1. 1. Presentation HEALTH PROFESSIONAL ESSENTIALS
2. 2. Question Diabetes mellitus is a major world health problem. Treatment and management of diabetics is a very significant issue for governments, society and both pharmacists and pharmaceutical companies. Completing this assignment will help you to gain a deeper understanding of diabetes mellitus. The length of this assignment excluding graphs, figure legends and references should be no more than 1000 words. The % of marks allocated to each section is a guide to the word length for that section. Where appropriate references should be included using the Harvard System cited appropriately in the text with correct formatting in the reference list. As a guide a minimum of 4 but no more than about 12 references should be used. You are advised to use references from both primary and secondary sources. Assignments should be typed and submitted using learnonline via the Course Website. Graphs should be incorporated into the text or submitted as separate attachments. Due date/time is 5:00pm 10th June myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
3. 3. Question 1a. What is the physiological basis of the disease diabetes mellitus? 1b. What is the significance of the mellitus suffix? (5% of assignment marks ) 2. Individuals with the disease are classified into two main groups. What are they and what is the basis of the classification system used? (5% of assignment marks ) 3a. How are patients diagnosed as diabetics? 3b. How are diabetics treated? (20% of assignment marks) 4. What changes in the storage and mobilisation of glucose and fat (triglycerides) would you expect to see in this disease? What symptoms might a diabetic show as a result of these metabolic changes. myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
4. 4. Question 5. Two overnight fasting patients, A & B, were each given a dose of 75g of glucose at time zero. Their blood glucose levels were measured at 0, 30, 60, 90, 120 and 240 minutes after ingestion of the glucose using a glucose specific assay. The brief procedure for this assay is:- a. Add 5.0 ml of assay reagent to sufficient tubes for the assay b. Add 0. 1 ml of each glucose standard to a tube of assay reagent c. Add 0. 1 ml of each test serum to a tube of assay reagent. d. Mix the contents of each tube and read the absorbance at 625 nm. The results obtained are shown in the two tables below. Table 1 - standards Glucose standard (mmol/L) Absorbance @ 625 nm 0 0.02 3 0.21 6 0.43 9 0.65 12 0.83 myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
5. 5. Question Table 2 patient results Time (min) Absorbance-Patient A Absorbance- Patient B 0 0.26 0.47 30 0.48 0.63 60 0.25 0.80 90 0.23 0.76 120 0.24 0.63 240 0.30 0.58 myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
6. 6. Question Plot a standard graph of absorbance at 625 nm against glucose concentration You must use Excel. Determine the concentration of glucose in each patient serum sample and plot glucose concentration against the time over which the samples were obtained. Comment on the results for the two patients (20% of assignment marks ) 6. What existing and potential problems would a pharmacist need to be aware of when treating a diabetic client?myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
7. 7. Diabetes Mellitus-Physiological Basis Diabetes mellitus- metabolic disorder- causes due to poor uptake of glucose- increases glucose level in the blood. Beta cells of the islets of Langerhans in the pancreas secrete insulin- stimulated by the increased sugar level. System breaks down carbohydrates into glucose that are obtained from the diet. Absorption of this glucose is mediated by the blood cells and produce energy. Cells require the hormone insulin to absorb glucose. Either system fails to synthesize enough amounts of insulin or cells become non respondent to insulin. Thus, glucose level in the blood increases- leads to diabetes mellitus developmentmyassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
8. 8. Diabetes Classification Type 1 diabetes mellitus It is also called juvenile diabetes-prevalent in children. Partly inherited and few are linked with certain viruses. Type 2 diabetes mellitus Non-insulin dependent diabetes mellitus. In this type of diabetes- beta cells fail to produce enough amounts of insulin or cells become less responsive to insulin- situation is called insulin resistance. The main reasons are genetic factors and lifestyle. Gestational diabetes It affects pregnant women and generally disappears after the child birth. Approximately, 2-10% of all the pregnant women suffer from this type of diabetes myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
9. 9. Diabetes Diagnosis Measuring plasma glucose level Measuring fasting plasma glucose level Measuring glycated haemoglobin Symptoms of increased blood sugar level Oral glucose tolerance test Glycated haemoglobin A1C test Confirmatory test: one of these tests is repeated again on another day. myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
10. 10. Diabetes Treatments Monitoring blood glucose level Healthy eating and regular physical activity help to monitor blood sugar level. Consumption of fruits, whole grains and vegetables and decreasing amount of sugar in regular diet help to maintain blood sugar level. Regular aerobic exercises maintain blood sugar level and reduce blood sugar level. myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
11. 11. Diabetes Treatments Insulin therapy Generally recommended with type 1 diabetes. Different types of insulin available in the market- type of insulin selected based on patients need. It is administered mostly through injection. Medication Oral medication, mainly metformin- acts as stimulus- increase insulin secretion by pancreatic cells. Pancreas transplantation may be performed in diabetes type1 and bariatric surgeries may be performed in diabetes type 2 diabetes. Metformin myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
12. 12. Changes in Glucose and Fat Storage and Mobilisation In Diabetes Due to decrease in insulin, absorption of glucose is inhibited- cells start to metabolize the fatty acids It produces ketone bodies that enters into circulation. Increased ketone bodies leads to diabetic ketoacidosis development - cause serious health issues. In the absence of insulin- mobilization of glucose from blood to the cells diminished- blood sugar level increased. Increased blood sugar increases glucose concentration in urine It causes excessive electrolyte loss and fluid from the system. myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
13. 13. Problems, a Pharmacist Should Know Metformin is widely used medication. It is associated with gastrointestinal side effects such as nausea, weakness, diarrhoea, metallic taste in mouth and vomiting may occur. To diminish side effects, medications can be used. Metformin administration in empty stomach may cause hypoglycaemia. myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
14. 14. References Brunton, S. (2014). Identification and Prevention: Underutilized Tools in Diabetes Treatment?. Clinical Diabetes, 32(1), 1-2. doi:10.2337/diaclin.32.1.1 BUSCHARD, K. (2011). What causes type 1 diabetes? Lessons from animal models. APMIS, 119, 1-19. doi:10.1111/j.1600- 0463.2011.02765.x Edgerton, D., Moore, M., Winnick, J., Scott, M., Farmer, B., & Naver, H. et al. (2014). Changes in Glucose and Fat Metabolism in Response to the Administration of a Hepato-Preferential Insulin Analog. Diabetes, 63(11), 3946-3954. doi:10.2337/db14- 0266 Florez, J. (2014). Insights From Monogenic Diabetes and Glycemic Treatment Goals for Common Types of Diabetes. JAMA, 311(3), 249. doi:10.1001/jama.2013.283981 myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
15. 15. References Fowler, M. (2010). Diagnosis, Classification, and Lifestyle Treatment of Diabetes. Clinical Diabetes,28(2), 79-86. doi:10.2337/diaclin.28.2.79 Nash, J. (2015). Dealing with diagnosis of diabetes. Practical Diabetes, 32(1), 19-23. doi:10.1002/pdi.1915 Rubio-Cabezas, ., & Argente, J. (2008). Current Insights into the Genetic Basis of Diabetes Mellitus in Children and Adolescents. Journal Of Pediatric Endocrinology And Metabolism, 21(10). doi:10.1515/jpem.2008.21.10.917 Taylor, R. (2012). Insulin Resistance and Type 2 Diabetes. Diabetes, 61(4), 778-779. doi:10.2337/db12- 0073 myassignmenthelp.com/answers/healthcare-diabetes-mellitus-is-a-major-world-health-problem- treatment-and-manage.html For more information :
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