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Diabetes and Drug Treatments
Differences between Types of Diabetes
The first type of diabetes is Type 1 diabetes, which affects approximately 5-10 percent of all people diagnosed with this disease. This is an autoimmune disease most frequently met in children and young people under 20. The pancreas of such patients is unable to produce insulin, or its quantity is insufficient. The cause of the condition is unclear. There are scholars who believe that Type 1 diabetes is genetic, and the cells of the pancreas are not developed properly – therefore, their functioning is impaired.
However, there are also those who think that the major cause of the condition is a virus that affects the pancreas, destroying its cells. The disease is incurable, and patients who suffer from it need insulin shots or a pump for life (coupled with proper nutrition to prevent blood sugar fluctuations) (Atkinson, Eisenbarth, & Michels, 2014). This type is sometimes referred to as juvenile diabetes.
The second type, Type 2 diabetes, is not inborn and is typically found in elderly or overweight people (adult-onset). Yet, the number of cases of children and young people diagnosed with this type is on the rise, mainly due to fast food and inactivity. This is the most frequently met of all types of diabetes (90% cases). The key difference from the previous type is that the pancreas of patients produces insulin (although its amount can also be insufficient), but the body cannot use it in a proper way.
Furthermore, unlike Type 1, Type 2 diabetes is a lifestyle disease as it mostly appears in obese people who lead a sedentary life. This implies that it can be prevented (Kahn, Cooper, & Del Prato, 2014). However, it must be noted that heredity and age also range among the risk factors.
The third type is gestational diabetes, which affects pregnant women (usually during the second trimester) and is met in 4% of all cases of diabetes. Unlike the types described above, this condition disappears after the baby is delivered (although it is likely to appear in the next pregnancy). The older the woman is when she gets pregnant – the higher the risk of developing gestational diabetes. This condition also increases the patient’s risk of having Type 2 diabetes (Moyer, 2014).
Treatment of Type 2 Diabetes
Metformin is one of the most common drugs prescribed for patients suffering from Type 2 diabetes. For proper preparation for metformin administration, the patient needs to lose weight and become more physically active since otherwise, blood sugar cannot be lowered. They also need to be tested for glycosylated hemoglobin, blood glucose, hematologic parameters, and renal function and informed about the risk of lactic acidosis. The administration starts from 850 mg once a day or 500 mg twice a day (the response is visible at doses above 1500 mg). The medication is given with meals (Lalau, Arnouts, Sharif, & De Broe, 2015). The diet must be plant-based, high in fiber, and low-fat to ensure due blood sugar control. Simple sugars must be excluded. Excess of body iron is also to be avoided.
Short-term effects of Type 2 diabetes include increased thirst, fatigue, frequent need to urinate, pain in the feet and hands, etc. In the long term, the disease damages all body systems. Diabetes leads to coronary heart disease, elevated blood pressure, diabetic retinopathy, sexual dysfunction, digestive problems, slow wound healing, sexual dysfunction, high cholesterol, diabetic nephropathy, etc. Since the body of the affected is unable to use insulin properly, diabetes medications are aimed to increase its sensitivity to insulin. As a result, the hormone is used more effectively (Kahn et al., 214). Furthermore, they prevent the liver from excessive production of glucose.
Fibromyalgia
Fibromyalgia is a condition that causes musculoskeletal pain, memory loss, fatigue, mood issues, headache, depression, irritable bowel syndrome, anxiety, and sleep disturbances, which may result from surgery, trauma, psychological stress, or infection. The disorder is more commonly met in women. Other risk factors include family history (an individual is more likely to develop the condition if a relative has it) and other disorders (such as rheumatoid arthritis, osteoarthritis, etc.) (Clauw, 2014). Fibromyalgia is currently incurable but can be relieved with relaxation, exercise, and other stress-reducing measures.
The disease is managed by different types of medications. First and foremost, pain medications are administered to deal with muscle spasms, pain, and fatigue. Antidepressants (duloxetine and milnacipran) are block pain signals. Patients can also be recommended to take serotonin inhibitors. Anti-epileptics are required to slow down nerve signals (lyrics and Neurontin are often prescribed for this purpose).
Benzodiazepines relax muscles, help relieve tension, and improve the quality of sleep (valium is the most common one). The same function is performed by muscle relaxants (such as Flexeril and cycloflex). Non-narcotic analgesics (tramadol) kill pain; however, they are not as strong as narcotic analgesics (opioids), which are used only when other drugs are ineffective (Häuser, Walitt, Fitzcharles, & Sommer, 2014). Finally, over-the-counter painkillers can be added to other types of drugs.
Gender is one of the major factors that impact the effects of medications. As has already been mentioned, the disorder is more common in women. They have more symptoms, and their discomfort lasts for longer periods, which requires an increased dosage and prolonged treatment. Women have up to 18 tender points (as compared to 6 points in men). This accounts for the fact that over-the-counter painkillers are often ineffective for female patients. They are also more sensitive to antidepressants and are likely to develop side effects (Clauw, 2014). One of the ways to reduce them is doing yoga, which teaches relaxation techniques, increases muscle strength, and helps with headaches.
References
Atkinson, M. A., Eisenbarth, G. S., & Michels, A. W. (2014). Type 1 diabetes. The Lancet, 383(9911), 69-82.
Clauw, D. J. (2014). Fibromyalgia: A clinical review. Jama, 311(15), 1547-1555.
Häuser, W., Walitt, B., Fitzcharles, M. A., & Sommer, C. (2014). Review of pharmacological therapies in fibromyalgia syndrome. Arthritis Research & Therapy, 16(1), 201. Web.
Kahn, S. E., Cooper, M. E., & Del Prato, S. (2014). Pathophysiology and treatment of type 2 diabetes: Perspectives on the past, present, and future. The Lancet, 383(9922), 1068-1083.
Lalau, J. D., Arnouts, P., Sharif, A., & De Broe, M. E. (2015). Metformin and other antidiabetic agents in renal failure patients. Kidney International, 87(2), 308-322.
Moyer, V. A. (2014). Screening for gestational diabetes mellitus: US Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 160(6), 414-420.
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