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agonists, insulin, or a combination of these drugs; other drugs often prescribed to patients with type 2 DM to prevent complications include ACE inhibitors, ARBs, statins, and aspirin. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Unlike sulfonylureas, Metformin does not produce hypoglycemia and does not cause hyperinsulinemia and is the preferred initial pharmacologic agent for treatment of type 2 DM. The usual dose is 2000 mg per day divided into 2 – 3 doses given with meals to prevent GI adverse effects, it may be immediate-release or extended release. Short-term complications of type 2 DM include hypoglycemia, DKA, and hyperosmolar nonketotic syndromes. Long-term complications of type6
Diabetes and Drug Treatments2 DM include microvascular complications such as retinopathy, nephropathy, and neuropathy, and macrovascular complications such as cardiovascular diseases, cerebrovascular complications, and peripheral vascular diseases. Individuals with type 2 DM are also at a higher risk of infections.7
Diabetes and Drug TreatmentsReferencesAmerican Diabetes Association (ADA). (2017). Statistics About Diabetes. Retrieved from Arcangelo, V.P., Peterson, A.M., Wilbur, V., & Reinhold, J.A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott, Williams, & Wilkins.Brutsaert, E. (2017). Diabetes Mellitus (DM). Merck Manual Professional Version. Retrieved from -disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/diabetes-mellitus-dmCalabria, A. (2017). Diabetes in Children and Adolescents. Merck Manual Professional Version. Retrieved from -disorders-in-children/diabetes-in-children-and-adolescentsDrugs.com. (2017). Metformin. Retrieved from Fox, C. S., et al. (2015). Update on Prevention of Cardiovascular Disease in Adults with Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Diabetes Care. 38(9). 1777-1803. Retrieved from Friel, L. A. (2017). Diabetes Mellitus in Pregnancy (Gestational Diabetes; Pregestational Diabetes). Merck Manual Professional Version. Retrieved from -complicated-by-disease/diabetes-mellitus-in-pregnancy8
Diabetes and Drug TreatmentsHuether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: MosbyLaureate Education, Inc. (Executive Producer). (2012). The endocrine system and diabetes. Baltimore, MD: Author.9