class
Treatment and/or management of diabetes are essential in improving the quality of life of the patients, in addition to preventing other medical issues that may arise as a result of the condition. The goal of medication is to maintain healthy levels of glucose in the body, while preventing development of adverse outcomes arising from untreated diabetes. There are different types of medications, either pharmacological or otherwise. Sulfonylureas will be the drug selected for the purpose of this paper.
Sulfonylureas is a term used to refer to a group of orally administered hypoglycemic agents that are primarily used for treating type2 diabetes (Arcangelo & Peterson, 2013). The main purpose of the Sulfonylureas is to realign the metabolism of lipids, carbohydrates, and proteins in the body.
Mechanism of Action
The Sulfonylureas work by binding themselves to the beta cell receptors, consequently causing the closure of adenosine triphosphates channels, which are potassium channels (Arcangelo & Peterson, 2013). When the potassium channels close, the calcium channels open and the level of cytoplasmic calcium increases. The increased levels of cytoplasmic calcium consequently stimulate the production of insulin. Sulfonylureas have no effects on patients with type1 diabetes, which implies that their primary hypoglycemic action is on the beta cells. These drugs benefit the patients by stimulating the production of insulin.
Side Effects
The use of Sulfonylureas is accompanied by some side effects of which all patients should be aware before commencing on the medication. Hypoglycemia is the most common short term effect of the medication (Arcangelo & Peterson, 2013). Also, the use of this medication among pregnant women has not been established. Long-term effects of Sulfonylureas include increased cardiovascular effects and weight gain (TA, 2014).
Preparation
There is no preparation required for this medication, other than it should be stored in a cool and dry place, in a closed container at room temperature. The drug is mostly in tablet form.
Administration
The most common route of administration for Sulfonylureas is oral.
Diet
Food affects the absorption of Sulfonylureas, and patients should consume exactly as instructed by the doctors. It is recommended by ADA (2016) that Sulfonylureas be taken atleast 30 minutes before meals, as their action may reduce after meals.
Diet
While some Sulfonylureas are consumed before meals, others required that they be consumed with a meal in order to reduce the gastrointenstinal side effects (Arcangelo & Peterson, 2013). It is imperative that patients adhere to the dietary instructions given by a doctor, as this contributes to the management of the DM and the impacts of the Sulfonylureas.
Impact of DM
Diabetes mellitus has negative effect on patients. Patients with diabetes experience a reduced quality of life due to the arising diseases that may accompany DM. People suffering from diabetes are at an increased risk for cardiovascular diseases, blindness, amputation of limbs due to increased risk to infections, and fatalities.
Summary
Diabetes mellitus is a common disease which affects people of all gender and age alike. The effects of DM continue to impair the healthcare system, especially as the incidence of the disease continues to rise. There are available treatment methods, including injections and tablets. This paper reviewed the difference between the types of diabetes, and the available treatments, concentrating of Sulfonylureas as one form of treatment. The paper also pursued the effects of this drug on patients, as well as the dietary requirements and its administration.
References
American Diabetes Association, ADA. (2016). Diabetes basis. Retrieved April 7, 2016, from
http://www.diabetes.org/diabetes-basics/
Arcangelo, P. M. & Peterson, A. M. (2013). Pharmacotherapeutics for advanced practice: A
practical approach (3rd eds). Ambler, PA: Lippincott Williams & Wilkins.
CDC. (2016). 2014 national diabetes statistics report. Retrieved April 7, 2016, from
http://www.cdc.gov/diabetes/data/statistics/2014statisticsreport.html
TA, S. (2014). Diagnosis and classification of diabetes mellitus. Diabetes care, 37, S81.
