Read a selection of your colleagues’ response on Diabetes and respond by providing

Read a selection of your colleagues’ response on Diabetes and respond by providing recommendations for alternative drug treatments and patient education strategies for treatment and management. Need assistance with feedback on response below

COLLEAGES RESPONSE BELOW:

Diabetes Mellitus as we all know is a blood sugar disease, the seventh leading cause of death and the most common endocrine disorder in the United States (Rosenthal & Burchen, 2021). Glucose, liver, glucagon, and insulin are major factors in diabetes. Glucose is stored in the liver as glycogen and is used by the body when it needs it. Insulin is a hormone that regulates the amount of glucose in the body. It is secreted by the beta cell of the pancreas; the Islets of Langerhan, while the glucagon is used to bring up the sugar or glucose in the body, it is 9released by the pancreas if the blood glucose is low.

For a normal person who has consumed too much sugary foods, the pancreas will release insulin to help reduce sugar and bring it into the cell to be used by the body for energy. But, for a diabetic person, it is either the body is resistant to insulin or is dependent on the insulin. Genetics is a non-modifiable risk factor for getting diabetes, however we can curb the risk by living a healthy lifestyle, getting involved in physical activity and eating healthy (Rosenthal & Burchen, 2021):

When the sugar gets so high with the body not being receptive to insulin (Hyperglycemia), the sugar lingers in the body, destroys major organs in the body, resulting in renal failure, heart disease, neuropathy, blindness, stroke, and/or impotence and amputation (Rosenthal & Burchen, 2021). The body metabolizes or burns fats for energy, ketones, which are typical of type ! diabetes. Invariably, there may be a situation where insulin is not enough to burn the fats. They have carbohydrates metabolism issues (Rosenthal & Burchen, 2021).

Diabetes is grouped majorly into 2: type 1 and type 2. Then gestational and juvenile pending on their pathophysiology.

In Type 1 diabetes-there is no insulin at all. It is an insulin-dependent diabetes or juvenile-onset diabetes common in childhood and adolescence, but can also occur in adults. The cause is autoimmune, (Rosenthal & Burchen, 2021). They burn fats which are by products of ketones hence they are termed Diabetic ketoacidosis (DKA). In DKA, too much acids are involved, acetone breath, fruity smell, kaussmaul breathing, abdominal pain, nausea and vomiting. Usually treated with insulin and low carbohydrate diet.

For Type 2 diabetes may be related to lifestyle, genetics, obesity, lack of exercise. It is a type of DM that the insulin is not enough to reduce blood sugar. Formerly called non-insulin dependent diabetes mellitus or adult-onset diabetes, but now occurring in children as well (Rosenthal & Burchen, 2021). Usually treated with oral anti-diabetic medication or non-insulin injectable medications, and managed with low calorie diabetic diet and exercise (Rosenthal & Burchen, 2021).

However, Gestational diabetes is a type of diabetes that happens during pregnancy to pregnant women due to the production of hormones by the placenta which are not in conformity with insulin; production of the hormone, cortisol that influences high blood sugar more in pregnancy, and lastly since glucose can cross the placenta from the mother to the fetus, hyperglycemia or high blood sugar in the pregnant woman will increase insulin secretion in the fetus. It usually goes away after delivery (Rosenthal & Burchen, 2021). From experience, a blood sugar 1-hour test recommended by the MD usually between 28 to 30 weeks in pregnancy. Usually above 130 indicates a failed test, after which a 3 hour test is ordered. If failed, it indicates gestational Diabetes. Fast 2 hours before test, an oral glucose drink would be given to you to drink in 5 minutes, after which one’s blood will be drawn. Risk factors include maternal age more than 25 years, obesity, previously large baby, multiple pregnancies and family history of DM.

And, Juvenile diabetes is a name formerly used for type 1 diabetes because it is common among children and adolescence (Rosenthal & Burchen, 2021).

For the purpose of this discussion, I would like to talk about type 1 DM. Like earlier mentioned, it is a type of DM where there is no insulin secretion, formerly called insulin dependent diabetes or juvenile-onset diabetes. Type 1 DM is now occurring in adulthood. The cause of the disease is autoimmune, that is why it is primarily due to the destruction of the pancreatic beta cells, which is the cell that releases insulin (Rosenthal & Burchen, 2021). Type 1 DM is characterized by polyuria, polydipsia, polyphagia, and weight loss. Ketoacidosis is common due to possibility of  low insulin (Rosenthal & Burchen, 2021). Dietary consideration would be low carbohydrates (45-60%): grains, starchy vegetables such as corn and potatoes, dry beans and milk, cookies and soda. The amount of carbohydrate intake affects effect of insulin. Insulin with too much carbohydrate would lead to hyperglycemia, whereas insulin dosage with too little carbohydrate would end up in hypoglycemia (Rosenthal & Burchen, 2021). Fats (<20%). Healthy fats such as wall nuts, avocado. Not saturated fats. Proteins ( 15-20%): Not red meats, rather chicken, turkey, fish, egg white, low fat cheese, and plant based beans are good sources.

So, to treat Type 1 DM, daily insulin is the major drug for treatment, which may be followed with Lisinopril (ACE inhibitor). Insulin Lispro-Humalog (short duration, fast acting), Regular Insulin (short duration, short acting), Insulin glargine (Long duration)- Lantus. Metformin (Rosenthal & Burchen, 2021). While mixing insulin before administration, use clear to cloudy. Sitagliptin ( Sodium-Glucose Cotransporter 2 inhibitor, SGLT2-inhibitor).

Short-term and Long-term Impact of Type 1 Diabetes Mellitus on Patients.

Long term impact is diabetic nephropathy (renal insufficiency or renal failure) as result of poor glycemic control, reason why Lisinopril or Losartan, an Angiotensin II receptor blocker are used to preserve the kidneys of the diabetics (Rosenthal & Burchen, 2021). Neuropathy (where you feel pins and needle-like feelings on your toes and fingers)- most times their sensation is either diminished or absent-a reason why a diabetic person would carry a needle in his leg without knowing he has a needle stuck in there. Also, because of no sensation they are prone to having vascular ulcers or diabetic foot ulcer as wounds do not heel.   Blindness, Glaucoma, as optic nerves are damaged, stroke and heart diseases- no wonder diabetic patients are placed on statins to control and manage stroke and cholesterol. Impotence is also real. Short term impacts are hyperglycemia.

The Effect of the Drug Treatment

The effects of treatments on patients maybe hypoglycemia, low potassium as regular insulin further drives potassium into the cell. Regeneration of B cells, weight reduction, and blood pressure  reduction, especially with SGLT2-inhibitors. (Otto et. al., 2017) .