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Essays on prevention of type 2 diabetes
Management of type 2 diabetes essay
Management of type 2 diabetes essay
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As the incidence of type 2 diabetes is steadily increasing, the demand for treatment options is increasing. Dipeptidyl peptidase-4 inhibitors (DPP-4) are a new class of oral anti-hyperglycemic medications that target the incretin system found in the gut. Evidence has shown that treatment with DPP-4 inhibitors has shown significant reductions in HbA1c and increased pancreatic β-cell function without an increased risk of hypoglycemia. In this document, the pharmacology, clinical efficacy, and incidence of adverse effects will be reviewed in an attempt to target a patient population that would benefit the most from treatment with DPP-4 inhibitors.
The role of DPP-4 inhibitors in type 2 diabetes mellitus management
INTRODUCTION
Type 2 diabetes mellitus is a chronic, progressive disease that currently affects approximately 285 million people worldwide and is estimated to affect 430 million people by 2030.1 As the numbers increase, the demand for effective treatments also increases. In addition to lifestyle modifications, the current recommendation for the first-line treatment for people with new-onset type 2 diabetes mellitus is metformin, an oral anti-hyperglycemic agent. In patients who are currently taking metformin but are inadequately controlled, a second oral agent is typically added on. Several second-line oral anti-hyperglycemic agents are available, including older agents such as sulfonlyureas, glinides, thiazolidinediones, α-glucosidase inhibitors, and amylin agonist (pramlintide), as well as newer agents such as dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists.2 However, the debate on which second-line agent should be used is omnipresent.
In 2006, the first oral DPP-4 inhibi...
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13. Monami M, Vitale V, Ambrosio ML, Bartoli N, Toffanello G, Ragghianti B, et al. Effects on Lipid Profile of Dipeptidyl Peptidase 4 Inhibitors, Pioglitazone, Acarbose, and Sulfonylureas: Meta-analysis of Placebo-Controlled Trials. Advances in Therapy. 2012 Aug 24;29(9):736–46.
14. Jose T, Inzucchi SE. Cardiovascular effects of the DPP-4 inhibitors. Diabetes and Vascular Disease Research. 2012 Feb 15;9(2):109–16.
15. Monami M, Dicembrini I, Antenore A, Mannucci E. Dipeptidyl Peptidase-4 Inhibitors and Bone Fractures: A meta-analysis of randomized clinical trials. Diabetes Care. 2011 Oct 24;34(11):2474–6.
16. Klarenbach S, Cameron C, Singh S, Ur E. Cost-effectiveness of second-line antihyperglycemic therapy in patients with type 2 diabetes mellitus inadequately controlled on metformin. Canadian Medical Association Journal. 2011 Oct 3;183(16):E1213–E1220.
I would classify hypertension and diabetes as both being cost effective or decreased costs and increased effectiveness according to the four quadrants. (page 128). It is more cost effective for these patients to monitor and treat rather allowing the illness to spiral out of control that could create more expensive treatment (page 169). A patient could save money by buying a portable electronic monitor, commit to exercising, and limiting salt and other dietary recommendations. It is important for the patient to take control of their illness and learn ways to reduces any adverse effects to improve
Scheen AJ. Antidiabetic agents in subjects with mild dysglycaemia: Prevention or early treatment of type 2 diabetes. Diabetes and Metabolism. 2007;33:3-12.
• Diabetes Mellitus: Diabetes mellitus (Type I Diabetes and Type II Diabetes) has been associated with an increase in arterial stiffness . O’Rourke’s studies showed that PWA does not aid in the diagnostics of diabetes mellitus. Further research by Cruickshank showed that PWV is a powerful independent predictor of mortality for diabetes.
The pathophysiology of diabetes mellitus in is related to the insulin hormone. Insulin is secreted by cells in the pancreas and is responsible for regulating the level of glucose in the bloodstream. It also aids the body in breaking down the glucose to be used as energy. When someone suffers from diabetes, however, the body does not break down the glucose in the blood as a result of abnormal insulin metabolism. When there are elevated levels of glucose in the blood, it is known as hyperglycemia. If the levels continue to remain high over an extended period of time, damage can be done to the kidneys, cardiovascular systems; you can get eye disorders, or even cause nerve damage. When the glucose levels are low in one’s body, it is called hypoglycemia. A person begins to feel very jittery, and possibly dizzy. If that occurs over a period of time, the person can possibly faint. Diabetes mellitus occurs in three different forms - type 1, type 2, and gestational.
Metformin is prescribed for long-term treatment of Type II Diabetes Mellitus. It can be used alone or in combination with other drugs for diabetes management as part of a health plan that includes proper diet and exercise. Metformin, which has a low affinity for plasma protein binding, limits glucose production in the hepatic system, lowers absorption of glucose in the intestines and improves insulin sensitivity by enhancing uptake and utilization of glucose (FDA, 2008). This drug does not cause an increase in insulin, making it less likely to cause a patient to become hypoglycemic compared with other common antihyperglycemic medications.
