Type II Diabetes in Evidence-Based Pharmacology  Essay Assignment paper

Type II Diabetes in Evidence-Based Pharmacology  Essay Assignment paper

Type II Diabetes in Evidence-Based Pharmacology  Essay Assignment paper

Today, diabetes is a serious public health concern that bothers millions of people around the whole world. In the United States, approximately 30.3 million people have diabetes as their primary diagnosis, with only 23.1 million people who are diagnosed and 7.2 million people who are not diagnosed because of their unawareness or poor awareness of this disease’s peculiarities (Centers for Disease Control and Prevention, 2017). There is also one interesting fact that the same number of people, 23.1 million, includes the adults who are aged 65 years or older and have prediabetes. Diabetes mellitus type 2 accounts for 95% of all cases of this disease. By 2035, the population with type II DM is expected to rise to 592 million (Pradeep & Haranath, 2014). Type I diabetes is not as frequent as type II, and it is usually observed among children and adolescents who are younger than 20 years. In this paper, diabetes mellitus (DM type 2) will be reviewed through a synthesis of relevant information about its pathophysiology, genomic issues, diagnosis, and treatment to develop an effective care plan with appropriate follow-ups and referrals for diabetes patients. Type II Diabetes in Evidence-Based Pharmacology Essay

Pathophysiology

Diabetes mellitus is a metabolic disease that is characterized by a high blood sugar level that tends to increase due to insulin resistance or an insufficient insulin secretory response (Pradeep & Haranath, 2014). Type II DM is a major type of diabetes, and 8.3% of adult patients have it. The review of its pathophysiology is one of the first steps to be taken to comprehend its urgency and identify as many effective treatment approaches as possible. Insulin secretion and resistance are two important processes in pancreatic beta cells. Obesity or overweight is defined as one of the possible causes of type 2 diabetes because this condition leads to an increased level of free fatty acids and amino acids in plasma (Kahn, Cooper, & Del Prato, 2014). As a result, glucose can neither be produced to its full extent nor be transported to muscle cells, causing insulin resistance in a short period. Type II Diabetes in Evidence-Based Pharmacology Essay

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The production of fat cells also leads to lipid breakdown and an increased level of glucagon in the blood (Pradeep & Haranath, 2014). The release of glucagon promotes the development of hyperglycemia and unpredictable and uncontrollable changes in α-cells and β-cells. The work of the central nervous systems, as a key regulator of a metabolic process, undergoes certain changes as well. One of the nervous system’s functions is to control the level of glucose in the blood through neuronal input. The vagus is the nerve that is responsible for insulin secretion, and its destruction influences hepatic glucose production and promotes lipid accumulation.

In general, the pathophysiology of glucose metabolism in DM type 2 may be developed in four different ways: an increased production of glucose in the liver, increased carbohydrate intake, a decreased peripheral glucose intake, and decreased insulin secretion. Regarding the age continuum for the chosen disease, these problems may be developed in different ways. It is suggested to separate early-onset DM type 2 into two types of patients: pediatric (younger than 19 years) and adult (older than 19 years) (Wilmot & Idris, 2014). For example, type II DM diagnosis may be associated with a myocardial infarct in patients younger than 45 years. Frailty progression is usually observed in the elderly until the end of life. Type II Diabetes in Evidence-Based Pharmacology Essay

Genomic Issues

Despite numerous approaches to understanding the pathophysiology of type II DM, this disease is still poorly investigated from a genomic point of view. The results of various genome-wide association studies, it is possible to investigate the genetic basis of type II DM and the reasons for patients’ vulnerability to this disease (Mahajan et al., 2014). Many researchers tie the prevalence of this disease to the raised rates of obesity among the population, high energy intake, a lack of physical activities, and such crucial risk factors as ethnicity or family history (Wilmot & Idris, 2014). Genetic predisposition to diabetes is a crucial aspect, especially when it interplays with certain environmental factors. Type II Diabetes in Evidence-Based Pharmacology Essay

