Improving the Guidelines for Combination Therapy for Type II Diabetes Patients

Diabetes can be treated in three basic ways: by diet, by diet in conjunction with tablets, or diet in conjunction with insulin. Diet serves as an initial control for non-urgent patients. If a person’s diet will have a major effect on glycaemic control, it does so reasonably quickly, within a few weeks of changing

This article discusses the use of dulaglutide and sitagliptin in the management of type 2 diabetes. Dulaglutide is a recombinant GLP-1 Fc fusion protein, which acts by linking GLP-1 analog peptide and a variant of lgG4 Fc fragments in humans. As such, the analog of GLP-1 has posed effects and has shown elevated efficacies in the management of type 2 diabetes. The primary efficacy in the baseline of HbA was altered during the end of 52nd week. The objective of secondary efficacy included a change in HbA during the end of the 26th and 104th week. The percentage of patients achieved HbA targets ranged between 7.5% to 6.5% in a central laboratory and the body changed significantly. However, current treatment majorly focuses on increasing

A person with type 2 diabetes may be treated with insulin as well as an oral hyperglycaemic drug. Discuss why this combination may be prescribed.

Everybody knows that obesity is a big factor in developing type-2 diabetes, and that part of coping with this metabolic disorder is lifestyle change. If blood glucose does not go down, then medicines are introduced. Some type-2 diabetics even have to administer insulin in order to keep their blood glucose levels

The member has an approximate 8 year 6 month history of Type 1 Diabetes that is managed with continuous subcutaneous insulin infusion (pump) therapy.

The mainstay of type 2 diabetes medication is Metformin due to the cost, safety of the medication and limitied side effects. Metformin reduces glucose levels through two pathways; it reduces hepatic glucose production and increases the insulin tissue sensitivity. Monotherapy is normal for this medication; however, it can be utilized in combination with other medications. Metformin used in conjunction with Sodium glucose cotransporter provides a greater control over the level of glucose in the body due to the reduction of glucose production, increase in sensitivity, reduction of reabsorption of glucose and the excretion of glucose through the kidneys, basically the glucose control is through 4 different pathways making it a synergetic effect on diabetes type 2. According to Inzucchi et al.(2016), the combination of these medications helped patients reduce their overall A1c (0.5-1.0), lose weight (2kg) and a reduction in their blood

Type 1 diabetes is a serious chronic condition that tends to arise prior to adulthood. The disease requires substantial lifestyle changes in order to cope, and can lead to several debilitating outcomes if left unchecked. According to the American Diabetes Association ([ADA], 2017), Type 1 diabetes is defined as a chronic condition where the body no longer produces the insulin hormone, and is therefore unable to utilize and store glucose. As a result, individuals with Type 1 diabetes may experience excessively high or low blood glucose levels: hyperglycemia and hypoglycemia respectively (ADA, 2017). Both sides of the spectrum can have devastating effects on the body’s cardiovascular and renal activities, in addition to deteriorating the peripheral

It is no secret that Diabetes type II is rapidly becoming a public health problem that is attacking epidemic proportions worldwide. In fact, according to an online article by the Washington post titled, “CDC Says Diabetes Numbers Increasing,” Author Stein, Rob claims that the federal Centers for Disease Control and Prevention has estimated that as of the year 2012, approximately 26 million Americans were clinically diagnosed with type II diabetes. Not to be confused type I diabetes however. Type I diabetes is where the body is typically insulin-dependent as beta cells are constantly attacked and destroyed by the immune system. Type II diabetes on the other hand, is where the body, may or may not make enough insulin; a hormone that serves to regulate the movement of sugars into the cells, and if it does make enough insulin, the body tends to not respond to it properly. In other words, one suffering from type II diabetes does not convert sugar into energy, but rather stores it in their bloodstream. This has caused type II diabetes to be the most common form of its type. As a result, those who suffer from type II Diabetes normally result in extra body-fat, hypertension, and high cholesterol.

This question warrants investigation as T2DM is a gateway disease. Overtime, the disease progresses to affect other bodily functions, harming both an individual’s physical and psychological well-being. For example, T2DM is responsible for higher risks of neuropathy, low bone density, hypertension, heart disease, lower limb amputations and vision and hearing loss, as well as psychological disorders such as depression and dementia. According to 2015 statistics from the American Diabetes Association, T2DM is the 7th leading cause of death in the United States, contributing to 332,341 US deaths. However, treatments that address the causes of T2DM are more prudent than current treatments which focus on mitigating the complications that arise

Type II Diabetes Mellitus (DM) is a chronic disease that influences the physical and social aspects of life for millions of people living in New York City (NYC). The excess accumulation of glucose in the blood caused by this disease can lead to the breakdown of many organs in the human body leading to increased hospitalizations and mortality. Although diabetes is a manageable disease given the appropriate care and education, the disease and its complications disproportionately affect African-Americans or non-Hispanic blacks then any other ethnic group in NYC. The NYC Department of Health & Mental Hygiene (DOHMH) reports death rates among black New Yorkers are higher than among whites, regardless of neighborhood income. There is a significant number of non-Hispanic blacks afflicted in low-income neighborhoods due to the environmental injustices such as lack of fresh food options, neighborhood poverty, and limited recreational space for physical activity and exercise. With lifestyle modification as the mainstay of treatment, recognizing the environmental deficiencies and rectifying these problems at the local and federal levels will help to decrease this health disparity.

Considerable advances in the past treatment of type II diabetes include the application of lifestyle intervention and prevention efforts aimed at delaying development of glucose intolerance in order to evade diabetes and the progression of new curricula of glucose in the blood-lowering prescriptions to appendage current treatments (DeFronzo, 2010) (Mazzola, 2012). Presently, the control and maintenance of type II diabetes centres on control of glucose by the decrease of haemoglobin and glucose in the blood (DeFronzo, 2010). Current treatment strategies focus on the progression of therapeutic factors that affect the defects contributing to type II diabetes and thus, provide sustainable glucose control through a delaying of disease development

The FDA has not approved use of this medication with type 1 diabetes. With type 1 or Juvenile diabetes the immune system destroys the cells that release insulin, which will eventually eliminate insulin production from the body. (WebMD, 2014) This medication is also not approved for use in those with decreased kidney function due to the effects on the GFR.

Patients may benefit from early treatment with basal insulin added to oral antidiabetic drug (OAD) through early glycemic

For many type 2 diabetic patients, lifestyle modifications with a combination of metformin is not effective. For improved individualized HbA1c targets, a combination of metformin and a secondary therapy is recommended. (5) Although this therapy is recommended, many healthcare providers recommend patients to use a dual or triple oral therapy before choosing to use injectable basal insulin and a GLP-1 in order to reach the desired individualized targets.

Despite a wide variety of available treatment options, management of T2D continues to be challenging. A considerable number of patients fails to meet the primary treatment targets outlined above. Only 52% of patients reach the recommended HbA1c concentration of <7.0%, for example (13). These significant unmet clinical needs are due both to the progressive nature of the disease and to the shortcoming of the existing therapies, with weight gain and hypoglycemia (too low level of blood sugar) in the first instance.