Based on Arcangelo& Peterson (2013), diabetes or diabetes mellitus refers to a clinically and genetically heterogeneous group of disorders associated with high blood sugar levels due to either the deficiency of insulin or cellular resistance to the insulin action. Diabetes prevalence has been growing at significantly high rates, and it is no longer associated with predominantly wealthy nations. Research reports presented by the World Health Organization in 2014 indicate that approximately 422 million adults all over the world have diabetes. The low and middle-income countries have recorded the highest increase in prevalence rates compared to the high-income nations.
Diabetes is classified into four different types. Type 1 diabetes is believed to be an autoimmune disease that occurs when the beta cells responsible for producing insulin are destroyed (Arcangelo& Peterson, 2013). Lack of insulin is what causes the blood sugar or glucose levels to rise. Patients will, therefore, need insulin injections for them to survive. Type 1 diabetes is most common in children and young adults below 30 years. Type 2 diabetes prevails when the body is not able to properly use the insulin that is produced. The muscle cells and adipose become less sensitive to the insulin. It might also occur when the pancreas starts producing fewer amounts of insulin than what the body needs (ADA, 2015). In both situations, glucose levels in the blood will skyrocket. Type 2 diabetes is more prevalent in patients who are older than 30 years.
Gestational diabetes affects expectant women in the middle or late pregnancy when they become intolerant to glucose levels. The anti-insulin effects caused by progesterone, human placental lactogen, and cortisol are the most likely causes because the blood glucose levels usually return to normal after delivery. Risks to the baby include breathing problems at birth, abnormal weight gain at birth and higher diabetes and obesity risk later in life (Mandal, 2015). Mothers diagnosed with gestational diabetes face an increased risk of developing type 2 diabetes and may also need cesarean section due to the enormous baby size. Juvenile diabetes is the least common type. It usually begins in early childhood, which is why it’s called the juvenile. It is caused by genetic conditions such as pancreatic diseases and hormonal abnormalities. This type only accounts for 1% to 5% of all diabetes cases.
Type 2 is the most common diabetes type accounting for approximately 95% of all cases. The primary risk factors are a family history of diabetes and obesity. Treatment programs have to be individualized according to the patient’s needs. Diet and exercise alone can be used in controlling type 2 diabetes. However, drug therapy is recommended when exercise and diet fail to control glucose levels (ADA, 2015). Incretins are taken to suppress the inappropriate release of glucagon by the alpha cells while stimulating secretion of insulin from pancreatic cells. Exanitide is only available as an injection and can be used with other oral agents or as a monotherapy. A 5mcg dose is injected in mornings and evenings or before taking the largest meal of the day. The patient has to ensure the injections are spaced more than six hours apart (Arcangelo& Peterson, 2013).
Diabetes usually leads to severe consequences on the health and well-being of the patients when it is not controlled. Diabetes leads to many other complications like stroke, heart attack, kidney failure, nerve damage and loss of vision when it is left untreated. The condition impacts heavily on the finances of the patients and their families, and even the economies of countries. Nurse practitioners should recommend diabetes screening as part of the routine medical examination of the patients. Early detection and treatment of diabetes will help in reducing the severe impacts and complications (Mandal, 2015).
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for Advanced Practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
American Diabetes Association. (2015). Your type 2 diabetes action plan: Tips, techniques, and practical advice for living well with diabetes.
Mandal, A. K. (2015).Handbook of diabetes for general practitioners.