The Importance Of Diabetes

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

Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.

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

The study had an overall total of 1150 participants. Although there were many participants to begin with, they did not provide all of the feedback the researchers had requested.  This resulted in the expulsion of their participation, so their results were not included in the final reports of the study. The number of patients that did provide the essential information added up to a total of 901. The profile for a participant was a patients diagnosed with Type 2 diabetes in the last 6 months, but has been diagnosed no more than 10 years ago. They had to be between 35-70 years of age. Their BMI had to be more or less than 24 kg/m2 and have an HbA1c more or less than 6.5%. They also had to have treatment with a diet or oral glucose lowering medication. Those needing insulin shots, had been diagnosed with chronic diseases, or had a change in diet or lifestyle 3 months prior to the study were not included in the overall

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

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

Diabetes is a growing but preventable health concern in the United States.1 It is a problem in the body where blood glucose levels rise higher than normal.1 According to the facts released by the American Diabetes Association in 2013, 25.8 million Americans (8.3%) have diabetes 2 and approximately 90% of all cases of diabetes worldwide are considered type 2 diabetes.3 Type 2 diabetes is a progressive disease where the body cannot use insulin properly and the patient ends up using an oral hypoglycemic agent.1 One of the many classes of medications to help manage diabetes is sulfonylureas, including glyburide and glipizide. These drugs close K-ATP channels on Beta cell membranes and cause the pancreas to release more insulin to lower blood sugar.4 Both glipizide and glyburide are metabolized in the liver5, have high protein binding5, and can decrease hemoglobin A1c (HbA1c) up to 1%-2%.6 According to the Health Insurance Association of America, health insurance is defined as "coverage that provides for the payments of benefits as a result of sickness or injury".7 Insurance companies always strive to achieve their target glycemic goal via the most effective and cost effective therapeutic strategy.8 A literature search was conducted to find data on the benefits of converting patients from glyburide to glipizide to find out why insurance prefers the switch.

Diabetes is associated with an increased risk of developing primarily vascular complications that contribute to morbidity and mortality of diabetic patients. Poor glycaemic control leads to vascular complications that affect large (macrovascular), small (microvascular) vessels or both. Macrovascular complications include coronary heart disease, peripheral vascular disease and stroke. Microvascular complications contribute to diabetic neuropathy (nerve damage), nephropathy (kidney disease) and retinopathy (eye disease).

Diabetes has reached an epidemic proportion in the United States. Currently, the management of diabetes in the hospital is often considered secondary compared with the condition that prompted the inpatient admission (Clement et al., 2004). Hospitalized patients with diabetes suffer increased morbidity, mortality, length of stay and other related hospital costs compared to non-hyperglycemic patients. These negative healthcare outcomes are observed more frequently in hospitalized patients with newly discovered hyperglycemia (Umpierrez et al., 2012).

The evidence-based practice should be the force behind changes in medical and nursing practice especially when it is advantageous to patient's health. Moreover, this principle should always be the first requirement despite the financial hurdles we face these days. With that in mind, one of the obstacles which we are trying to overcome in my department is for the leaders to realize that treating diabetic patients with GLP-1 drugs has been proven to be cost-effective while providing greatest HbA1c and weight reductions comparing to other hypoglycemic agents ( ). Besides, those patients would ultimately have higher life expectancy and less microvascular and macrovascular complications leading to considerably improved lifestyle. Although our case

Opposing this American Diabetes Association and European Association published theorem against the use of rosiglitazone. Unfortunately, it had no impact and the drug was still in market. Moreover, in 2009 the annual sale baffled $1 billion. Further, the US Senate Committee on Finance disclosed the reports of analysis done by GSK and USFDA, Rosiglitazone Evaluated for Cardiac Outcomes and Regulations of Glycemia in Diabetes (RECORD). This study depicted a deficient and inconsistent data to allow or controvert the demonstration of risk of MI. Further ADOPT study and DREAM study were conducted. These two also certified that rosiglitazone is not showing significant side effect as CV or

There is growing concern that intense glucose lowering or the use of certain agents may be associated with adverse cardiovascular outcomes.

Pharmacological interventions used to improve glucose control include both oral glucose lowering agents and injectables including glucose like peptide & insulin. Apart from insulin the choice of available pharmacological interventions to treat diabetics has expanded rapidly over the past decade. Till date, the efficacy & safety of these therapies have not been well documented in people with diabetics & CKD.

Diabetes is one of the biggest epidemic crises of the 21century. Uncontrolled diabetes is associated with microvascular and macrovascular complications. Tight glycemic control has been linked to a reduction in the development of these complications in both type 1 and type 2 diabetes. The invention of Glucose Meter has changed the diabetes care by enabling patients to monitor their blood glucose level according to their diet, medications and activity. control of glycaemia within the established recommended values is a major therapeutic goal for diabetic patients both in the hospital and outpatient setting. Using of self monitoring of blood glucose 9SMBG0 devices will help diabetic patients detect, prevent or manage of hypo- and hyper

Diabetes is a systemic disease caused by a decrease in the secretion of insulin or reduced sensitivity or responsiveness to insulin by target tissue. (Beale, et al., 2011) The incidence of diabetes is growing rapidly in the United States and worldwide. An estimated 347 million people around the world are afflicted with diabetes. (Whalen, et al., 2012) According to World Health Organization (WHO), Diabetes prevalence among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014. It is the major cause of blindness, kidney failure, heart attack, stroke and limbic amputation. World Health Organization (WHO) projects that diabetes will be the 7th leading cause of death in 2030. It is a complex and costly disease that can affect nearly every organ in the body and result in devastating consequences. The leading cause of non-traumatic lower extremity amputations, renal failure, and blindness in working-age adults, diabetes is also a major cause of premature mortality, stroke, cardiovascular disease, peripheral vascular disease, congenital malformations, perinatal mortality, and disability. (Cefalu, 2000) Insulin therapy and oral hypoglycemic agents have demonstrated improvement in glycaemic control. However, Insulin therapy has some disadvantages such as ineffectiveness following oral administration, short shelf life, of the need for constant refrigeration, and fatal hypoglycaemia, in the event of excess dosage.