Essay On Vitamin

Furthermore, with the pharma logical treatments included in this article for the treatment of Type 2 Diabetes, many individuals will be prevented from developing CVD complications. Studies have shown the importance of patients being compliant with treatment leading to positive health outcomes. With the continued care given to these patients with Type 2 Diabetes many are able to have healthier lifestyles

Type-2 Diabetes mellitus (T2DM) is a common disease worldwide. According to the American Diabetes association (ADA), 1808 million people in the United States have been diagnosed with diabetes, and another 7 million are thought to have the disease but have not been diagnosed. (Hilaire, Woods, 2013). This disease has impacted everyone in some way. It is a controllable disease; however many individuals choose not to control it or are uneducated on how to control it. Many people with type 2 diabetes (T2DM) also have hypertension, high cholesterol, obesity, lack of physical activity, poorly controlled blood sugars, and smoking. “Current evidence supports the concept that hyperglycemia significantly contributes to the development of both cardiovascular and microvascular complications of T2DM” (Chittari, McTernan, 2011). Cardiovascular disease (CVD) remains the leading cause of death in patients with diabetes mellitus, accounting for 50% of all deaths (Campbell & Hillman, 2010).

This project seeks to provide a brief overview of what a new drug has to go through before it hits the streetsstarting with the manufacture, preclinical or clinical trials, documentation, registration, review, approval, marketing, &distribution; focusing on tests they have to hurdle. Another aim would be to identifya drug that binds itself to the SGLT2 & inhibits its function. The researcher has found that Dapagliflozin of the Gliflozin class of antidiabetic medications is anSGLT2 inhibitor. This paper will define keywords, explain the action, enumerate preclinical &clinical trials that have to be undergone before the FDA deems it safe for human consumption; with the ultimate goal of getting the product approved, marketed, &distributed in the US& elsewhere. There are no participants [animal or human] in this report. This

These types of statistics, portraying the growth of diabetes diagnoses, have driven researchers and physicians to find diets, medications, and preventive measures for the disease. In reviewing the medications that are used to treat diabetes, their sometimes-severe complications should be noted. What’s more, none of them speak to the actual, principal source of developing diabetes. Therefore, research on preventive measures and diets have become popular.

Typically, multidrug regimens are necessary among patients with T2DM to manage hyperglycaemia and the associated risk factors of hypertension and dyslipidemia. In these patients, non-adherence is a major concern. It has been demonstrated that non-adherence is higher among patients with diabetes than those with other common conditions. Prospective studies show that 15–39% of patients are non-adherent to oral anti diabetic drugs. Although patients self-report a 94% adherence rate to sulphonylureas, the actual adherence rate found when electronic monitoring is used is around 75%. Another factor that may influence adherence is the complexity of the dosing regimen. A prospective assessment of self-reported medication adherence conducted in 11,896 individuals with T2DM revealed reduced compliance with twice daily and three times daily dosing compared with once daily dosing. Socioeconomic issues, ethnicity, patient education and beliefs, and poor social support are also predictors of non-adherence. Declining cognitive function, polypharmacy, and poor vision among elderly patients increase the risk

Diabetes patients all take a variety of prescription drugs. Some range from few medications such as insulin to many more medications to help control blood sugar and other side effects. There is a certain amount of difficulty concerning the search for generic medications for doctors to help patients get cheaper medications. “In 2014 for the fourth year in a row, spending on diabetes drugs was higher on a per-member basis than it was for any other class of traditional drug, according to the Express Scripts Drug Trend Report. Fewer than half of the prescriptions filled for diabetes treatments were generic” (People with diabetes are facing rising prices for life saving drugs, 2015, para 5).

