Different Diabetes Types Discussion Essay

GIVE SHORT RESPONSES FOR EACH DISCUSSION. EG: QUESTION 1.)…………. ………. ………. ………. REFERENCEC 2 QUESTION 2.)……….. ………. ……….. ………. REFRENCES TOTAL 4 REFRENCES ONLY 1 ) Responde to Paige who selected a different type of diabetes than I did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management. 4 sentences 2 refrence . Different Types of Diabetes There are several different types of diabetes; type 1, type 2, and gestational. Type 1 diabetes happens when the pancreas makes little to no insulin. This type was called juvenile diabetes because of its prevalence in the younger population. It is considered an auto-immune disease where the body attacks it’s own beta cells that make insulin. This type of diabetes usually occurs in younger people but can occur at any age. Symptoms can take months or years to show up. The cause can be genetic or an environmental issue that causes this form of diabetes to develop. Different Diabetes Types Discussion Essay. Managing this form of diabetes can be tricky, due to pills not being an option. The patient will need an insulin pump or to self-inject the insulin. Blood sugars must be regularly checked and managed (CDC, 2020). Type 2 diabetes is different. It is usually caused by poor, unhealthy, lifestyle habits. This type of diabetes usually shows in people over the age of forty-five but is starting to happen to younger and younger patients. In this type of diabetes, your cells don’t react correctly to insulin and your pancreas continues to make insulin trying to keep up. Eventually, the body cannot keep up with the high levels of blood sugar, and damage starts happening to the body. This form of diabetes can be controlled by diet and exercise but is usually controlled with pills or self-injecting of insulin (CDC, 2020). Gestational diabetes happens in two to ten percent of pregnancies. When a woman is pregnant her body goes through a lot of changes and makes more hormones. Some of these changes can cause the cells to not use insulin effectively. Having gestational diabetes can cause issues for the mother and the baby. The mother can have high blood pressure through the pregnancy, require a c-section, and even have type 2 diabetes after the baby is born. The baby could be very large (increasing issues with birth), be born early, have low blood sugar at birth, and be predisposed to diabetes later in life. For this type of diabetes healthy eating, exercise, and monitoring the blood sugar is usually enough. However, there are cases where pills or insulin are needed to manage the elevated blood sugars (CDC, 2020). Medication Choice and Administration I choose to focus on type 1 diabetes because most of the patient population I deal with daily have type 2 diabetes and I wanted to know a little more about type 1. Only about five percent of all cases of diabetes are type 1 (Rosenthal & Burchum, 2020). Different Diabetes Types Discussion Essay. Type 1 diabetics are typically treated with prandial and basal insulin (ADA, 2018). Human insulin is the same as the insulin the pancreas makes. Human insulin analogs have the same actions as human insulin but can have different timing (Rosenthal & Burchurm, 2020). Type 1 diabetics usually have two options. They can use long and rapid insulin subcutaneous injections multiple times a day, or they can choose to use a pump that has a catheter that sits subcutaneously. The pump gives a basal dose of insulin and is programmed at mealtimes to give a bolus (Mayo Clinic, 2017). Dietary The patient should be taught to match prandial insulin with carbohydrate intake (ADA, 2018). If the patient overdoses or under doses the prandial dose, hypoglycemia or hyperglycemia can occur (Rosenthal & Burchum, 2020). Patients should try to focus on a low-fat, high-fiber diet, and limit refined carbohydrates as much as possible. Teaching should be done to correctly count carbohydrates and understand how to give insulin doses to match those carbs (Mayo Clinic, 2017). Impacts of the Medication Hypoglycemia is the biggest concern of insulin use and can cause permanent neurological issues if episodes are happening often. If sites are not rotated or cleaned properly, infections can occur. Currently, there are studies to see if insulin could be causing hypertension, atherosclerosis, clotting issues, and hyperlipidemia in some patients. Patients should anticipate weight gain when beginning an insulin regimen. If blood sugars are too high the patient could go into diabetic ketoacidosis and if the blood sugars are too low the patient\’s kidney function could be impaired (Drugs.com, 2020). References ADA. (2018). 9. Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes—2018. Diabetes Care, 41(1), S73-S85. https://doi.org/10.2337/dc18-S008 CDC. (2020, April 28). Diabetes basics. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/index.html Drugs.com. (2020). Insulin side effects. https://www.drugs.com/sfx/insulin-side-effects.html Mayo Clinic. (2017, August 7). Type 1 diabetes – Diagnosis and treatment. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnosis-treatment/drc-20353017 Rosenthal, L., & Burchum, J. (2020). Lehne\’s Pharmacotherapeutics for advanced practice providers (2nd ed.). Saunders. 2.) 