Diabetes Programs: The Scripps Whittier Diabetes Institute Experience. Curr Diab Rep Current Diabetes Reports, 14(2). Doi:10.1007/s11892-013-0462-0
Cardiovascular Diseases (CVD) are the currently the leading cause of death globally for both men and women accounting for 21.9 per cent of total deaths and is projected to increase to 26.3 per cent by 2030 . Statins are the treatment of choice for the primary and secondary prevention of cardiovascular disease and in the management of hypercholesterolaemia because of their proven efficacy and safety profile. Evidences are showing their effectiveness in reduction of cholesterol synthesis and number of pleiotropic effects, which may be cholesterol dependent and cholesterol independent. The present review focus on the origin, properties and effects of statins on endothelial function ( non lipid action of statins) through the increase of endogenous production of NO in different pathways.
Sethi, J. K., Vidal-Puig, A. J., (2007). Targeting fat to prevent diabetes. Cell Metab. . 5 (5), 357-70.
...t compliance, and medication adherence is highly correlated with positive health outcomes. Thus, a medicine that maximizes patient adherence, delivers the same efficacy as previously used drugs, and shows no additional adverse effects is exceedingly likely to become the drug of choice. Of particular interest to researchers currently are the medications glyburide and metformin. As more and more research continues, it is hypothesized that these drugs will become part of the pharmaceutical regime in the treatment of gestational diabetes mellitus. In fact, both glyburide and metformin have been successfully prescribed to treat GDM in other countries for several years. Glyburide, especially, is predicted to gain the approval by the FDA in the coming years as, at least, a second line medication since it has shown to only cross the placenta in insignificant quantities.
There are many identifiable risk factors that are both modifiable, and non-modifiable. The gender of the patient is a major risk factor, as women are more likely to develop osteoporosis. Of the almost 50 million Americans diagnosed with osteoporosis, 80% are women. Females at any age have less bone density than males, but in the mid-30's women experience bone loss at a rate of 1% each year (Berarducci, 2008). Walker (2010) adds to the previous statistics, citing around one out of three women over the age of fifty will have a fracture related to osteoporosis, compared to one in 12 men.
Diabetes has been around for 2000 years. Over the years there has been a vast improvement in treatments which are still ongoing to this day. In the 17th century, diagnoses were done through urine tests and one was diagnosed if one’s urine was sweet. In the 20th century, doctors would advise patients to go on radical diets of less than 450 calories per day. In 1921 insulin was finally discovered.
2. Artex Medical, Inc. America’s Choice for Diabetic Needs Published by the National Diabetes Education Program in 2013 Read on 03/24/2014 (pamphlet)
Diabetes Mellitus is a chronic health condition in which the level of glucose in the blood is higher than usual. Type 1 diabetes occurs when the pancreas does not create enough insulin and type 2 diabetes occurs when insulin is produced, but is not adequate in lowering blood glucose levels or there is resistance to the insulin (Edwards, 2007, p. 9). Diabetes mellitus is the leading cause of end-stage kidney disease, foot and leg amputations, and new cases of blindness in the United States (Ignatavicius & Workman, 2010, p. 1465-66). People with type 1 diabetes are required to take insulin to manage their glucose levels. People with type 2 diabetes are usually prescribed oral medications such as sulfonylurea agents, meglitinide analogues, or biguanides to help control their glucose levels. Twenty to 30% of people with type 2 diabetes require insulin therapy as well (Ignatavicius & Workman, 2010, p. 1471). In addition to medication therapy, diet and weight control can help manage both type 1 and type 2 diabetes. Because diabetes mellitus can cause such severe complications, it is important that people with diabetes understand the importance of certain health and lifestyle choices, such as their diet and weight to manage their disease. Patients with diabetes mellitus should pay special attention to the amount of carbohydrates, protein, fat, and minerals that are included in their diet. Monitoring these components of their diet, along with weight management, can help control their diabetes mellitus.
Diabetes is becoming an increasing problem in the United States, with half of all Americans becoming either diabetic or pre-diabetic. Treatments for Type-1 diabetes include taking insulin to help increase your glucose levels (blood sugar), eating healthy, maintaining healthy weight, and monitoring your daily levels. Type-2 treatments include most of Type-1’s treatments (excluding the taking of insulin) and in some cases a special diabetes medication or insulin therapy (Type-2).... ... middle of paper ...
According to Krisha McCoy on her article: The history of Diabetes; “In 150 AD, the Greek physician Arateus described what we now call diabetes as "the melting down of flesh and limbs into urine." From then on, physicians began to gain a better understanding about diabetes. Centuries later, people known as "water tasters" diagnosed diabetes by tasting the urine of people suspected to have it. If urine tasted sweet, diabetes was diagnosed. To acknowledge this feature, in 1675 the word "mellitus," meaning honey, was added to the name "diabetes," meaning siphon. It wasn't until the 1800s that scientists developed chemical tests to detect the presence of sugar in the urine”.