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Explain the difference between diabetes mellitus type 1 and type 2.

Diabetes mellitus (DM) affected an estimated 415 million individuals worldwide in 2015 and is expected to rise to 642 million by 2040 (Lau et al., 2019). Diabetes mellitus, according to Arcangelo et al. (2020), is a clinically and biologically diverse group of conditions described as a chronic metabolic disease characterized by excessively increased plasma glucose as a result of either insulin insufficiency or cellular resistance to the action of insulin. A fasting plasma glucose of less than 100 mg/dL and a glucose tolerance test 2 hours post-load glucose result of less than 140 mg/dL are considered normal (Arcangelo et al., 2020). Additionally, a normal glycosylated hemoglobin level or hemoglobin A1C is 5.7-6.4 percent. The two forms of diabetes mellitus encountered in medical practice are Type I and Type II.

Type 1 diabetes mellitus (DM) is believed to be an autoimmune condition in which insulin-producing beta cells of the pancreas are destroyed. Insulin, a critical hormone that increases cellular absorption and utilization of glucose while also maintaining metabolic activities throughout the body, is secreted by beta cells (Arcangelo et al., 2019). Type I  1DM patients must have insulin replacement treatment for the rest of their lives. Diabetic ketoacidosis (DKA) occurs without insulin and is life-threatening (Lucier & Weinstock, 2022). Type I diabetes mellitus is one of the most common chronic illnesses in children, but it can strike at any age.

In type II DM, adipose and muscle cells become less responsive to the effects of insulin, or the pancreas manufactures less insulin than the body requires (Arcangelo et al., 2019).  Type II diabetes is the most prevalent type, accounting for over 90% of all occurrences of diabetes in adults. It is more common in the elderly, but it is increasingly observed in children, adolescents, and younger people due to poor lifestyle variables such as increased sedentary behavior, poor diet, and obesity. Hyperglycemia, insulin resistance, and other metabolic abnormalities such as high blood pressure (BP), aberrant lipid profiles, inflammatory responses, excessive coagulation, and excessive oxidative stress are symptoms of type II diabetes mellitus (Ughreja & Ughreja, 2019).

How does glyburide help decrease blood sugar levels?

Glyburide belongs to the sulfonylureas drug family, which is used to treat type 2 diabetes. Like other sulfonylureas in its family, Glyburide works by binding to sulfonylurea receptor 1 (SUR1) receptors in the membranes of potassium adenosine triphosphate (ATP)-dependent channels in the beta cells. After the cell is depolarized, sulfonylureas block these channels, releasing insulin (Arcangelo et al., 2017). Glyburide works by increasing the amount of insulin produced by the pancreas, which helps to lower blood sugar levels.

What are the key teaching points for patients taking oral antidiabetics?

The primary goal of DM treatment is to keep blood sugar levels within the target range. Self-monitoring of blood glucose is critical for assessing therapy response, according to Arcangelo et al. (2017). The drug should be taken at the same time every day. Patients must be informed that the drug aids in controlling hyperglycemia episodes but does not cure diabetes. The indicators of hyperglycemia and hypoglycemia should be explained to patients. Patients should also be informed about oral antidiabetics’ side effects, adverse events, and interactions and when to seek medical help. Patients should also be educated on lifestyle modifications, diet, and exercise.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2017). Pharmacotherapeutics for advanced practice: a practical approach (4th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins American.

Lau, L.-H., Lew, J., Borschmann, K., Thijs, V., & Ekinci, E. I. (2019). Prevalence of diabetes and its effects on stroke outcomes: A meta-analysis and literature review. Journal of Diabetes Investigation, 10(3).  https://onlinelibrary.wiley.com/doi/full/10.1111/jdi.12932.

Lucier, J., & Weinstock, R. S. (2022). Diabetes Mellitus Type I. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK507713/

Ughreja, R. A., & Ughreja, R. A. (2019). Type 2 diabetes mellitus, physical activity, yoga and telomere length: A literature review. Journal of Insulin Resistance 4(1).  https://doi.org/10.4102/jir.v4i1.52Links to an external site. .

 

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