Pharmaceutical Control of Diabetes

Introduction

Diabetes is one of the most dangerous diseases that have been claiming the lives of human beings today. Diabetes itself is expressed in the human body as a serious disorder which will affect the nature and way in which our bodies will use energy and food that has been consumed (Rosenstock & Brazg, 60). Normally, when a human being consumes sugar, it will be taken into the intestinal digestive system where it has to be broken farther down to small and simple sugar known as glucose. The broken glucose circulates in the body system before it is used as fuel in the cells. Insulin, on the other hand, is a hormonal substance produced in the human pancreas, and will help in moving glucose directly into the body cells. Once an individual has developed diabetes the pancreatic processes of producing insulin and accompanying glucose into the cells decreases, and as a result, the levels of sugar and blood glucose start to increase.

We have two identifiable diabetes types. People may have Type 1 or 2: the first type of diabetes occurs when the body is totally unable to generate insulin (Rosenstock & Brazg, 62). People having type 2 of the diabetes condition can successfully produce the hormone, insulin, but it is their body cells that fail to respond to the hormone. The two cases will result into increased glucose amounts in the blood leading to a lot of complications with the individual. Due to the nature of this disease, man has been troubling himself so greatly in coming up with appropriate measures through which the two types of the disease can be addressed. In this paper we look at the facts that underlie the application of pharmaceuticals in the control of diabetes. This is quite an important field of discussion since it will give us a better understanding on the possibilities of future control of diabetes through use of pharmaceuticals. Once these concepts about the disease have been understood, more and more medical physicians can come up with measures of improving the studies and coming up with possible solutions to this kind of infection that has been threatening human lives.

Background Information

The use of pharmaceuticals has not been something new in the increasing world of human medicine. This has exactly been the same thing with diabetes. In majority of the past diagnosis operations for diabetes, it has been noted that they bring very many challenges, and new challenges continue to spring out with each new study. Depending on the diabetes type that one is suffering from, the best way to deal with it is to think of a proper way of medication or use of insulin which can be injected freely into the blood system. Over the past few years, doctors and medical experts have been deeply involved in ways through which they can successfully control diabetes through the use of pharmaceutical products (Nathan & Buse, 25).

Medical experts and health care physicians have been long struggling with the many options that are available in the control and treatment of diabetes. Since type two of diabetes is quite discouraging, it has made the doctors to weigh out options and come up with appropriate decisions on the available pharmaceutical products that can be introduced into the human systems for the disease. In the recent decades, the number of pharmaceuticals that had been noted to have greater capabilities in containing diabetes is as follows: use of oral triple therapeutic drugs consisting of pioglitazone hydrochloride, metformin, and phosphate sitagliptin. There was also the use of nutritional counseling which would be done by a licensed professional dietician and the extensive use of exercises (American Diabetes Association).

Having used these intensive measures in dealing with the diabetes, it came to be noted that the most of them would have considerable impacts in reducing the amount of glucose levels in the blood. However, as more studies continued to be done on patients who had been administered with these pharmaceutical drugs, it was noted that their use resulted in reduced bone masses. With many developments within the pharmaceutical procedures, it became necessary to come up with more interventions in order to address most of the issues which had been noted with the past researches on diabetes and use of pharmaceuticals. Because it had been quite impossible to completely eliminate the chances of developing the disease, doctors argued for the use of nutrition and proper exercising in order to supplement the methods of treatment and control (Nathan & Buse, 25). From the researches that had been carried out, the use of pharmaceuticals, counseling, exercise and proper dieting was encouraged.

Pharmaceutical Control of Diabetes and Developments

Having noted the background of pharmaceutical significance in controlling diabetes, we will agree that the field provides better hopes for human population if more research is done to come up with a better way through which pharmaceuticals can be adopted. Today, numerous options for pharmaceuticals have become available in treating many patients having diabetes. Of the two diabetes types, type 2 has been effectively managed than type 1. In the control of diabetes mellitus, the most promising pharmaceuticals that have been identified and used have included the use of therapy. These therapies have revolved around mono-therapies, dual therapies, and triple-therapies. To effectively perfect these therapies, a number of agents are used. These include alpha-glucosidase inhibitors, AGIs, dipeptidyl peptidases IV, DPP-IV inhibitors, basal insulin, meglitinide, incretin mimetics, metformin, thiazolidinediones, TZDs, and sulfonylureas (Texas Diabetes Council). From all the researches and decisions arrived at with the use of these pharmaceuticals, it is quite clear that this form of medication is very complex and more studies will be relevant if proper combat of the disease is to be realized.

