Types of Diabetes and Pharmacotherapy

Diabetes is a major problem in the United States and affects millions of people who comprise children, adolescents, and adults. It can lead various alterations or life-threatening complications in case it is not treated in a timely and effective manner. Further, diabetes can cause disabilities or even mortality when not treated. The treatment of diabetic patients require pharmacotherapy for effective management, but lifestyle changes assist in delaying the complications associated with the condition. The paper explores the different types of diabetes along with the drug therapy for the management of type 1 diabetes to examine the preparation and administration of insulin.

 
 

Type 1 diabetes is also regarded as insulin-dependent diabetes. It is considered to be an autoimmune disorder, which develops when there is the destruction of the pancreatic beta cells. These cells assist in the secretion of insulin, which is important when it comes to the uptake of glucose by the cells and its subsequent metabolism within the body. Therefore, the impairment of the pancreatic beta cells interferes with insulin production and leads to the upsurge of body glucose. The prevalence of this type of diabetes is highest among people aged below 30 years. However, the autoimmune disorder can affect persons of all ages. The etiology of this disorder is linked to genetic susceptibility to the impairment of the pancreatic beta cells, the environment factors and autoimmunity problems. Type 2 diabetes also regarded as non-insulin dependent diabetes is another type of diabetes. It is different from type 1 diabetes in that its occurrence is as a result of reduced sensitivity of the muscle and adipose tissue to the activity of insulin. At times, type 2 diabetes is as a result of decreased manufacture of insulin in the pancreas. Unlike type 1 diabetes, it affects a majority of people aged above 30 years. Type 2 diabetes does not always require the use of insulin, which contrary to type 1 diabetes that renders patients insulin-dependent once diagnosed.

Gestational diabetes is another kind of diabetes that affects pregnant women and renders them glucose intolerant through the gestation period. Unlike the aforementioned types of diabetes, gestational diabetes is a short-term condition and blood glucose levels fall after child delivery. However, it increases the probability of the mother and the child acquiring diabetes mellitus. Juvenile diabetes is another variation of diabetes mellitus. It is type 1 diabetes that affects young child and adolescents. Just like type 1 diabetes, juvenile diabetes develops when there is little or no secretion of insulin, which interferes with glucose metabolism and causes the rise of glucose levels within the body. Unlike type 2 diabetes, a patient requires a regular infusion of insulin to lead a normal life. Juvenile diabetes rarely affects adults, and its prevalence is greatest in childhood and adolescence. It is similar to type 1 diabetes but different from type 2 diabetes taking into account its etiology. It is as a result of the autoimmune attack and damage of the beta cells located in the pancreas, which impairs insulin production.

The treatment of type 1 diabetes is a lifelong process that involves a daily use of insulin with the help of either insulin pump or insulin injections. Insulin therapy is appropriate for all patients who have type 1 diabetes, including individuals who cannot manage type 2 diabetes using exercise and diet. The drug therapy allows the patients with type 1 diabetes to control glucose metabolism and lead healthy lives, especially taking into consideration the complications that can result in the absence of insulin. The preparation of insulin takes into account the duration and onset of action of the drug. Semisynthetic insulin is a product of recombinant DNA technology and comprises amino acids similar to those present in the human endogenous insulin. It minimizes the possibility of patients experiencing local reactions. The lispro insulin is an altered version of the normal human insulin that is associated with rapid onset and fast action within a short time. The initiation of insulin therapy requires the individualization of patient doses. A basal insulin together with a bolus insulin provided approximately fifteen minutes prior to every meal is recommended for patients who have never received insulin therapy. It is recommended that patients who have type 1 diabetes receive at least two daily injections. In most cases, health practitioners prescribe a combination of either a short or rapid-acting insulin or intermediate-acting insulin. A combination of these types of insulin is recommended twice every day, more specifically fifteen minutes before taking breakfast and dinner.

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The recommended ratio of intermediate-acting to the rapid or short-acting insulin is 2:1 before taking breakfast with a ratio of 1:1 recommended before taking dinner. Patients who have type 1 diabetes should expend two-thirds of the recommended insulin dosage in the morning and the remaining dosage in the evening. Even so, the best approach to adopt when it comes to administering insulin is taking a basal insulin at least once every day. A bolus dose is taken before every meal. The adjustment of doses to suit patient needs and clinical response is carried out in increments of about 1-2 units. The administration of insulin glargine is carried out at bedtime, and the combination of this insulin type with another is discouraged. The insulin sensitivity factor and the 1500 rule assist in adjusting insulin dose. Patients should monitor the consumption of carbohydrates and eat nutritious foods, which have high fiber and low-fat content. Some foods comprise fruits, whole grains, vegetables, and limit the intake of animal products.

Type 1 diabetes causes weight loss and affects kidney function. It also impacts negatively on the functionality of the eyes, blood vessels, the heart, and the nervous system. On the long-term, the disease induces life-threatening complications, which comprise neuropathy, eye damage, nephropathy, cardiovascular problems, skin problems, and foot damage. The use of insulin is associated with increased incidence of allergic reactions, hypoglycemia, lipodystrophy, and hypokalemia.

In conclusion, diabetes affects children, adolescents, and adults of all ages. The various types of diabetes comprise type 1 diabetes, gestational diabetes, type 2 diabetes and juvenile diabetes. These types of diabetes have various differences. Type 1 diabetes, juvenile diabetes and Type 2 diabetes affect people of varying ages with high prevalence noted at specific age range. On the other hand, gestational diabetes affects expectant mothers. Unlike other types of diabetes, it is temporary. Insulin therapy is mandatory when treating patients who have type 1 diabetes and requires dietary restrictions for effective management of the condition.

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