Metformin will be started off at 500 to 1000 mg once daily and them titrate up to 2000 mg once
daily not to exceed maximum dose of 2500 daily (Drugs.com, 2017). Pediatric initial dose for ten
years and above is immediate release Metformin 500 mg twice daily with meals and can be
titrated up to 1000 mg twice daily (Drugs.com, 2017). Arcangelo et al. (2017), recommends that
oral type two DM medications are to be used in conjunction with dieting and proper exercise to
increase metabolism and insulin uptake. Take Metformin with meals to reduce side effects such
as nausea, diarrhea, indigestion, and upset stomach (Drugs.com, 2017). Arcangelo et al. (2017),
recommends avoiding excessive alcohol consumption due to the risk of lactic acidosis, which
can be fatal.
Complications related to Type two DM
According to the ADA (2017), when blood glucose levels get out of balance, short-term
complications can occur with fatal consequences of not treated promptly. Hypoglycemia,
4

DIABETES TYPES AND TREATMENTS
hyperosmolar non-ketotic syndromes, diabetic ketoacidosis (DKA), and coma are complications
related to type two DM. Too much insulin therapy, oral antihyperglycemic, or not enough food
can lead to hypoglycemia. Huether and McCance (2017), recommend frequent monitoring of the
blood sugar levels while taking insulin or antihyperglycemic medications.
Brutsaert (2017), stated that microvascular and macrovascular alterations can cause long-
term complications as well as infections. Retinopathy, neuropathy, nephropathy, are the most
common microvascular problems and cardiovascular diseases, peripheral vascular diseases, and
cerebrovascular problems are the most common macrovascular complications (Laureate
Education, 2012). Brustaert (2017), explains the risks related to lower extremity vascular
insufficiency and neuropathy are infectious diseases, fungal infections, and bacterial foot
infections that could lead to limb amputation.
Summary
Diabetes mellitus (DM) can be from loss of insulin secretion or developing insulin
resistance. The most common types of DM are type one, two, gestational DM and juvenile DM.
Type one is most common in children and type two used to be rare but has been increasing
related to childhood obesity. DM during pregnancy is considered gestational diabetes that occurs
in about 5% of all pregnancies and increases the risk of for women to develop type two diabetes.