1 ) Responde to kenneth who selected a different type of diabetes than I did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management. 4 sentences 2 refrence . Diabetes and Drug Treatments Diabetes is primarily a disorder of carbohydrate metabolism. Symptoms mainly result from a deficiency of insulin or from cellular resistance to insulin\’s actions. Different Diabetes Types Discussion Essay. The principal sign of diabetes is sustained hyperglycemia, which results from impaired glucose uptake by cells and from increased glucose production (Rosenthal & Burchum, 2020). There are two major types of diabetes; type 1 diabetes mellitus (abbreviated as T1DM) and type 2 diabetes mellitus (abbreviated as T2DM). Both T1DM and T2DM have similar signs and symptoms. Where the two types of diabetes differ is from etiology, prevalence, treatments, and outcomes (illness severity and deaths). Differences between T1DM and T2DM T1DM age of onset is usually childhood or adolescence, while that of T2DM is usually older than 40 years. The prevalence of T1DM is approximately 5%, while that of T2DM is approximately 90% – 95%. The etiology of T1DM is autoimmune process, while that of T2DM is unknown, but there is a strong familial association, suggesting that heredity is a risk factor. The primary defect of T1DM is the loss of pancreatic β cells, while the primary detects for T2DM Insulin resistance and inappropriate insulin secretion. The insulin levels in T1DM Reduced early in the disease and completely absent later, while in T2DM insulin levels may be low (indicating deficiency), normal, or high (indicating resistance). Insulin replacement is mandatory, along with strict dietary control in T1DM, while Treat with an oral antidiabetic or noninsulin injectable agent and/or insulin, but always in combination with a reduced-calorie diet and appropriate exercise. Symptoms of T1DM include polyuria, polydipsia, polyphagia, weight loss, while with T2DM symptoms may be asymptomatic initially. While T2DM patients are frequently obese, T1DM patients are usually thin and undernourished at diagnosis. Finally, ketosis is common with patient of T1DM especially if insulin dosage is insufficient, while absent in patient of T2DM (Bhardwaj, Choudhary & Sharma, 2018). Gestational diabetes mellitus and Juvenile diabetes mellitus Gestational diabetes is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Gestational diabetes mellitus (GDM) is an increasingly common condition of pregnancy. It is associated with adverse fetal, infant, and maternal outcomes, as well as an increased risk of GDM in future pregnancies and type 2 diabetes for both mother and offspring (Parsons, Sparrow, Ismail, Hunt, Rogers & Forbes, 2018). Different Diabetes Types Discussion Essay. Diabetes appears in women during pregnancy and then subside after pregnancy. The most common cause of insulin resistance in pregnant women are hormones and adipokines secreted from the placenta, including tumor necrosis factor-α, human placental lactogen, and human placental growth hormone. Besides, increased estrogen, progesterone, and cortisol during pregnancy contribute to a disruption of the glucose-insulin balance (Alfadhli., 2015). The most common risk factors are; obesity, older maternal age, history of GDM, strong family history of diabetes, member of an ethnic group with a high prevalence of T2DM, polycystic ovary syndrome, and persistent glucosuria (Alfadhli., 2015). Juvenile diabetes mellitus was mostly amounting to children who lack anti-islet autoantibodies. However, it is currently identified as type I diabetes, because it occurs at any age (Lodha, Das, Ghanshyam & Bhansali, 2018). One type of drug used to treat T1DM: Insulin Insulin is the mainstay of therapy for individuals with type 1 diabetes. Generally, the starting insulin dose is based on weight, with doses ranging from 0.4 to1.0 units/kg/day of total insulin with higher amounts required during puberty (American Diabetes Association, 2018). Insulin is used to treat all patients with T1DM and many patients with T2DM. Insulin is synthesized in the pancreas by β cells within the islets of Langerhans. The immediate precursor of insulin is called proinsulin. The principal stimulus for insulin release is a rise in blood glucose, and the most common cause of glucose elevation is eating a meal, especially one rich in carbohydrates. Insulin acts in two ways to promote anabolic effects. First, it stimulates cellular transport (uptake) of glucose, amino acids, nucleotides, and potassium. Second, insulin promotes synthesis of complex organic molecules. Under the influence of insulin and other factors, glucose is converted into glycogen, amino acids are assembled into proteins, and fatty acids are incorporated into triglycerides (Rosenthal & Burchum, 2020). Different Diabetes Types Discussion Essay.              There are many insulin preparations or formulations. Major differences concern time course, appearance, concentration, and route of administration. Because of these differences, insulin preparations cannot be used interchangeably. In fact, if a patient is given the wrong preparation, the consequences can be dire. Unfortunately, medication errors with insulins remain all too common, which explains why insulin appears on all lists of “high-alert” agents (Rosenthal & Burchum, 2020).