Diabetes Mellitus Disorder of Carbohydrate Metabolism

“The term Diabetes Mellitus is from the Greek word for fountain and the Latin word for honey. Diabetes is a disorder of carbohydrate metabolism and the symptoms mainly result from insulin deficiency to from cellular resistance to insulin’s actions” (Rosenthal & Burchum, 2021 p. 397). The differences between Diabetes 1, 2, gestational, juvenile are:

Diabetes type 1-was once called juvenile-onset or insulin-dependent diabetes, but because more people including children are developing type 2 those terms are not used anymore. In type 1 diabetes there is a destruction of pancreatic B cells-which are responsible for insulin synthesis and release into the bloodstream. The destruction of B cells is due to the autoimmune process, the cause is unknown as mentioned in Rosenthal & Burchum, 2021 p. 397.

Diabetes type 2- is the most common form of diabetes, it used to be called non-insulin- dependent diabetes or adult set diabetes. As with type 1 these terms are not used because all age groups can develop type 2. With type 2 insulin there is insulin resistance and impaired insulin secretion and over time pancreatic B cell function diminishes, insulin production and secretion reduce over time” (Rosenthal & Burchum, 2021 p. 397).

“Gestational Diabetes is diabetes that develops in pregnancy and then subsides rapidly after delivery. The placenta produces hormones that work against insulin’s actions, cortisol production increases threefold and cortisol promotes hyperglycemia. Hyperglycemia in the mother will stimulate excessive insulin in the fetus which can have adverse effects on the fetus” (Rosenthal & Burchum, 2021 p. 398).

“Metformin is an oral drug used in type 2 diabetes and is given as monotherapy at the start of diagnosis of type 2 if there are no contraindication. As a first line drug if has beneficial effects on A1C and weight and cardiovascular mortality” (ADA, 2018, p. 575). Diet and lifestyle changes are recommended as well. Nutrient dense carbs, whole unprocessed non-starchy vegetables, and eating less refined, highly processed carbs is recommended (ADA n.d.). Short- and long-term effects of diabetes are short term, in the beginning of a patient’s diagnosis the patient may not need a lot of medication prescribed because the body may still be able to work on its own and be effective with diet and lifestyle changes. Long term as time goes on the patient may need more medications to control blood sugar levels. “There may be increased complications to body and other systems (cardiovascular, kidneys) there may also be side effects of the medication for example metformin is associated with B12 deficiency” (ADA, 2018).

References

American Diabetes Association (n.d.) Retrieved from https://www.diabetes.org/nutrition

American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment:

Standards of medical care in diabetes-2018. Diabetes Care, 41(Supplement 1), S73-S85.

Retrieved from http://care.diabetesjournals.org/content/41supplement_1/s73.full-text.pdf

Rosenthal, L. D., & Burchum, J.R. (2021). Lehne’s pharmacotherapeutics for advanced practice

Nurses and physician assistants (2^nd ed.) St. Louis, MO: Elsevier. Chapter 48, “Drugs for

Diabetes Mellitus” (pp.397-398)

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Diabetes Mellitus Disorder of Carbohydrate Metabolism