Diabetes mellitus is a group of metabolic diseases brought on by hyperglycemia from a defect in insulin secretion, insulin action, or both. The diagnose of DM is determined by glycosylate hemoglobin (HbA1c) levels, fasting blood sugar levels, 2-hour plasma glucose level during oral glucose tolerance testing using 75-g oral glucose load, or a random glucose levels of individual with symptoms (McCance & Huether, pg. 684). The HbA1c range 6.5% or higher indicates diabetes type 2 and verifies the permanent attachment of glucose to hemoglobin molecules and tells the average plasma glucose exposure over the life of red blood cells 120 days (McCance & Huether, pg. 685). Type 1/juvenile diabetes is most common with pediatrics. According to McCance & Huether between 10-13% of children diagnosed with type 1 diabetes have a 1st degree relative parent or sibling with type 1 diabetes. The onset for type 1 diabetes is a long period with gradual destruction of beta cells eventually leading insulin deficiency and hyperglycemia and the body does not make insulin. Type 2 Diabetes affects 9.3% of adults in the US according to McCance & Huether. DM II is a chronic condition that affects the way the body processes sugar this usually happens during adulthood.
The body doesn’t make enough insulin to regulate the excessive amounts of sugar circulating in the bloodstream (mayoclinic. et. al). Gestational diabetes appears during pregnancy and then goes away after delivery of the baby. Blood sugars are monitored closely during pregnancy. Diet and insulin are usually used during the pregnancy (Rosenthal, L. D., & Burchum, J, R. 2021 pg. 398). DM II is usually controlled by losing weight, eating healthy, and exercise. If diet and exercise aren’t enough then diabetic medications or insulin are usually added (Rosenthal, L. D., & Burchum, J, R. 2021 pg. 402). Metformin is usually the 1st drug used for DM II which is an oral tablet used to decrease blood glucose production in the liver and improve the body’s sensitivity to insulin so that the body can use insulin more effectively. Some people start having vitamin b12 deficiency from the diabetic medication and need to take supplements; other meds are sulfonylureas example glyburide which helps the body excrete insulin but can cause weight gain ((Rosenthal, L. D., & Burchum, J, R. 2021 pg. 399). Insulin is added if the oral medications are not enough. Long-term the goal would be to control DM II without medication or insulin. Lifestyle changes for the better are the key to maintaining this goal.
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children(8th ed.). St. Louis, MO: Mosby/Elsevier
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
What is Diabetes Mellitus? Retrieved from https://www.mayoclinic.org/symptoms/what is diabetes-/basics/causes/November 24,2020
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