Linkage analysis is used when it is necessary to detect rare genetic loci and get a patient prepared for any possible complications. Considerable progress in genetic knowledge cannot be neglected. BMI values were used to identify the connection between the risk of diabetes and the risk of obesity. The effects of visceral fat accumulation were discovered. New metabolic factors were introduced to explain the connection between β-cells and insulin-sensitive tissues (Kahn et al., 2014). However, many fields remain to be unknown and unexplained. It is necessary to investigate such concepts as an allelic spectrum, pleiotropy, and appropriate loci of genes in regards to their biological relevance and insight. Type II Diabetes in Evidence-Based Pharmacology Essay

Literature Review: Data Collection

One of the most important aspects of current research is to collect the needed information properly. All facts and findings have to be credible and up-to-date. In this case, web-based data was collected to develop a systematic literature review. Such databases as Medscape, PubMed, and PsycINFO were utilized to gather the required number of scholarly articles from different academic journals. GoogleSholar was chosen as the main search engine in this project. To save time and find the necessary material, several excluding details were added. First, the period of publication was established: the last seven years (from 2010 to 2017). Second, the location was specified (the US sources). Finally, several keywords, including “type 2 diabetes”, “diabetes mellitus”, “US population”, “diagnosis”, “treatment”, and “patient care” were used. They were combined in different ways to find articles that can be used to cover different points of the current paper. Type II Diabetes in Evidence-Based Pharmacology Essay

To introduce the latest electronic clinical tools and guidelines, it was decided to address the International Diabetes Federation (2017) and their recent clinical practice recommendations that could be used for managing type 2 diabetes. The choice of such a source is explained by the necessity to investigate various approaches to diabetes treatment and utilize recent information about diabetes, its prevalence, and care plans.

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Disease Basics and Treatment: Literature Review

Type II DM is a chronic disease that has to be properly diagnosed and treated under long-term expert attention. Many complications and threats to life can be observed in diabetes patients. During the last several years, diabetes took the seventh position on the list of the diseases that might lead to death among the American population (Tucker, 2017). There is also a condition that is called “prediabetes” when the level of blood sugar is higher than normal, but not high enough to be a sign of type 2 DM. Prediabetes may be treated with the help of lifestyle changes so that no serious pharmacological interruptions are necessary. In the United States, the total estimated cost of diabetes and prediabetes was $245 billion ($176 billion on direct medical expenses and $69 billion on reduced productivity) in 2012 (Slabaugh, Curtis, Clore, Fu, & Schuster, 2015). Still, many people are unaware if they might have diabetes, who do not know about its main symptoms, and who cannot understand when it is time to address a doctor and be checked for this disease. Type II Diabetes in Evidence-Based Pharmacology Essay

Among the most frequent symptoms of type 2 DM, there are frequent urination, excess thirst, constant hunger, unexplainable weight loss, blurred vision, fatigue, and the changes of skin color (Pradeep & Haranath, 2014). Sometimes, people are confused by such signs and believe that they suffer from depression or some kind of insignificant infection. However, it is necessary to remember that diabetes is dangerous due to the possibility of the immune system to destroy cells which are responsible for the production of insulin. The body becomes unable to protect itself, and a healing process slows down promoting the development of new infections (Pradeep & Haranath, 2014). Insulin resistance makes it impossible to move glucose through cells. Glucose is the source of energy, and instead of sharing this energy with other blood cells, it promotes the creation of new bloodstreams with a high blood sugar level. Such dysfunctions may occur because of the presence of at least one risk factor and lead to serious complications. Type II Diabetes in Evidence-Based Pharmacology Essay

Potential complications type II DM patients may suffer from include kidney and liver problems, cardiovascular diseases, nerve damage, problems with eyes or hearing, and a poor skin condition (Billings & Florez, 2010; Slabaugh et al., 2015; Wilmot & Idris, 2014). Intensive therapy and the presence of pharmacological and non-pharmacological treatment are important inpatient care. However, before, a patient should be tested to make sure that diabetes type 2 is a correct diagnosis. As a rule, such tests are offered: Random/fasting plasma glucose tests to measure the level of blood glucose, glycated hemoglobin test to identify the level of glucose during the last three months, and oral glucose tolerance test to check the level of sugar in the blood (Pradeep & Haranath, 2014). Treatment is based on the use of such medications as insulin, sulfonylurea, metformin, or different inhibitors to reduce the level of blood sugar.Type II Diabetes in Evidence-Based Pharmacology Essay

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