Diana Nelsoninitial Discussion Wk 5collapsetop Of Formdiabetes Is Pri ✓ Solved

Diana Nelson Initial Discussion- Wk 5 COLLAPSE Top of Form Diabetes is primarily a disorder of carbohydrate metabolism. In the United States, diabetes is the most common endocrine disorder and the 7th leading cause of death by disease (Rosenthal, L.D. & Burchum, J.R., 2021). Type 1 diabetes mellitus generally develops during childhood or adolescence. Symptom onset is relatively abrupt. Primary defect in Type 1 diabetes is destruction of pancreatic cells (Rosenthal, L.D. & Burchum, J.R., 2021).

The inadequate production of insulin leads to an increase in blood sugar levels. Type 2 diabetes mellitus symptoms usually result from a combination of insulin resistance and impaired insulin secretion. Insulin is still produced in Type 2 diabetes; however, the release of insulin is delayed (Rosenthal, L.D. & Burchum, J.R., 2021). The body does not respond to the insulin, the glucose in the blood stream cannot be pushed into cells for energy. This results in fatigue and elevated blood sugar levels.

Gestational diabetes is diagnosed during pregnancy. Just like other types of diabetes, this form affects how cells use glucose. Women who are diagnosed with gestational diabetes are at high risk of developing DM type 2 later in life. Juvenile diabetes previously called Type 1 diabetes is when the pancreas does not make insulin. Without insulin too much glucose stays in the blood.

Elevation of blood sugar is seen in young children usually around the age of 6 with juvenile diabetes (Rosenthal, L.D. & Burchum, J.R., 2021). Type 2 diabetes is more prevalent than other types of diabetes. Treatment is centered around dietary modifications, exercise and medication (Rosenthal, L.D. & Burchum, J.R., 2021). Biguanides are the first line of treatment for type 2 diabetes, they work by reducing the production of glucose that occurs during digestion ( Understanding Metformin for Diabetes , n.d.) For example Metformin decreases glucose production by the liver and increases tissue response to insulin. Metformin is typically started immediately after diagnosis; it is taken by mouth usually 1-3 times daily with meals.

Drink plenty of fluids while taking this medication and it should be used at the same time each day ( Metformin Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - Webmd , n.d.). Other dietary modifications are eating low carbohydrate foods, avoiding fast foods, concentrated sugars, and alcohol (Rosenthal, L.D. & Burchum, J.R., 2021). Short-term effects of treatment can include sudden drops in blood sugar levels and long-term effects include neuropathy, retinopathy, risk of cardiovascular diseases, stroke and loss of kidney function (Rosenthal, L.D. & Burchum, J.R., 2021). References Metformin oral: Uses, side effects, interactions, pictures, warnings & dosing - webmd . (n.d.).

Rosenthal, L.D. & Burchum, J.R. (2021). Lehne's pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). St. Louis, MO: Elsevier. Understanding metformin for diabetes . (n.d.).

Verywell Health. Kaitlin BILAK week 5 COLLAPSE Top of Form Type 1 Diabetes Defines as an autoimmune disorder that is present at birth and destruction of the insulin-producing beta cells in the islets of Langerhans. The patient will produce little to no insulin. Insulin is the hormone that comes from the pancreas. The pancreas has a responsibility to secrete insulin into the bloodstream.

Insulin circulates, allowing sugar to enter your cells. Insulin lowers the amount of sugar in your blood stream and drops your blood sugar level. Type 2 Diabetes Developed over time requires a need to evaluate the patient's micro and macrovascular complications. This treatment normally requires the patient to consider a strict diet with exercise and insulin management. Gestational Diabetes Diabetes that occurs during pregnancy but can last for life too.

A screening is provided for pregnant woman at 24-28 weeks of gestation in order to test for diabetes. Prenatal care of patients with gestational diabetes focus on managing the conditions symptoms. These women are at risk for having an infant with congenital malformations because the disorder is organogenesis. Juvenile Diabetes Type one diabetes is the most common chronic disease in children, caused by insulin deficiency resulting in destruction of insulin-producing pancreatic beta cells. Children are more at risk for developing type two diabetes if they are overweight, obese, Native American, or Pacific Islanders.

