Question

A. You have been following Mr. Miller for the past 2 years. You have worked with him trying to get him to lose weight by changing his lifestyle and nutritional habits. He continues to be overweight (body mass index [BMI] of 33) and has tried to cut down his carbohydrate and fat intake, but now presents with polyuria, polydipsia, and an elevated random blood sugar of 164. You have ordered an HbA1c test in the past, as he is at high risk for diabetes, and the values have been less than 6.2 %. However, his most recent test indicated an HbA1c greater than 7% You diagnose him with type 2 diabetes mellitus and talk to him about medications I 1. What is the first medication you would prescribe? Discuss how you made this decision. 2 What education regarding Mr. Miller's medication management would you need to do?

please give patho of the disease and drug, medication of choice and dosage

side effects and education

Answer 1

1).

After diagnosing the type II diabetes mellitus, the first prescribed drug is, "metformin."

Type II diabetes mellitus (Type II DM) is non-insulin dependent. Means in the patients with Type II DM the beta cells secrete insulin but the insulin cannot bind to the receptor sites to exert its effect. So, the drugs that increase insulin sensitivity and glucose uptake by the muscles (Eg: metformin, glibenclamide) are helpful for these patients. The risk of Type II DM increases with age and obesity.

Metformin is the only biguanide, which is widely used in the treatment of type II diabetes mellitus. This drug acts by increasing the insulin sensitivity of the cells and thus, increase the cellular glucose uptake.

The initial dose for metformin is, 500 mg taken two times a day before meals.

2). The patient must be educated about the importance of reducing taking simple sugars and other carbohydrates. Eating food rich in fiber, and with fewer carbohydrates is important to regulate the blood glucose levels.

The patient must be informed about the common side effects observed with metformin, which include nausea, gastrointestinal disturbances, headache, and dizziness. The patient must be educated about the signs of lactic acidosis (severe muscle pains) that result from lactic acid accumulation.