Free Diabetes And Drug Treatments Essay Sample

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Introduction

Diabetes is growing as a chronic disease worldwide. Data estimations show that more than 13,000 youths are diagnosed with diabetes across United States. Type-2 diabetes is increasing rapidly among children due to the sedentary lifestyle. Classification of Diabetes is based on age, symptoms, treatments and its significances (National Diabetes Data Group, 1979).

Types of Diabetes

Type-1
Type 1 Diabetes is an autoimmune disorder. With Type-1, diabetes body erroneously begins to act against its insulin-producing cells and starts to demolish them. As a result, the insulin hormone formation is stalled. Type 1 Diabetes develops slowly for years and expresses itself after a long period. Historically Type 1 Diabetes was mostly found in children in the age group of eight to nineteen years (Rubin, 2011).

Type-2

Type-2 diabetes occurs due to deficiency of insulin rather it develops a resistance to the secretion of insulin and its functioning. Type-2 diabetes results in a chronic condition known as hyperglycemia. The main characteristics of Type-2 diabetes are abnormality in carbohydrate and fat. The reasons for Type-2 diabetes range from environmental to genetic factors. Eating disorders, obesity and lack of physical activity are some other important factors. Type-2 diabetes is emerging as the primary concern for youths and children. As high as 8-45% of new diabetes diagnosed are found to be childhood diabetes. The disease has increased into children by almost 33% in that past decade and a half. Several government and non-government organizations are working towards fighting this disease (Peterson, Silverstein, Kaufman & Warren-Boulton, 2007).

Gestational Diabetes

Gestational diabetes is prevalent among women during the 24th week of pregnancy. It occurs during the gestational period and vanishes after the birth. The occurrence of gestational diabetes does not signify an onset of diabetes. A major concern is to protect the baby from complications. Gestational diabetes has an impact on the baby’s weight. However if diabetes exists prior to the conception in that case it does not affect the baby’s health (National Diabetes Data Group, 1979).

Juvenile Diabetes

Juvenile Diabetes is the name of Type 1 Diabetes. Type-1 diabetes had prevalence mostly in young children. In this kind of diabetes, the immune system terminates the function of the body that makes insulin hormone thereby stopping the insulin secretion. Amongst children it is a life threatening disease and must be treated properly (Rubin, 2011).

Understanding Type-2 Diabetes

Diagnostic criteria, symptoms, and risk factors
It is difficult to differentiate between type 1 and type 2 diabetes in a child. Adolescents with type 1 diabetes exhibit the presence of antibodies against islet cell antigens, insulin autoantibodies. Type 2 diabetic children show insulin resistance with excessive weight (Peterson, Silverstein, Kaufman & Warren-Boulton, 2007).
The classic symptoms of Diabetes type 2 are polyuria, polydipsia, polyphagia, weight loss and blurred vision. Though these symptoms take longer time to appear and remain undiagnosed for several years (Arcangelo & Peterson, 2006). The major risk factors for Diabetes type 2 are family history, obesity, age (above 45), previous history of IFG or impaired fasting glucose, HDL cholesterol, hypertension, and inactive lifestyle. ADA recommends fasting plasma glucose test (FPG) for screening of diabetes (Arcangelo & Peterson, 2006). Oral glucose tolerance test (OGTT) is also prescribed. FPG below 100 mg/dl and 2 hour post-load (PG) below 140mg/dl is considered normal glucose. FPG 126 or more and PG 200 or more necessitate repetitive confirmation. FPG at least 100 or below and PG 140 or below is considered having IGT (Impaired Glucose Tolerance) (Arcangelo & Peterson, 2006). Certain drugs can cause hyperglycemia, such as thiazide diuretics, nicotinic acids, glucocorticoids, and beta blockers (Arcangelo & Peterson, 2006).

Drug Therapy

Effective treatment programs for treating Diabetes type 2 prefer training of self-management. The treatment plan for Diabetes should be customized according to the patient age, behavior, and symptoms (Peterson, Silverstein, Kaufman & Warren-Boulton, 2007). Self monitoring of glucose level in blood, medical nutrition therapy, exercises, drug therapy, and periodic evaluation of treatment objectives are prerequisite for an effective management plan. The treatment of children varies from adults. The main purpose of treatment in children is to reduce insulin sensitivity without affecting their physical growth, sexual maturity, and self-managing capabilities (below five-year children) (Peterson, Silverstein, Kaufman & Warren-Boulton, 2007). The principal goal of drug therapy is to achieve Glycemic control (Hemoglobin A1c level below 6.9%), blood pressure, lipid and micro albumin control (Arcangelo & Peterson, 2006). Pharmacologic therapy for type 2 is selected according to the level of hyperglycemia, symptoms, and co-morbidity. Suggested medications are Metformin, sulfonylureas, thiazolidinediones, and α-glucosidase inhibitors (Peterson, Silverstein, Kaufman & Warren-Boulton, 2007; Arcangelo & Peterson, 2006). In type 2, first-line therapy involves monotherapy with only one oral agent. Second line therapy is preferred due to the inefficiency of first line, which requires additional oral agents like, sulfonylureas with biguanides or others. Insulin is introduced in third line therapy in the case of failure of second and third agents (Arcangelo & Peterson, 2006).

Dietary Considerations and Nutrition Therapy

Adopting an active lifestyle, diet and exercises are sufficient to treat diabetes in 10% of youths along with oral medication of Insulin. It is necessary to understand the food contribution to glucose, cholesterol and blood pressure levels (Arcangelo & Peterson, 2006).
Healthy diet, physical activity and exercises assist in maintaining blood glucose, body weight, good and bad cholesterol (Rubin, 2011). The nutrition therapy for diabetes management excludes high sugar and fat content as well as alcohol. High fluid consumption is essential to avoid dehydration. Obese youth should be counseled to reduce weight and increase physical activity (Peterson, Silverstein, Kaufman & Warren-Boulton, 2007).

Short Term and Long Term Impact of Diabetes type 2

The short term impacts of Diabetes type 2 are hyperglycemia, hypoglycemia, hyperglycemic hyperosmolar non-ketotic syndrome (HHNS), and polyuria. The long-term impacts of type 2 include microvascular complications, cardiovascular risks, dyslipidemia. The hypertension can cause retinopathy, nephropathy, and neuropathy. The most common side effects of Diabetic treatment are GI disturbances, abdominal distention, diarrhea, and liver disease (Arcangelo & Peterson, 2006).
Early prevention is the best cure, so a patient with a diabetic history should be properly monitored for glucose, cholesterol and lipid levels including blood pressure from a young age.

References

Arcangelo, V. P., & Peterson, A. M. (Eds.). (2006). Pharmacotherapeutics for advanced
practice: a practical approach (Vol. 536). Lippincott Williams & Wilkins.
Peterson, K., Silverstein, J., Kaufman, F., & Warren-Boulton, E. (2007). Management of type 2
diabetes in youth: an update. Am Fam Physician, 76(5), 658-664.
Rubin, A. L. (2011). Type 1 diabetes for dummies. John Wiley & Sons.
National Diabetes Data Group. (1979). Classification and diagnosis of diabetes mellitus and
other categories of glucose intolerance. Diabetes, 28(12), 1039-1057.