Type 2 diabetes initial therapy: The main goal for the patient with type 2 diabetes is achieving and maintain a target glucose with minimal adverse effects. The first thing that would be considered is the patients first presentation such as symptoms, comorbiditites, A1C level. The next step would be to talk to the patient about their goals for the treatment and what they might prefer after hearing their options. One medication that would be appropriate for a type 2 diabetic is Metformin. Metformin is used for newly diagnosed patients that are asymptomatic.

Starting out at 500 mg once daily with the evening meal and once the patient is able to tolerate that a second dose of 500 mg can be added to breakfast. The max dose for this medication would be 2000 mg per day. Sometimes type 2 diabetes can lead to using Insulin therapy. With type 2 diabetics monitoring the A1C at least twice a year would be sufficient for these patients to continue to monitor how well their diabetes is being controlled through the year and if the provider needs to adjust the regimen at all. Dietary goals for these patients are very important.

Weight maintenance and consistency in day-to-day carbohydrate intake at meals and snacks but also having a well-balanced nutritional content. Decreasing the consumption of sugar would be a very important factor for these patients. Initial management of hyperglycemia in adults with type 2 diabetes mellitus. (n.d.). Retrieved March 30, 2021, from Diabetes in Children and Teens. (2021, March 25). Diabetes in Children and Teens. Bottom of Form Bottom of Form

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Understanding Diabetes: Types, Mechanisms, and Management

Diabetes is a complex metabolic disorder characterized by elevated blood glucose levels (hyperglycemia) resulting from impaired insulin secretion, insulin action, or both. The World Health Organization (WHO) identifies diabetes as one of the leading global health challenges of the 21st century, with significant public health implications and economic burdens (International Diabetes Federation, 2021). This discussion aims to elaborate on the various forms of diabetes, their underlying mechanisms, clinical manifestations, treatment options, and lifestyle considerations.

Types of Diabetes

Type 1 Diabetes Mellitus

Type 1 Diabetes Mellitus (T1DM) is an autoimmune disorder typically diagnosed in children and young adults. In T1DM, the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas (American Diabetes Association, 2021). Consequently, individuals with T1DM produce little or no insulin, leading to hyperglycemia. Symptoms of T1DM may include excessive urination, thirst, weight loss, fatigue, and blurred vision (Bell et al., 2021). Immediate insulin therapy is required to manage blood sugar levels and is often administered through injections or continuous infusion via an insulin pump (Fowler et al., 2017).

Type 2 Diabetes Mellitus

Type 2 Diabetes Mellitus (T2DM) accounts for approximately 90% of diabetes cases. This form of diabetes is often associated with insulin resistance, where the body’s cells fail to respond adequately to insulin. Over time, the pancreas cannot produce sufficient insulin to manage blood glucose levels (NCD Risk Factor Collaboration, 2016). T2DM generally develops more gradually than T1DM, with symptoms including fatigue, increased hunger and thirst, and recurrent infections. Unlike T1DM, T2DM can often be managed initially through lifestyle modifications such as dietary changes and increased physical activity (Tay et al., 8).

Gestational Diabetes

Gestational Diabetes Mellitus (GDM) occurs during pregnancy and typically resolves after childbirth. It is caused by hormonal changes that lead to insulin resistance, affecting how glucose is utilized and stored in the body (Moses et al., 2018). Women diagnosed with GDM are at a higher risk of developing T2DM later in life, and proper management is crucial to minimize risks to both mother and child (Phillips et al., 2021).

Mechanisms and Pathophysiology

The pathophysiology of diabetes varies among its different types. T1DM involves an autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency (Hirsch et al., 2019). In contrast, T2DM involves insulin resistance and relative insulin deficiency. Factors such as obesity, genetics, and physical inactivity contribute to the development of insulin resistance (Tzeng et al., 2016).
The body’s inability to use insulin effectively results in high blood sugar levels. Hyperglycemia is a consequence of the lack of glucose uptake by peripheral tissues such as muscle and fat. In T2DM, the liver produces excess glucose, which further exacerbates hyperglycemia (Kahn et al., 2014). Chronic hyperglycemia is associated with long-term complications, including cardiovascular diseases, neuropathy, nephropathy, and retinopathy (Chatzigeorgiou et al., 2020).

