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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 tenyears 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 DMAccording 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 TREATMENTShyperosmolar 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. SummaryDiabetes 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.