NAFLD Patients: A Case Study

Statins are also another type of medication prescribed if you have a high blood cholesterol level, this lowers cholesterol. This medicine blocks the formation of cholesterol and increasing the number of LDL receptors in the liver, which helps remove the LDL cholesterol from your blood. This helps slow the progression of CHD, and will make having a heart attack less likely. However, not everyone is suitable for this medicine.

I have chosen metformin to treat this patient and this medication is a biguanide. Metformin is currently the only medication in this class (Woo & Wynne, 2012). According to Woo & Wynne (2012), metformin is the first line treatment for type 2 diabetics in adults as a monotherapy (pg. 604). Metformin is appropriate as the first medicinal treatment of this patient’s diabetes. This is validated by the American Diabetes Association Standards of medical care in diabetes (2016) which states that if lifestyle changes have not affectively achieved glycemic goals, metformin is the recommended pharmacologic treatment (pg. 9).

Diabetes is a growing concern and health challenge for the American people (b). Diabetes is a condition in which the body cannot react to insulin appropriately or either cannot produce insulin efficiently (w). “Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications” (w). There are numerous forms of diabetes amongst the nation, however, there are three main forms of diabetes. Most people have heard of type one diabetes, type two diabetes, and gestational diabetes because they are common. Type two diabetes deals with a resistance to insulin, while

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

Based on 2014 hepatic encephalopathy guideline, NA’s hepatic encephalopathy is classified as type C and recurrent due to the cirrhosis and 2 episodes of HE occur with a time interval of 6 months or less. Typical signs and symptoms consistent with his HE includes confusion, forgetfulness, and anxiety. According to the guideline, the goals for the treatment are maintaining two to three bowel movements per day, decreasing elevated ammonia level, prevention of recurrent episodes of HE, and improvement of daily functioning. Lactulose is the first choice for treatment of overt HE. Currently, patient is on lactulose only once a day because of his noncompliance. The dose frequency is incorrect since he does not have at two to three bowel movements per day. Increasing frequency back to three times a day is recommended for the patient. Moreover, rifaximin is an effective add-on therapy to lactulose for prevention of OHE recurrence. Also, counseling the effects of lactulose and rifaximin, importance of adherence, early signs of recurring HE, and actions to be taken if recurrence are also beneficial for the patient.

Fish oil suppliments have been renounced by health care professionals as one of the best ways for patients to increase their chances of battling heart disease and hypertension. But until now, these claims have been unproven and untested. The National Institute of Health has stated that they would like to examine the benefits of fish oil suppliments in a larger study of previous examinations of this phenomenon.

Metoformin is a medication used to treat Type 2 diabetes. Metformin is classified as a biguanide and antidiabetic medication. Its therapeutic classification is an antihyperglycemic. Metformin, which is the drug’s generic name, is also known under its trade names: Fortamet, Glucophage, Glucophage XR, Glumetza and Riomet. Metformin is an oral hypoglycemic medication and has three main actions: Metofrmin increases the binding of insulin to insulin receptors in skeletal muscles and fat, which works to improve tissue sensitivity to insulin. Through this action, glucose is able to be transported into skeletal muscles and fat and the body is able to use glucose to function properly. Metformin also suppresses gluconeogenesis, which is the production of glucose from non-carbohydrate sources such as fat and protein. Metformin also prevents the liver from converting stored glycogen into glucose. All these actions work together to lower the level of blood sugar and also lower the Hemoglobin A1C value, ensuring diabetics have better control of their blood sugar.

prescribed to improve sensitivity of the body tissues to insulin so that the body uses

Metformin is a medication that works by decreasing the amount of glucose that the liver

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.

Incretins reduces gastric emptying and also inhibit glucagon release from the alpha-cells and improves the glycemic control alongside decreases the body weight and systolic blood pressure in type 2 diabetic patients [26]. Risk of hypoglycemia is low due glucose-dependent mechanism of action. Thus, incretin mimetics have become an important part for treating T2DM. Incretin based drugs include DPP-4 inhibitors and GLP-1 receptor agonists (Exenatide and Liraglutide).

The majority of children with NAFLD are asymptomatic. Occasionally patients may complain of vague abdominal pain, fatigue, or malaise, however, liver disease is usually found incidentally on physical exam or routine lab work1. Children may have mild to moderate hepatomegaly; however, the majority of these children are overweight or obese, making liver palpation a challenge. In addition to obesity and visceral adiposity, children with NAFLD often present with acanthosis nigricans on the back of their neck or intertrigenous areas, which is suggestive of insulin

Patient has a CVD (cardiovascular disease); can be exacerbated by having high cholesterol (could be the cause of his angina). Therefore, atorvastatin 80 mg was initiated for secondary prevention of CV

Insulin potentiation therapy is celebrated for being both safe and innovative in the field of cancer treatment. Best of all, unlike chemotherapy and other treatment methods, insulin potentiation therapy has minimal side effects and does not make patients feel nauseous, experience liver damage, or suffer from radical hair loss. I

One source of great mortality and morbidity in Europe and North America is the cardiovascular disease, Atherosclerosis. It is recognized as a chronic inflammatory disease of the intermediate and large arteries characterized by the thickening of the arterial wall and is the primary cause of coronary and cerebrovascular heart disease (Wilson, 2005). It accounts for 4.35 million deaths in Europe and 35% death in the UK each year. Mortality rate are generally higher in men than pre-menopausal woman. Past the menopause, a woman’s risk is similar to a man’s (George and Johnston, 2010). Clinical trials have confirmed that lipid accumulation, endothelial dysfunction, cell proliferation, inflammation matrix alteration and foam cell formation are