From a past study, a patient of 53 year was subjected to pharmaceutical drugs and therapy for diabetes. At the time the medication was being administered, the patient’s lycosylated hemoglobin, HbA1c was high at 9.4 percent (Lebovitz, 928). This patient was given an aggressive kind of pharmaceutical treatment and therapy. This included metformin which had been titrated to about one hundred mg twice on daily basis, which had been put in pioglitazone hydrochloride. Having been given this treatment, the HbA1c hemoglobin level was seen to reduce from 7.0 percent in three years time. Upon continual intake of the pharmaceutical therapies, the patient had reduced his sugar levels by 4.3 percent. The medical records of this patient also indicated of a considerable level of glucose in the blood. In addition, doctors also realized that the use of pioglitazone and metformin was appropriate in managing diabetes condition. Some other medications were also found to have worked better on the patient. These included medications that had the capability of lowering lipids in the body like calcium atorvastatin, which contain enzymatic angiotensin-converting inhibitor, hydrochlorothiazidee and antiplatelet agents like aspirin.

Today, the medical field has come up with many options that can be applied in treating and controlling diabetes in patients. The use of meglitinides, sulfonylureas, AGIs, DPP-IVs inhibitors, basal insulin and incretin mimetics has been effective in controlling the disease (Lebovitz, 929). These are therapeutic substances and inhibitors that have the ability to slow down the chances of diabetes manifestation in an individual. There has been the use of oral agents or exenatide that have the ability to lower HbA1c levels. Through the intensive application of these forms of medications it will be possible to achieve a reduction in the HbA1c levels. Biological assays have also been done in the laboratory to come up with oral anti-diabetic agents that can inhibit the accumulation of glucose in the blood. The biggest question has been on when to accept a given compound as a proper source of medication for diabetes. In order to do this, there is a benchmark which is used: If some form of medication will by a great margin reduce HbA1c levels in a patient by about 1 percent, and if this percentage reduction will achieve the goal for that particular treatment, then it would be recommended to use that kind of medication. However, should that particular medication be unable to give the very expected one percent HbA1c level reduction, then that medicine should not be recommended as an appropriate medication for the patient (Ratner & Maggs, 399). In that case, it would be necessary to put the patient on insulin therapy at once.

In the year 2006, the Texas Diabetes Council, TDC, came up with a Diabetes Tool Kit, and posted it in the website. This kit included a pharmaceutical algorithm for the people to apply whenever making a decision about the control of the disease through glycemic management, and especially for the patients suffering from type 2 diabetes. Majority of experts tried the pharmaceutical algorithm on their patients and the system has been found quite effective. The major goal behind the use of the algorithm has been in achieving a low level of HbA1c which would automatically be less if not equal to 6 percent. If these results can be realized without hypoglycemia, then the indications are that it is appropriate (Ratner & Maggs, 420). Further researches at TDC have been to have a self-monitored reduction of glucose levels in the human blood such that it is equal or slightly less than 100 mg/dL. There is also a new method that has been developed in monitoring glucose levels in the blood. This method is known as the two-hour post-prandial mode in which the blood glucose levels are monitored to be less than 140 mg/dL especially when patients have recorded very high blood sugar levels.