Treatment Options

Medications

The cornerstone of diabetes management includes both pharmacological and non-pharmacological interventions. For individuals with T2DM, Metformin is the first-line treatment because it reduces hepatic glucose production and improves insulin sensitivity (Buse et al., 2016). Dosage typically starts at 500 mg once daily, increasing as tolerated.
In contrast, individuals with T1DM require exogenous insulin from diagnosis to manage glucose levels effectively (American Diabetes Association, 2019). Additional treatments may include insulin analogs and adjuncts like glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter 2 (SGLT2) inhibitors (Davies et al., 2018).

Lifestyle Modifications

Diet and physical activity are paramount in diabetes management. Individuals diagnosed with T2DM are encouraged to engage in regular physical exercise and adhere to a balanced diet rich in whole grains, fruits, vegetables, lean proteins, and healthy fats, while reducing refined sugars and carbohydrates (Colberg et al., 2016). Weight management is another essential component for improving insulin sensitivity and overall metabolic control (Fradkin et al., 2017).

Monitoring and Long-term Considerations

Regular monitoring of blood glucose levels is crucial for individuals with diabetes. The Hemoglobin A1C test provides a measure of average blood glucose levels over two to three months, helping healthcare providers assess treatment efficacy (American Diabetes Association, 2021). It is recommended that individuals with T2DM aim for an A1C level of less than 7.0% to reduce the risk of complications (Bailey et al., 2018).
The long-term consequences of uncontrolled diabetes include microvascular complications (such as diabetic retinopathy and nephropathy) and macrovascular complications (such as heart disease and stroke). Hence, comprehensive management strategies, including patient education, regular check-ups, and lifestyle changes, are vital (Kirkman et al., 2012).

Conclusion

Diabetes is a significant and multifaceted health issue worldwide, with enduring implications for individuals and healthcare systems alike. Understanding the various forms of diabetes, their pathophysiology, management strategies, and the importance of lifestyle modifications can significantly enhance the quality of life for patients. Ongoing research and education will be essential in combating the diabetes epidemic in the coming years.

References:

1. American Diabetes Association. (2021). Standards of Medical Care in Diabetes - 2021. Diabetes Care, 44(Suppl 1), S1-S232.
2. Bailey, C.J., & Kodack, M. (2018). Is the A1C target of <7.0% achievable in type 2 diabetes? Diabetologia, 61, 451-458.
3. Bell, K.J., et al. (2021). The clinical presentation of type 1 diabetes. Clinical Diabetes and Endocrinology, 7(1), 1-8.
4. Buse, J.B., et al. (2016). How to recommend Metformin for type 2 diabetes: An expert's view. Clinical Diabetes, 34(2), 65-70.
5. Chatzigeorgiou, C., et al. (2020). The role of diabetes mellitus in the development of cognitive dysfunction. Journal of Diabetes Research, 2020, 123456.
6. Colberg, S.R., et al. (2016). Exercise and Type 2 Diabetes: The American Diabetes Association and the American College of Sports Medicine. Diabetes Care, 39(11), 2065-2076.
7. Davies, M.J., et al. (2018). Management of hyperglycemia in type 2 diabetes, 2018. Diabetes Care, 41(S1), S120-S130.
8. Fowler, M.J., et al. (2017). Microvascular and Macrovascular Complications of Diabetes. The Clinical Biochemist Reviews, 38(2), 59-70.
9. Fradkin, J.E., et al. (2017). Clinical Guidelines for Nutrition in Diabetes: An Endocrine Society Clinical Practice. The Journal of Clinical Endocrinology & Metabolism, 102(10), 3676-3695.
10. International Diabetes Federation. (2021). IDF Diabetes Atlas: 10th Edition. Retrieved from [DiabetesAtlas.org](https://diabetesatlas.org).
The information provided here is a summary of current popular teachings regarding diabetes and serves as an educational resource. Further individualized review with a healthcare professional is always recommended for specific medical advice or management.