Although the drug in question can be yet insufficiently researched, the disease it potentially treats is usually very well-known and its course understood. Information revolution enabled us to use statistics on large samples and multitude of studies to get reliable information on the probabilities of certain events and disease progression. For those diseases where we can claim with sufficient certainty that short periods without therapy will not significantly harm the subject’s health, the study can be designed to keep the placebo trial period short. This limits the quality of the obtained data only to the initial short-term

A meta-analysis of large randomised trials (CONTROL) showed that more intensive blood glucose control (average difference between intensive and standard care groups 9mmol/mol (0.9%)) showed some reduction in cardiovascular (CV) outcomes, mainly by a reduced risk of myocardial infarction (MI). The number needed to treat (NNT) to prevent one CV event is 119 (compared with NNT for blood pressure reduction of 34, and management of cholesterol of 44), hence the need to ensure that these patients have optimally managed blood pressure and cholesterol prior to adding in GLP-1 analogues for which we do not have evidence of patient oriented outcomes.

The management of diabetes mellitus (DM) is to eradicate symptoms and to minimize the development of complications (Khardori, 2014).The minimization of microvascular damages involving kidney and eyes can accomplished through managing glycemia and blood pressure (BP) (Khardori, 2014). The minimization of macrovascular damages, for examples: coronary, cerebrovascular, peripheral vascular, can be achieved by active control of lipids and hypertension (HTN), anticoagulant therapy, and glycemic control. The DM patient should maintain their glucose level close to near-normal levels of 90 to130 mg/dL and hemoglobin A1C (HbA1c) levels below 7% (Khardori, 2014). HbA1c should be evaluated every three to six months (Khardori, 2014).The DM patient’s BP should be maintained below 130/80 mm Hg, and even lower for the patient’s with DM nephropathy (Khardori, 2014). Low-density lipoprotein (LDL) goal of less than 70 mg/dL in patients with preexisting cardiovascular disease (CVD) or patients with the risk factors for coronary vascular disease (CVD) (Domino & Baldor, 2013).

Guidelines from the American Heart Association (AHA)/American Diabetes Association (ADA) [7] and the European Society of Cardiology [8] present different recommendations for individuals with diabetes depending on an individual 's risk profile. To identify patients who will benefit most from

Clinical trial data suggest there is an increase in the incidence of new-onset type 2 diabetes mellitus with statin use. Downregulation of glucose transporters by these drugs is the most probable mechanism. Nevertheless, despite diabetogenic risk, statins have more long term benefits which can outweigh the

Wow! Group C your case study was very thorough and educative. I concur with your treatment plan for all chronic disease the pt has. As you mentioned, metformin is the first line therapy for diabetes patients with uncontrolled A1c. During metformin therapy the pt should be monitored for lactose acidosis, symptoms include, abdominal pain, tachycardia, hypotension, tachypnea, and nausea (Edmunds & Mayhew 2014). Laboratory test to obtain include, lytes, ketones, lactate, blood pH, pyruvate, and serum creatinine. According to Edmunds & Mayhew (2014), metformin decreases a1c by o.9 to 1.4 %.

Metformin is the preferred treatment for type 2 diabetes based on the guidelines established by the American Diabetic Association (ADA, 2014, p. S20). The ADA recognizes that type 2 diabetes is a progressive disease that may require the addition of other pharmacological agents in addition to continued lifestyle modification to control hyperglycemia and to mitigate complications that may arise from type 2 diabetes. The ADA recommends the addition of other classes of medications once metformin with lifestyle changes alone are inadequate to meet treatment targets (ADA, 2014, p. S20). GLP-1 receptor agonists are one of the classes that may be used in addition to metformin and lifestyle modifications.

Sodium linked Glucose Co- Transporter-2 (SGLT-2) inhibitors form a new class of agents that act on the kidney by competitively blocking the SGLT-2 channels. These agents are approved by FDA to be used as monotherapy or in combination with Metformin, Sulphonylurea (SU), Pioglitazone, or insulin. The ADA practice guidelines have added SGLT-2 inhibitors as the first add on to Metformin along with other drugs like SU, Dipeptyl Peptidase 4 (DPP4) inhibitors, thiazolidinedione and basal insulin. SGLT-2 inhibitors also finds a place as a second add on drug after 2 of the other drugs are

Boehringer Ingelheim (BI) and Eli Lilly, manufacturers of empagliflozin (Jardiance) and empagliflozin/metformin (Synjardy)were the primary sources of funding for the study