Drug Glucose Lowering Agents For Treating People With Diabetics And Chronic Kidney Disease

Diabetes can be treated in three basic ways: by diet, by diet in conjunction with tablets, or diet in conjunction with insulin. Diet serves as an initial control for non-urgent patients. If a person’s diet will have a major effect on glycaemic control, it does so reasonably quickly, within a few weeks of changing

Diabetes is a disease where the body is unable to produce or use insulin effectively. Insulin is needed for proper storage and use of carbohydrates. Without it, blood sugar levels can become too high or too low, resulting in a diabetic emergency. It affects about 7.8% of the population. The incidence of diabetes is known to increase with age. It’s the leading cause of end-stage renal disease in the US, and is the primary cause of blindness and foot and leg amputation. It is known to cause neuropathy in up to 70% of diabetic patients. Individuals with diabetes are twice as likely to develop cardiovascular disease. There are two types of diabetes: Type 1 and Type 2.

Uncontrolled diabetes can affect nearly every organ of the body; of which, heart disease and kidney failure are most commonly impacted. Known as diabetes mellitus, a collective term for various blood abnormalities, the term diabetes refers to either a scarcity of insulin in the body or the body’s inability to accept insulin. Though the symptoms of diabetes are manageable, many are unaware as to having it. According to the CDC report “2011 Diabetes Fact Sheet,” approximately 6 million people in the United States have undiagnosed diabetes. Undetected, diabetes can become deadly. In a recent World Health Organization report “Diabetes Action Now: An Initiative of the World Health Organization and the International Diabetes Federation,” it

Diabetes mellitus (DM) is a pandemic that affects millions of people. The growth rate of unrecognized pre-diabetes in America is expected to rise up to 52% by 2020 (Lorenzo, 2013). As the prevalence of diabetes increases, so will the complications and burden of the disease. One of the leading causes for cardiovascular disease, renal failure, nontraumatic lower limb amputations, stroke, and new cases of blindness is DM (Lorenzo, 2013).

Diabetes is a growing concern and health challenge for the American people (b). Diabetes is a condition in which the body cannot react to insulin appropriately or either cannot produce insulin efficiently (w). “Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications” (w). There are numerous forms of diabetes amongst the nation, however, there are three main forms of diabetes. Most people have heard of type one diabetes, type two diabetes, and gestational diabetes because they are common. Type two diabetes deals with a resistance to insulin, while

Diabetes Mellitus (DM) or Type 2 Diabetes is seen as a metabolic disease that is categorized by abnormally high blood glucose or hyperglycemia. Diabetes Mellitus is also formerly known as noninsulin-dependent diabetes mellitus and is the most common form of diabetes that is seen. Insulin is a hormone that is supplied to the body that allows us to efficiently use glucose as fuel. When carbohydrates are broken down into sugars in the stomach glucose enters the blood circulation simulating the pancreas to release insulin in an appropriate amount to become used for energy. With diabetes mellitus the body does not properly make use of the insulin supplied for the body. This causes the pancreas to produced an extra amount if insulin which the body cannot keep up with, causing an imbalance to the blood glucose levels (American Diabetes Association, 2015). In the united states diabetes affects almost 29.1 million people, while the another 86 million people have pre-diabetes but do not know. It is also known as the 7th leading cause of death in the country in the recent years (MedicineNet.com, 2016). For a patient suffering from a chronic form of diabetes mellitus understanding how these mechanisms lead to the condition can be used as preventative measures. Potential consequences as well as the causes and clinical manifestations will ensure a better knowledge on the issue to monitor the condition.

Diabetes has become a widespread epidemic, primarily because of the increasing prevalence and incidence of type 2 diabetes. Diabetes is an endocrine disease in which the body has either a shortage of insulin or a decrease ability to use insulin or both. Insulin is a hormone that allows glucose to enter the cells and be converted into energy. Diabetes can be characterized as a prevailing, incapacitating, and deadly disease. There are a number of risk factors that increase a person’s tendency toward developing type II diabetes. Modifiable risk factors include obesity, physical inactivity and poor dietary habits are just a few. The

