Diabetes mellitus affects millions of people across the globe every day by producing dangerous balances of sugars in the blood stream and body cells. There are three distinct types of diabetes with their own pathophysiology and, therefore, their own drug treatments.
Type 1 diabetes was previously known as insulin-dependent diabetes or juvenile diabetes. This chronic condition occurs when the pancreas does not produce enough or any insulin. This hormone is needed to permit glucose to enter cells in order to produce energy. Instead, glucose is trapped in the bloodstream. Type 1 diabetes can be caused by genetics and exposure to particular viruses. Generally the disease presents in childhood, hence the name juvenile diabetes, but it can begin as last as adulthood in some cases. Signs and symptoms include increased frequent urination, thirst, bedwetting in children who previously didn’t, unintended weight loss, extreme hunger, irritability and other mood changes, fatigue and weakness, blurred vision, and vaginal yeast infection in women.
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"Different Types of Diabetes Mellitus".
Even though there has been extensive research into the disease, there currently is no cure for type 1 diabetes. Modern research has allowed these patients to live longer, and healthier lives than previously as there are now updated treatment options. For people with type 1 diabetes, since their bodies to not produce the amount of insulin necessary, taking injectable insulin will be a life-long necessity. Managing these levels is also done with counting carbohydrates, frequently monitoring blood sugar levels, eating healthier food options, and regularly exercising .
Keeping blood sugar levels as long to normal as possible, without spike should be the goal. Daytime levels before meals should be between 70 and 130 mg/dL and after meal levels should not exceed 180 mg/dL two hours after a meal .
Type 2 diabetes is the most common form. While type 1 diabetes is caused by the lack of insulin being produced by the body, type 2 diabetes is characterized by the body no longer being able to use insulin. Because glucose is not allowed to enter the cells, and the blood sugar level starts to rise, the pancreas attempts to counteract and produces more insulin. Eventually, the pancreas simply cannot keep up, and blood glucose levels continue to rise. This leads to cells which do not have enough energy to function properly. Increased levels of sugars in the blood can damage the eyes, nerves, kidneys and heart musculature. There are some ethnic groups which are more vulnerable to type 2 diabetes than other. These include African American, Native American, Asian American and Pacific Islander, and Latino populations .
Treatment for some people with type 2 diabetes can be completed with lifestyle changes, primarily losing weight, becoming active, and eating healthier diets. Without extensive lifestyle changes, type 2 diabetes often progresses, and medications will be necessary over time. Other people will require the use of oral medications and the administration of insulin. There are many options for oral medications. Metformin improves the body’s sensitivity to insulin and lessens the production of glucose in the liver. Sulfonylureas assists the body in secreting insulin Meglitinides are similar to sulfonylureas but are more faster-acting. Thiazolidinediones are similar to metformin but have more side effects and risks. DPP-4 inhibitors assist in the reduction of blood sugar levels but are not highly effective. GLP-1 receptor agonists slow down the digestion process which in turn lowers blood sugar levels. The final class of type 2 diabetes drugs are SFLT2 inhibitors. These drugs force the kidneys to excrete sugar in the urine instead of reabsorbing it into the blood .
The third type of diabetes is gestational diabetes. This occurs in pregnant women who were not previously diabetic. It usually begins around the middle of pregnancy. The causes of gestational diabetes are not entirely understood. It is thought that hormones which are produced by the placenta can block insulin from acting correctly on the mother’s body via insulin resistance. Complications of gestational diabetes include an extra large baby, the need for a cesarean section, preeclampsia, and hypoglycemia .
Treatments for gestational diabetes are similar to the other types when it comes to living a healthy lifestyle, losing weight, and eating well. Drug treatments include glyburide which is an oral medication which stimulates the pancreas to produce more insulin. This drug does not cross the placenta, so it is safe to use without affecting the fetus. Metformin is also recommended. While this drug does cross the placenta in minuscule amounts, it has been found to not cause any damage to the fetus. Insulin injections are also an option to control gestational diabetes .
Diabetes mellitus is categorized in three ways due to the reason that blood sugars are not able to move into the body cells that need it for energy. In type 1, the pancreas does not supply any or enough insulin. The only way to treat this is through insulin injection to supplement. Type 2 is a situation where the cells are unable to utilize the glucose. Different oral medication is available to treat it. Similarly, gestational diabetes occurs in pregnant women, possibly due to placental hormones. Each type the diabetes mellitus benefits from losing weight, eating healthy, and getting active.
- American Diabetes Association. (2015). Facts About Type 2. Retrieved from American Diabetes Association: http://www.diabetes.org/diabetes-basics/type-2/facts-about-type-2.html
- Centers for Disease Control and Prevention. (2010, June 7). Gestational Diabetes and Pregnancy. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/pregnancy/diabetes-gestational.html
- Haines, C. (2009, July 29). Oral Medications for Gestational Diabetes. Retrieved from Everyday Health: http://www.everydayhealth.com/gestational-diabetes/oral-medications-for-gestational-diabetes.aspx
- Mayo Clinic Staff. (2014, August 2). Type 1 Diabetes. Retrieved from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/basics/treatment/con-20019573
- Mayo Clinic Staff. (2014, July 24). Type 2 Diabetes. Retrieved from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/type-2-diabetes/basics/treatment/con-20031902
