drugsfordiabetesmellitus.docxVIP

Drugs for Diabetes Mellitus Chapter 44 1 Prevalence of Diabetes Mellitus (DM) in the U. S., all ages. Total: 25.8 million people or 8.3% of the population have diabetes. Diagnosed: 18.8 million people Undiagnosed: 7 million people (23.6 million / 7.8% CDC 2007) CDC 2010 2 Diabetes Pathophysiology Leading cause of End Stage Renal Disease (ESRD) 56,000 lower-limb amputations/year Leading cause of adult blindness: 12-24,000 cases/year 3 Diabetes: Estimated Economic Impact in the U. S. in 2007 Total $174 billion (direct medical $116 billion). People diagnosed with Diabetes incurred costs that were 2.3 X higher than what would be in the absence of the disease. Indirect costs: $58 billion (disability, time lost from work, premature mortality) CDC 2007 4 The Healthy Pancreas Liver Hyperglycemia (High Blood Sugar): Pancreas releases Insulin, cells uptake glucose. The Liver converts glucose to glycogen for storage. Results in normal blood glucose level. Hypoglycemia (Low Blood Sugar): Pancreas releases glucagon (antagonist to Insulin) which causes Liver to convert the stored glycogen to glucose (glyconeogenisis). Thus blood glucose level rises to normal level. 5 Type I Diabetes Mellitus Type I (IDDM) 5-10% of diabetic population: lack of Insulin secretion due to autoimmune destruction of Beta Cells (genetic, immunological environmental causes). Classic Symptoms: Hyperglycemia ( fasting BSL 126 X 2, Polyuria, Polyphagia Polydipsia, glucosuria, weight loss and fatigue Treatment: Insulin Therapy Dietary Restrictions Exercise Pearson Education, Inc. 2011 6 Diabetes Mellitus Type II (90-95% of diabetic population): Insulin receptors in the target cells have become insensitive or resistant to the hormone. Also, in response, hypersecretion of insulin by the Pancreas, leading to beta cell exhaustion and death. Treatment: Oral Hyperglycemic Medications Lifestyle Modifications 7 Impact Upon Health Poorly managed or u