Diabetes continues to be a growing problem for the United States population especially type 2 diabetes, which “accounts for about 90% to 95% of all diagnosed cases of diabetes”(Center for Disease Control and Prevention (CDC), 2014). Type 2 diabetes, formally known as adult onset diabetes, is defined as a “disorder of insulin resistance in which the cells primarily within the muscle, liver, and fat tissue do not use insulin properly. As the need for insulin rises the cells in the pancreas gradually lose the ability to produce enough hormone”(CDC, 2014). Diabetes as a whole affects about “9.3% of the US population or 29.1 million people” (American Diabetes Association (ADA), 2014; CDC, 2014). Despite the high prevalence of the disease, it is only going to continue to grow if nothing is done to correct the problem. The “United States spent an estimated $245 billion on diabetes in 2012” (ADA, 2014; CDC, 2014). This outrageous number and the drastic impact diabetes has on health should emphasis the need to reduce the diabetic population in the future.

Interventions used in treatment of type 2 diabetes should be those that improve the probability that the patient will have better long term control of diabetes. It is therefore imperative that early diagnosis is given fast priority especially when metabolic abnormalities of diabetes are less severe. Lifestyle interventions are key in containing type 2 diabetes. It is common knowledge that sedentary lifestyle and over nutrition which lead to obesity and overweight increase the risk of type 2 diabetes (Peters & Davidson, 1996). Interventions that reverse or improve these factors have beneficial effects on control of glycemia in established type 2 diabetes.

“Diabetes causes 6 deaths every minute and one in 20 deaths in the world is due to the condition. Every year it is estimated that 3.2 million people in the world die due to the diabetes or its related causes.”

Diabetes is a very common chronic medial disorder and expected to be a big medical challenge of the twenty first century (Clark, 2004). It is a condition, in which the glucose level in the blood becomes so high that the body is unable to utilize it properly. This long-term condition results when the pancreas of the victim is either not able to produce enough insulin (sometimes even cannot produce any insulin) or the insulin produced cannot work properly. Diabetes is divided into two main types: Type 1 and Type 2. Type 1, also known as insulin dependent diabetes milletus (Masharani, 2008) cannot be prevent while Type 2 can be prevented but if the patient is at pre-diabetes stage.

Diabetic nephropathy, an irreversible kidney failure, continues to be the most common cause of end stage renal disease requiring either a kidney transplant or renal replacement therapies, such as dialysis (Bilous, 2013). Worldwide, approximately fifty percent of cases of end-stage chronic kidney disease are caused by diabetes mellitus, with type II comprising the majority (Vladu, 2014). The prevalence of diabetes has been estimated to increase worldwide with the total number of diabetics rising from 285 million in 2010 to 439 million in 2030 (Mantelo, Oliveira, Ferraz, Lima, & Silva, 2015). This rise in diabetes is a concern to public health, as the effects of diabetes can have life altering consequences.

Diabetic nephropathy has worldwide prevalence due to diabetes complications crises , according to the united states renal data system reports that most common patients affected with type 2 diabetes were developed to End-Stage Renal Disease (ESRD) for twenty years , although the newly incidence of diabetes have been rising within constant level during the last twenty years until 2000 , the prevalence of diabetic nephropathy expected to rise 70% by 2015 ((Rossing, 2006).data records from Canada , Australia , Japan , Europe , show similar increases in ESRD related to incidence of diabetes (Van Dijk et al,2005) .

One of the diseases is diabetes mellitus which is a major cause of renal failure. This disease can be defined as an increase of fasting blood glucose that is affected by a deficiency in insulin hormone. The normal range for glucose (fasting) in the blood is 2.8-6.0 mmol/L. It is classified into two groups, type 1 (insulin-dependent diabetes mellitus) and type 2 (non insulin-dependent diabetes mellitus). Stein (2008, p.6) points out that kidney failure happens most often when patients have suffered from diabetes mellitus for more than 10 years. According to United States Renal Data System (USRDS) report in 2007, approximately 44% of primary causes of renal failure is diabetes mellitus in the United States in 2005. Also, Stein (2008) indicates that 15% of dialysis patients are influenced by diabetes mellitus in the United Kingdom. Diabetes mellitus has negative affects throughout the kidneys where the increase of the range of blood sugar causes the damages to the cells in the kidneys. This leads to the presence of the glucose in the urine which is known as glycosuric.

The management of patients with diabetes is classified in the current review under the following categories: a) Non-Pharmacological, b) Pharmacological, c) Monitoring of glycemic control, d) Prevention, e) Clinic organization and f) Referral and admission.