Although this type can affect any age, it is most likely to 2
Diabetes be seen in middle-aged or older patients. This type must also take medications for survival, however these medications are not always injected and can be controlled with oral medications. This is the most common form of diabetes seen in the population. Gestational diabetes develops in some when while they are pregnant and generally goes away once the baby is born. Unfortunately, women who develop this type are at greater risk for developing type II at a later date in their lives. Occasionally the diagnosis that is made during pregnancy is actually type II diabetes (National Institute of Diabetes and Digestive and Kidney Diseases, 2018). Type II Diabetes and Sulfonylureas Sulfonylureas are a major group of oral hypoglycemic agents used to treat type II diabetes that correct derangements of carbohydrate, lipid, and protein metabolism (Arcangelo & Peterson, 2017). Sulfonylureas bind to specific receptors on beta cells, causing adenosine triphosphate (ATP)-dependent potassium channels to close (Arcangelo & Peterson, 2017). The calcium channels subsequently open, leading to increased cytoplasmic calcium, which stimulates the release of insulin (Arcangelo & Peterson, 2017). Theorists have hypothesized that these drugs also have extrapancreatic effects involving the liver, muscle, and adipose cells, but because these agents are ineffective in patients with type I diabetes, it appears that their predominant hypoglycemic action is on the beta cells (Arcangelo & Peterson, 2017). When used alone, these agents have the most significant effect on blood sugar, especially in patients who are lean and insulinopenic (Arcangelo & Peterson, 2017). Sulfonylureas are divided into first and second-generation classes with the second- generation being the stronger of the two, however patients should be started at the lowest dosages first to determine the effect the medications have on the disease process and then titrated for optimal effect on blood glucose levels (Arcangelo & Peterson, 2017). Unfortunately, according to Arcangelo and Peterson (2017) approximately one third of the patients will not 3
Diabetes respond to these medications and after approximately 10 years 50% of the patients will have adequate glycemic control at which point the patient will need to change the medication they are using to control their diabetes. Of these failures, many of them are due to non-adherence of diet and medication regimen or stressful events such as infections (Arcangelo & Peterson, 2017).
- Summer '15
- Diabetes, American Diabetes Association