Differences Between The Types Of Diabetes

Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.

Please discuss Jardiance in the management of type 2 diabetes and lowering A1C versus Januvia

To Prepare:

  • Select one type of diabetes to focus on for this Discussion. (I selected Type 2 DM)
  • Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
  • Think about the short-term and long-term impact of diabetes you selected on patients, including the effects of drug treatments.

Answer

The Management of Type 2 Diabetes

Diabetes mellitus (DM) is a metabolic condition marked by unnecessarily elevated blood glucose levels. There may be a drop in insulin production, resistance to insulin’s effects, or both (Goyal & Jialal, 2022). There are various types, including type 1, type 2, Latent autoimmune diabetes in adults (LADA), gestational diabetes, maturity-onset diabetes of the young (MODY), and others (Sapra & Bhandari, 2021). Type 1 diabetes occurs when one’s immune system attacks and destroys insulin-producing cells in the pancreas, which causes a marked insulin deficit. Type 2 diabetes is characterized by decreased sensitivity to the insulin’s action and an inability to create enough insulin to get the better of the “insulin resistance” (Penman et al., 2023). In pregnancy, gestational diabetes mellitus can be any degree of glucose intolerance (Quintanilla & Mahdy, 2019). Non-insulin-dependent diabetes diagnosed under 25 is a heterogeneous condition known as MODY (Sapra & Bhandari, 2021). In this discussion, we will cover the short and long-term effects of type 2 diabetes, the proper preparation and administration of medication, and the related dietary adjustments.

Jardiance

The drug empagliflozin, sold under the brand name jardiance, is used in managing type 2 diabetes mellitus. It is in the class of sodium-glucose co-transporters-2 (SGLT-2), which blocks glucose reabsorption in urine (Sizar et al., 2020). Jardiance is available in film-coated tablets as a 10 mg preparation taken daily with breakfast. The dose is increased to 25 mg preparation only if initially tolerated. Volume depletion, if present, must be corrected before administration. If the eGFR is greater than 45 in patients with renal impairment, no dose change is required; however, precautions must be taken if it is lower (Sapra & Bhandari, 2021). It can be used alone or with other antidiabetics as an adjunct to exercise and lifestyle modification. The American Diabetes Association (ADA) recommends combined therapy with metformin if the A1c is more than 9%. Jardiance reduces A1C by slightly more than 1% over time, while Januvia (sitagliptin) reduces it by lower than 1% over time (Chung et al., 2018). Therefore, unlike jardiance, which reduces the mortality and morbidity associated with heart disease, Januvia is not ideal for people with heart failure.

Appropriate preparation for Jardiance use includes getting a complete medical history to rule out contraindications. The Patients must be informed of the medication’s proper use, including dosing, food and side effects. Patients should decrease the consumption of foods that are rich in carbohydrates. The side effects could be dyslipidemia, urinary tract infections, or vaginal mycotic infections (Sizar et al., 2020). It also causes volume depletion from its diuretic qualities, such as syncope, dehydration, hypovolemia, and hypotension. Patients should increase their fluid intake due to this effect but not sugary drinks. Thus, nurses must understand the adverse event profile of this drug and monitor side effects and therapeutic effects at follow-up visits.

The Effects of Diabetes and Drug Treatment.

Diabetes and its treatment have immediate and long-term implications for a person’s lifestyle. The acute consequences of diabetes include ketoacidosis, hypoglycemia, hyperosmolar hyperglycemia, and diabetic coma (Goyal & Jialal, 2022). Nephropathies, neuropathies, and retinopathies are chronic microvascular problems. Cerebrovascular disease, peripheral artery disease (PAD), and Coronary artery disease (CAD) are chronic macrovascular problems. Pharmacotherapy for hyperglycemia, LDL cholesterol reduction, blood pressure control with antihypertensives, and aspirin in secondary prevention can all be used to manage vascular problems effectively, lowering morbidity and mortality.

References

Chung, J. W., Hartzler, M. L., Smith, A., Hatton, J., & Kelley, K. (2018). Pharmacological agents utilized in patients with type-2 diabetes: Beyond lowering a1c. Pharmacy and Therapeutics, 43(4), 214–227. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871242/

Goyal, R., & Jialal, I. (2022, June 19). Diabetes mellitus type 2. NCBI; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513253/

Penman, I. D., Ralston, S., Strachan, M. W. J., & Hobson, R. P. (2023). Davidson’s principles and practice of medicine. Elsevier.

Quintanilla, B. S., & Mahdy, H. (2019, July 28). Gestational diabetes. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK545196/

Sapra, A., & Bhandari, P. (2021). Diabetes mellitus. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551501/

Sizar, O., Podder, V., & Talati, R. (2020). Empagliflozin. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532925/

 

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