Diabetes mellitus occurs when a group of metabolic diseases that affect insulin secretion, says "Understanding Medical Surgical Nursing" by Linda Williams and Paula Hopper. Insulin affects the blood glucose, commonly referred to as blood sugar, and the balance of glucose proves vital to the body because it is the main source of energy, states the Mayo Clinic. Diagnosis of diabetes means that an excessive amount of glucose exists in the blood, and an abundance of glucose can lead to serious health complications, says the Mayo Clinic.
Insulin
People with type 1 diabetes have no endogenous insulin in their body and must inject insulin daily to maintain their blood glucose level, states Williams and Hopper. Type 2 diabetics may also use insulin to control glucose. Insulin is a protein and cannot be taken by mouth; therefore, patients must inject it into the subcutaneous (fatty) tissue. Because insulin is frequently injected, patients must rotate the sites weekly to help with absorption, which are generally given in the trunk of the body, according to Williams and Hopper. The three different categories of insulin medications include short acting, intermediate acting and long acting. Short acting insulin medications include lispro (Humalog), aspart (NovoLog) and regular (Humulin R, Novolin R). Intermediate acting insulin medications include NPH (Humulin N, Novolin N) and Lente (Humulin L, Novolin L). Long acting insulin medications include Ultra Lente (Humulin U Ultralente) and Insulinglargine (Lantus AE). Multiple injections can be avoided by mixing insulins together and those combinations include 70 percent NPH and 30 percent regular (Humulin 70/30) or 50 percent NPH and 50 percent regular (Humulin 50/50).
Oral Hypoglycemic Medications
Oral hypoglycemic medications used for diabetes are not oral insulin pills, and are not used to treat type 1 diabetes, according to Williams and Hopper. Oral hypoglycemic medications only work with a partially functioning pancreas that still produces natural insulin. These drugs can increase the risk of cardiovascular disease. Insulin stimulating drugs work by getting the pancreas to produce and release more insulin. The names of these medications include tolbutamide (Orinase), chlorpropamide (Diabinese), glipizide (Glucotrol), glimepiride (Amaryl), glyburide (Mironase), repaglinide (Prandin), and nateglinide (Starlix). Insulin sensitizers inhibit the production and release of glucose by the liver, according to the Mayo Clinic. Those drug names include metformin (Glucophage), metformin/glyburide (Glucovance), pioglitazone (Actos), rosiglitazone (Avandia), and troglitazone (Rezulin). Absorption delayers work by reducing the rate of carbohydrate digestion and absorption, and include drugs such as acarbose (Precose) and miglitol (Glyset).
Other Medications
Chronic diabetes affects many other body systems. Cardiovascular complications can develop, as well as microvascular complications of the eyes and kidneys, and can be treated with high blood pressure medications, says Williams and Hopper. A chronic pain disorder called diabetic neuropathy can also develop as a result of diabetes, which requires prescriptions of pain medications including antidepressants, anticonvulsants, such as gabapentin and carbamazepine and sodium channel blockers, such as mexiletine.
References
- The Mayo Clinic: Type 2 Diabetes
- The Mayo Clinic: Diabetes
- "Understanding Medical Surgical Nursing"; by Linda S. Williams and Paula D. Hopper, 2003
