Assignment on Diabetes Treatments
Added on 2021-04-16
7 Pages1584 Words75 Views
Disease and DisordersNutrition and Wellness
|
|
|
Running head: TREATMENT OF DIABETES 1Treatment of DiabetesStudent’s NameInstitutional Affiliation
TREATMENT OF DIABETES2Treatment of DiabetesIntroductionType 2 diabetes mellitus (T2DM) is a disease caused by the increase in blood sugars,hyperglycemia. Diabetes results in cardiovascular diseases (CVA) and myocardial infarction.Long-term management of diabetes mellitus is therefore not just a reduction in hyperglycemia(Stratton et al., 2000), but glycemic control would too significantly benefit the T2DM patients.With glycemic control, cardiovascular risk factors for example blood pressure, body weight,glycated hemoglobin (HbA1c) and lipids are all in check. This is known as the multifactorialapproach for the t2dm treatment as it’s holistic in addressing the disease. Conventional methodsor commonly prescribed therapies for treating diabetes uses insulin glargine, sitagliptin, andpioglitazone. This paper explores the effectiveness of exenatide in glycemic control towardsachieving recommended goals for T2DM treatment (Diabetes, 1998).Exenatide is a GLP-1 receptor agonist that does reduce not only hyperglycemia but alsoimproves the body weight, blood pressure and lipid profiles in patients with T2DM. When usedtwice a day, exenatide has proven to reduce the risk of cardiovascular events and hospitalizationscompared with other glucose-lowering therapies. An important measure in this study is thenumber needed to treat (NNT) or the absolute benefit increase (ABI) which is the percentage ofpatients who reach the recommended treatment goals from each of the therapeutic groups. MethodologyThe study involved 3 randomized and controlled population organized in 3 phases;Duration -2, -3 and 4. Patients from each of the 3 phases/studies received a background therapy.Duration-2 were treated with metformin, duration-3 received metformin with or withoutsulfonylurea whereas duration 4 were suboptimally controlled through diet and exercise. All
TREATMENT OF DIABETES3patients had T2DM, their baseline glycated hemoglobin levels were in the range of 7.1 to 11.0%and a body mass index of 25-45 kg/m2. Also, all of the patients were over 18 years of age, andtheir medical history portrayed a stable body weight before the screening visit (Bonds et al.,2010). In all the trials, a standard dose of medication was administered for 26 weeks. Duration -2 patient received 2 mg of exenatide twice weekly and 100 mg of sitagliptin each day. 45 mg ofpioglitazone per day could be used in place of sitagliptin. Duration-3 patients received either 2mg of exenatide twice weekly or 4.0 to 5.5 mmol/L of insulin glargine each day. Duration-4patients were considered as ‘drug naïve’ and received 2 mg of exenatide twice weekly, 2000 mgof metformin a day and either a 100 mg of sitagliptin or 45 mg of pioglitazone a day. Bothmetformin and pioglitazone underwent weekly increments to achieve target doses for glycemiccontrol (Meloni et al., 2013). Study FindingsIt is worth noting that metformin is the commonly recommended therapy for treatment ofT2DM. Results from the study show that exenatide and metformin provided similarimprovement toward glycemic control. However, with exenatide, patients are in a better positionas it reduces both the body weight and risks of hypoglycemia. Also, at 95% confidence interval,the study favored exenatide over metformin for its ability to reduce glycated hemoglobin andfasting blood glucose to ≤6.5% and <6.99 mmol/L. Comparing exenatide and sitagliptin in duration-2 and duration-4, the trials show thatexenatide is more superior in reducing HbA1c (-1.5%) as compared to 0.9% (sitagliptin). Thegreatest goal in the trial was that exenatide was able to achieve <7%, recommended goal for theHbA1c. In both the studies, ABI favored exenatide compared to sitagliptin.
End of preview
Want to access all the pages? Upload your documents or become a member.
Related Documents
HND701: Pathophysiology of Diabetes - Complications of Diabetes Assessment 2lg...
|16
|4346
|158