So as to have improved performance with these kinds of medication, medical practitioners have advised that patients should be willing to incorporate professional medical nutrition advice and counseling, frequent exercising, and continual dietary observations. This will lead to the best results within the shortest time. It should also be noted that the very initial medical and pharmaceutical intervention that had been presented for use by Texas Diabetes Council and its algorithm, consisted of dual-complex therapy which would only be administered to the patient when the HbA1c levels had been recorded to be greater, or approximately at 7.5 percent (Riddle, 260). Doctors had also advised for a mono-therapy treatment only if the HbA1c levels recorded by the patient were something less than seven percent. Dual-therapy would also be advised in case the patient failed to give promising results with the mono-therapy. A number of options were since then developed in dealing with diabetes. Among the options include pharmaceutical combinations such as meglitinide, sulformin and TZDs (Riddle, 261). From this kind of treatment, if for the three months advised for this treatment has seen the patient’s level of HbA1c still high, the next course of action would be to use an orally given anti-diabetes agent in which acceptable amounts of exenatide have to be added to the regimen treatment. This ant-diabetes agent will facilitate quick recovery, and especially when used at the time when the pharmaceutical treatment is responding well in the reduction of the sugar levels in the patient’s blood. If the third month of the treatement still indicates a high level of HbA1c in the patient, usually above 1 percent which is the benchmark point, insulin will have to be added as an accompanying agent.

Another promising pharmaceutical compound that has been found effective for the condition is known as pioglitazone which has to be combined with metformin (Nathan & Buse, 23). The use of pioglitazone compound was found quite effective in 2008 when a study was carried out at TDC. This was found to help in reducing the HbA1c levels in a patient once taken two times each day. In about three to four weeks, the patient will have a reduced blood sugar level when the compound has been successfully administered. Doctors have also suggested that better results will be realized upon the use of exenatide, and especially when it has been combined with other forms of metformins. Although majority of the patients today have been seen to respond in various ways to exenatide with majority recording a typical 1-1.5 decrease on the HbA1c levels, the patients having poor glycemic systems controls may give about 4-5 percent HbA1c level reductions at the time the medication has been initiated. After the scenario was recorded in the patients, doctors set out to study the phenomenon as exhibited by exenatide. They found out that it had very many extra benefits potentialities like in improving the functions of beta-cells, improving the rate at which the body weight would be lost, and reducing chances of hypoglycemia.

Conclusion

It will be argued that the use of pharmaceuticals is the right way through which most of the diseases affecting man today can be fought. This is because there will be the invention of methods of control, treatment, and provision of suppressor compounds that will improve the life-span of individuals. Should the condition be hard to treat or rectify, the use of pharmaceuticals can be relevant in suppressing the rate at which the biological processes caused by the condition take place, and therefore the eventual result will be longer life-span (Ahren & Foley, 41). However, most of the researches that have been done have been biased for diabetes type 2 which will occur later in life. This means that type 1 has not been researched on much since it accounts for a lesser percentage of the diabetes patients. This being the case, doctors and medical researchers should come up with extra ways through which all the diabetes conditions can be studied in order to come up with better pharmaceuticals advices which can result in the control of the disease. Finally, people should as well be advised about proper lifestyles whereby they would engage themselves in exercises so that their body organs like the pancreas continue functioning well. This will not only prevent diabetes, but any other complication that may be faced by an individual. Once proper exercising has been integrated into the individual’s lifestyles, the next thing would be proper dieting and ensuring the individual is healthy.

References

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American Diabetes Association. Standards of medical care in diabetes—2008. Diabetes Care; 31(suppl 1):S12 -S54

Lebovitz, H. ‘Oral therapies for diabetic hyperglycemia.’ Endocrinol Metab Clin North Am. 30 (2001): 909 -933.

Nathan, D. & Buse, B. ‘Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes [published correction appears in Diabetes Care’. Diabetes Care, 49.7(2006): 16-28. Web.

Ratner, R. & Maggs, D. ‘Long-term effects of exenatide therapy over 82 weeks on glycaemic control and weight in over-weight metformin-treated patients with type 2 diabetes mellitus.’ Diabetes Obes Metabolism (2006): 419 -428.

Riddle, M. ‘Oral pharmacologic management of type 2 diabetes.’ Am Fam Physician. 60 (1999): 263 -269.

Rosenstock, J. & Brazg, R. ‘Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin added to ongoing pioglitazone therapy in patients with type 2 diabetes: a 24-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group study.’ Clinical Therapy. 23.6 (2006): 55 – 68.

Texas Diabetes Council, Texas Department of State Health Services. Diabetes Tool Kit. 4th ed. Austin, TX: Texas Department of State Health Services; 2007: 3.1, 5.1, 6.4. Publication No. E10-114. Web.