Question

Assignments, Chapter 38, Agents to Control Blood Glucose Levels

Briefly describe the pathophysiology of diabetes mellitus including alterations in metabolic pathways and changes to basement membranes.

Answer 1

Pathophisiology of DM

Type 2 diabetes mellitus has major problems of insulin resistance and impaired insulin secretion.

Insulin could not bind with the special receptors so insulin becomes less effective at stimulating glucose uptake and at regulating the glucose release.

There must be increased amounts of insulin to maintain glucose level at a normal or slightly elevated level.

However, there is enough insulin to prevent the breakdown of fats and production of ketones.

Uncontrolled type 2 diabetes could lead to hyperglycemic, hyperosmolar nonketotic syndrome.

The usual symptoms that the patient may feel are polyuria, polydipsia, polyphagia, fatigue, irritability, poorly healing skin wounds, vaginal infections, or blurred vision.

Agents to control blood sugar levels

Insulin lispro	A modified form of fast-acting insulin used to control hyperglycemia in diabetes mellitus.
Insulin glargine	A modified form of long-acting or basal insulin used to control hyperglycemia in diabetes mellitus.
Glimepiride	A sulfonylurea drug used to treat type 2 diabetes mellitus.
Disopyramide	A class 1A antiarrhythmic agent used to treat life-threatening ventricular arrhythmias.
Acarbose	An alpha-glucosidase inhibitor used in conjunction with diet and exercise for management of type II diabetes mellitus.
Metformin	A biguanide drug used in conjunction with diet and exercise for glycemic control in type 2 diabetes mellitus and used off-label for insulin resistance in polycystic ovary syndrome (PCOS).
Sulfadiazine	A sulfonamide antibiotic used in a variety of infections, such as urinary tract infections, trachoma, and chancroid.
Rosiglitazone	A thiazolidinedione indicated as an adjunct to diet and exercise to maintain glycemic control in type 2 diabetes.