Thread: RE: Discussion - Week 5: Initial Post

Running head: DIABETES

DIABETES 2

RESPOND TO  BOTH POST BELOW SEPARATELY who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management. PROVIDE 2 REFFERENCES EACH POST

POST 1

Anna Bide: Initial Post

Diabetes and Drug Treatments

Gestational, juvenile, type 1, and type 2 diabetes are the different ways through which diabetes can present it self. And also, Gestational diabetes mellitus (GDM) occurs during the second and third trimesters of pregnancy (World Health Organization 2021). Here, the blood sugar level is above average. However, it is beneath levels that may give a diabetes diagnosis. On the other hand, type I diabetes presents when the body has small amounts or completely lacks insulin. It is common in children and young adults and is often referred to as juvenile or insulin-dependent diabetes (Mayo Clinic Staff, 2021). Viruses and genetics lead to the condition. When the body shows signs of rebelling against insulin or cannot produce enough insulin, this is type II diabetes. Type 11 diabetes is lifestyle-oriented, and it develops slowly. It is chronic however, patients manage it with exercise and healthy diets. Type I and II diabetes often present with the same symptoms; increased thirst, fatigue, blurred vision, and extreme hunger.

Type I diabetes may result to life-threatening or disabling conditions. It may lead to kidney damages, diseases of the heart, and blood vessels among others. There is no treatment for the condition. Nevertheless, it is manageable by administering insulin all through the patient’s life (World Health Organization, 2021). The delivery of the insulin occurs through injections or insulin pumps. It is used in tandem with other approaches such as eating healthy foods; counting carbohydrates, fats, and proteins, and regular exercise. In the case of increased risks of cardiovascular events, aspirin helps to protect the heart. Cholesterol-lowering and high blood pressure medications are also used depending on the presentation of the disease (Mayo Clinic, 2021). Diabetes impacts blood glucose control. One short-term complication of juvenile diabetes is hypoglycemia which develops when there is an excess of insulin. It is vital to plan for insulin intake around meals and to regulate the amount of alcohol and other prescriptions such as aspirin as they cause hypoglycemia. In the long run, uncontrolled blood glucose levels will damage blood vessels leading to other significant complications.

References

Mayo Clinic Staff. (2021). Type 1 diabetes. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/diagnosis-treatment/drc-20353017.

World Health Organization. (2021). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes.

POST 2

RE: Discussion - Week 5: Initial Post

COLLAPSE

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Gestational Diabetes

Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance (Damm et al., 2016). Gestational diabetes is seen in pregnant women (CDC, 2020). This type of diabetes is found in women who did not have diabetes prior to pregnancy. This type of diabetes is usually detected in the middle of pregnancy (CDC, 2020). Most women are tested around 24-28 weeks. If gestational diabetes is not controlled, it can lead to complications with the newborn. Gestational diabetes will lead to an overfed baby that grows to large known as macrosomia (CDC, 2020). With that being said larger babies can lead to problems during delivery for the mother and the baby. Mother’s typically require a cesarean section which requires a longer recovery.

TREATMENT

Medication is necessary only if the blood sugar levels are uncontrollable with moderation of diet and exercise. The treatment of choice for Gestational diabetes is oral antihyperglycemic medication with insulin or the use of either one alone. The treatment of GDM can prevent short-term maternal and neonatal complications (Guo et al., 2019). Insulin has always been considered the therapy of choice for GDM and has been reinforced by the ADA (Guo et al., 2019). Insulin does not cross the placenta and lowers blood glucose by inhibiting glucose production release by the liver and stimulating peripheral glucose uptake (Guo et al., 2019). This treatment requires multiple daily injections and patients must be trained to do so. Patients have to also be educated on the potential weight gain and higher medical cost for treatment (Guo et al., 2019). Eating a healthy diet is no different than any other individual. Making sure to get enough fresh fruits, vegetables, and protein while avoiding processed foods.  Insulin requires close supervision of blood sugar prior to administering. The downfall of Insulin is that 70% of women experience hypoglycemia at some point during pregnancy (Guo et al., 2019). Metformin decreases the chance of neonatal hypoglycemia at birth vs the use of insulin to treat GDM (Guo et al., 2019).

SHORT TERM AND LONG TERM COMPLICATIONS

Women who develop gestational diabetes are at risk of developing Diabetes type 2. 50 % of mothers with GDM will develop diabetes within 10 years (Damm et al., 2016). They are required to have a glucose test done at least 6 weeks after delivery to monitor their glucose levels. Complications in offspring have been reported to show long-term metabolic complications (Damm et al., 2016). The underlying pathogenic mechanisms is unknown for the metabolic risk profile in children born to mothers diagnosed with GDM (Damm et al., 2016). GDM can also lead women to increased risk of pre-eclampsia during pregnancy and comorbidities such as cardiovascular diseases during pregnancy (Chang et al., 2016).  Children who are born to women with GDM are likely to develop childhood obesity (Zhang et al., 2016). These children are at high risk of developing autism and having a lower IQ (Zhang et al., 2016).

REFERENCES

Centers for Disease Control and Prevention (CDC) (2020). Pregnancy. Gestational Diabetes and Pregnancy. Retrieved from https://cdc.gov/pregnancy/diabetes-gestational.html

Damm, P., Houshmand-Oeregaard, A., Kelstrup, L., Lauenborg, J., Mathiesen, E., Clausen, T.  (2016). Gestational diabetes mellitus and long-term consequences for mother and offspring: a view from Denmark. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27174368

Guo, L., Ma, J., Tang, J., Hu, D., Zhang, W., Zhao, X., (2019). Comparative Efficacy and Safety of Metformin Glyburide, and Insulin in Treating Gestational Diabetes Mellitus: a Meta-Analysis. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31781670

Zhang C., Rawal, S., Seng Chong, Y, (2016). Risk Factors for gestational diabetes: is prevention possible. Retrieved from https://pubmed.ncbi.nih/gov/27165093

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