Discussion 1 (Everton)
- Diabetes, Glyburide, & Teaching Points of Oral Antidiabetic Agents
Explain the difference between diabetes mellitus type 1 and type 2.
Diabetes mellitus is a medical condition where the body is unable to regulate blood sugar levels. There are two types of diabetes mellitus: type 1 and type 2. Type 1 diabetes mellitus is when the pancreas is unable to produce insulin, which is a hormone that moves glucose from the bloodstream into the cells (Mayo Clinic, 2021). Without being able to produce insulin, glucose stays in the bloodstream resulting in an increase in blood sugar levels. According to Mayo Clinic (2021), treatment of type 1 diabetes mellitus consists of insulin, dieting or monitoring the intake of carbohydrates, fats and proteins, and improving one’s lifestyle, especially with exercising.
Type 2 diabetes mellitus is when the pancreas is not able to produce enough and does not use insulin properly and thus results in glucose staying in the bloodstream longer causing an increase in blood sugar levels (Mayo Clinic, 2021). According to Mato Clinic (2021), type 2 diabetes mellitus is treated typically through weight loss, a healthy diet, and exercising on a regular basis. However, if these lifestyle changes are not enough to manage one’s blood sugar levels, anti- diabetic medications will be needed. Pharmacological treatments to managing type 2 diabetes mellitus are metformin, which is an oral anti- diabetic medication that lowers the glucose production that comes from the lover and helps with improving the body’s sensitivity to insulin (Mayo Clinic, 2021). Other oral anti- diabetic medications used for type 2 diabetes mellitus are sulfonylureas, like glyburide, glipizide, and glimepiride (Mayo Clinic, 2021).
How does glyburide help decrease blood sugar levels?
According to Mayo Clinic (2021), glyburide is an oral anti- diabetic medication used for type 2 diabetes mellitus that helps the body release more insulin. In doing so, the body releasing insulin helps to move glucose out of the bloodstream and into the cells. With the glucose moving out of the bloodstream and into the cells, blood sugar levels decrease.
What are the key teaching points for patients taking oral antidiabetic agents?
For patients with type 2 diabetes mellitus, oral anti- diabetic medications are the first line of treatment. With these oral anti- diabetic medications, it is important to teach the patient to always pay attention to their bodies and monitor for signs or low blood sugar levels. Therefore, pay attention to signs of weakness, fatigue, dizziness, feeling jittery, blurred vision, and irritability (Mayo Clinic, 2021). Oral anti- diabetic medications can also cause an increase in weight; therefore, educating the patient on a healthy diet and exercise can not only help with managing their diabetes, but also to prevent any side effects occurring from these medications. It is important to educate the patient on continuously monitoring their blood sugar levels and to do periodic checks of their hemoglobin A1C levels to monitor whether their diabetes is being managed properly. In addition, to always ensure the oral medications are taken at the same time everyday with a meal and if any doses are missed, to take as soon as remembered. Emphasize to the patient that if they are unable to have anything to eat, to not take the medication at that time as it could cause their blood sugar level to become even lower.
References:
Mayo Foundation for Medical Education and Research. (2021, January 20). Type 2 diabetes. Mayo Clinic. Retrieved June 30, 2022, from https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199
Mayo Foundation for Medical Education and Research. (2021, March 27). Type 1 diabetes. Mayo Clinic. Retrieved June 30, 2022, from https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011 (Links to an external site.)
Collapse SubdiscussionRobinson, Lesing Dominique
Robinson, Lesing Dominique
TuesdayJul 19 at 4:42pm
Discussion 2( Dominique)
Type 2 Diabetes Mellitus
Type 1 vs Type 2 DM
In Type 1 Diabetes, the pancreatic cells responsible for producing insulin is destroyed and the body is not able to correctly regulate glucose level in the blood. Insulin acts as a key that unlocks the cells in the body glucose to be absorbed better into the cells. Glucose is stored in the liver and in the muscle tissues typically for energy and to ensure proper function of the organs in and on the body. Patients with Type 1 diabetes require injectable insulin typically right before or after eating a meal in order to absorb glucose from the food and preventing hyperglycemia. This disorder(Type 1 DM) is an autoimmune disease that may be acquired genetically or due to environmental, viral, or dietary factors (Basina, 2021). In Type 2 Diabetes, there is a disfunction in the way the body absorbs glucose mainly due to the reduction in the availability of insulin. This can be due to a disorder in the liver , pancreas, or muscle tissue that causes them to not be receptive to insulin. In both disorders, there can be an impairment in the pancreatic beta cells responsible for the production of insulin; in type 1, there is little to no production of insulin, and in type 2, there is production of insulin but some may have a decreased ability to unlock the cells. Both disorders can be treated with lifestyle changes such as diet and exercise , but typically type 1 diabetes patients requires insulin for their lifetime. The doctor may also add medications such as metformin which decreases the release of glucose from the liver along with injectable insulin. In type 2 diabetes, injectable insulin would only be required in case of uncontrollable hyperglycemia, but in majority of cases oral hyperglycemic medications such as metformin along with lifestyle changes regarding weight loss, dieting, and exercising will suffice (Piertrangelo, 2021).
Glyburide
Glyburide provides a different mechanism of action than that of metformin; It is in the drug class of sulfonlyureas. The mechanism of action of these drugs is to help the pancreas release insulin which decreases the amount of glucose in the blood. Common side effects include diarrhea, dizziness, headache, heartburn, nausea, gas, and weight gain. This drug is typically combined with diet and exercise to increase it effectiveness and to reduce the side effects associated with this medication. Adverse reactions that are considered life threatening includes an allergic reaction to the medication, hypoglycemia, liver issues, bruising, bleeding, and flu-like symptoms(University of Illinois, 2018). Certain vitamins and herbs, and alcohol can interact with glyburide; other medications such as heartburn meds (Cisapride), antibiotic medications (Clarithromycin), cancer medications (methotrexate), NSAIDs, and seizure medications can either increase or decrease the effects of glyburide (University of Illinois, 2018).
Patient Teaching
In the case of Ms. Jones, weight loss will be the number one lifestyle change that she will need to make. Being obese can cause certain disorders like fatty liver disease which can affect absorption and release of glucose in the body. The risk factors of Non-Alcoholic Fatty Liver Disease (insulin resistance, type 2 diabetes, high cholesterol, high triglycerides, and metabolic syndrome) all stem from obesity (Seladi-Schulmann, 2021). Improving her diet and becoming more active, which at her age can range from gardening to walking or even more cardiac healthy exercises, will be the next lifestyle changes. Regarding taking her medications, its not required for her to check her blood sugar often when taking oral hypoglycemic medication because it action does typically decrease blood sugar in a drastic manner. Glyburide typically taken 30 minutes before eating, but can also take a lower dose with or directly after breakfast (Hardin & Jacobs, 2021)
References
Basina, M. (2021, October20). What is type 1 diabetes? Healthline. https://www.healthline.com/health/type-1-diabetes-causes-symtoms-treatments
Hardin, M D., & Jacobs, T F. (2022, May 2). Glyburide. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK545313/
Piertrangelo, A. (2021, October 19). Understanding type 2 diabetes. Healthline. https://www.healthline.com/health/type-2-diabetes
Seladi-Schumann, J. (2021, November 11). What to know about fatty liver disease. Healthline. https://www.healthline.com/health/fatty-liver
University Of Illinois. (2018, February 16). Glyburide, oral tablet. Healthline. https://www.healthline.com/health/drugs/glyburide-oral-tablet
