Type 2 Diabetes Management: Pharmaceutical Approaches and Compliance

This report explores pharmaceutical interventions for managing type 2 diabetes, focusing on a case involving Bob, a 45-year-old construction worker with poor compliance to prescribed treatments. The report details alternative pharmaceutical approaches such as thiazolidinediones and insulin replacement therapy, considering Bob's lifestyle factors like smoking and drinking habits. It highlights the importance of monitoring A1c levels and adjusting medication strategies to improve glycemic control, suggesting thiazolidinediones as a second-line defense due to potential weight gain from sulphonylureas. The report also emphasizes the significance of smoking cessation and self-management education in controlling blood sugar levels. Desklib offers a wealth of resources for students, including similar reports and solved assignments.

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DIABETES MANAGEMENT
Diabetes management
Name of the student
University name
Author’s note

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Table of Contents
Introduction................................................................................................................................2
Pharmaceutical interventions for type 2 diabetes management.................................................2
Conclusion..................................................................................................................................3
References..................................................................................................................................4

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Introduction
The current assignment focuses on the concept of type 2 diabetes management
through compliance monitoring. In this respect, Bob was a 45 year old construction worker
detected with type 2 diabetes. The assignment focuses upon the different pharmaceutical
interventions which could be provided to Bob over here.
Pharmaceutical interventions for type 2 diabetes management
The patient Bob is a 45 year old man with type 2 diabetes management and fails to
follow the instructions provided by the physician. That is, he is not one of the most compliant
patients. Here, Bob is an overweight man who is a chain smoker along with compulsive
drinking habits. Since Bob is a diabetic, excess deposition of sugar can lead to narrowing of
the blood vessels, enhancing the chances of cardiac risk. As commented by Hausenblas,
Schoulda & Smoliga (2015), Bob is a chain smoker and has drinking habits which can further
deteriorate further. Bob had been presently put on 1000 mg metformin and lisinopril 20 mg.
The lisinopril had been suggested as a method of prevention of heart disorder. Bob received
a score of 9.5 after taking A1c test, which measures the amount of sugar present in the blood.
High A1c scores have been linked with certain from of diabetes. However, bob does not
follow the rules and regulations of diabetes management. Therefore, it becomes very
important to put bob on alternate medication to control the symptoms of diabetes in him.
Some of the alternate pharmaceutical approaches which could be implemented for
Bob are thiazolidinediones. Apart from these, Bob could also be put under insulin
replacement therapy, which will help in mimicking the normal pattern of insulin secretion.
Since bob was already on primary metformin doses, initially he could be put under long
acting basal insulin to improve glyecemic control. On the other hand, thiazolidindiones could

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also be used as a second line of defense (Wishah, Al-Khawaldeh & Albsoul, 2015). It is
suggested in case sulphonylureas is not tolerated by the patient. Since bob was an obese man
putting him on sulphonylureas could promote more weight gain, which could further increase
the risk of cardiac issues in the patient. Hence, thiazolidinediones was prescribed to bob
which acts via the peroxisome proliferator activated –receptor (PPAR- γ), which is a nuclear
transcription factors and decreases resistance to insulin by bringing about conformational
changes within the enzyme-substrate site (Ley, Hamdy, Mohan & Hu, 2014). As commented
by Chrvala, Sherr & Lipman (2016), smoking cessation and self management education can
also help Bob in controlling the elevated levels of blood sugar.
Conclusion
Therefore, the assignment focuses on the alternate medication patterns which can help
in controlling the type 2 diabetes within the patient who fails to follow the rules and
regulations otherwise. In the assignment, the physiological condition of Bob had also been
taken into consideration base upon which the secondary medications need to be prescribed.
Therefore, it is necessary that the past history along with medical and drug allergies of the
patient are taken into consideration before prescribing of the next option.

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References
Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes self-management education for
adults with type 2 diabetes mellitus: a systematic review of the effect on glycemic
control. Patient education and counseling, 99(6), 926-943.
Hausenblas, H. A., Schoulda, J. A., & Smoliga, J. M. (2015). Resveratrol treatment as an
adjunct to pharmacological management in type 2 diabetes mellitus—systematic
review and meta‐analysis. Molecular nutrition & food research, 59(1), 147-159.
Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2014). Prevention and management of type
2 diabetes: dietary components and nutritional strategies. The Lancet, 383(9933),
1999-2007.
Wishah, R. A., Al-Khawaldeh, O. A., & Albsoul, A. M. (2015). Impact of pharmaceutical
care interventions on glycemic control and other health-related clinical outcomes in
patients with type 2 diabetes: Randomized controlled trial. Diabetes & Metabolic
Syndrome: Clinical Research & Reviews, 9(4), 271-276.