NSC2500: A Comprehensive Review of Type II Diabetes Mellitus

This presentation provides a comprehensive overview of Diabetes Mellitus Type II, a metabolic disorder characterized by hyperglycemia due to insulin resistance and defective beta cells. It details the pathophysiology, starting from the impact of high sugar/fat diets and leading to impaired insulin secretion and organ damage. Key symptoms and affected body organs are identified, along with treatment options such as Biguanides (Metformin) and Thiazolidinedione (Rosiglitazone). The presentation delves into the mode of action, pharmacodynamics, and pharmacokinetics of these drugs, highlighting their relevance to nursing practice in providing safe and responsive care and supporting patient self-management. The conclusion emphasizes the importance of lifestyle modifications alongside medication for managing the disease effectively. Desklib offers a wealth of similar solved assignments and study resources for students.

DIABETES MELLITUS (TYPE II)
Name of the student:
Name of the university:
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Brief overview of disease
 Diabetes mellitus is a group of
metabolic disorder characterized by
hyperglycemia which resulted from a
defected secretion of insulin from the
body.
 Approximate 27 million people in
Australia are suffering from the
diabetes mellitus.
 Courcoulas et al. (2015). highlighted
that because of environmental factors
such as overweight, family history,
having a sedentary lifestyle prediabetic
causes insulin resistance and defected
beta cells of body which further give
rise to the type II diabetes.
Figure : diabetes mellitus
type ii
source: (Rubino et al.,
2016)

Homeostasis of the system in
diabetic patient
 Homeostasis is defined as a state of the steady
internal condition mentioned by living things. The
dynamic state of equilibrium is the condition
optimum for the body which varies organism to
organism as well as body conditions such as
temperature and fluid balance of the body (Marso et
al., 2016).
 Insulin stimulates the glycogen formation from
glucose which further help in balancing the blood
glucose level.
 Patient with diabetes are failed to produce and thus
their blood glucose level is not at homeostasis that
further started affected other organs of body.
 To maintain the homeostasis , patient is required to
inject insulin, consume medications and exercise to
maintain homeostasis of the body.
Figure : diabetes
mellitus type ii
source: (Rubino et
al., 2016)

Pathophysiology
The pancreases secrete insulin in
the bloodstream where it circulates
in the blood to lower the blood
sugar level through inducing
glucose metabolism.
glucose level increased in the blood
due to glycogen metabolism the
insulin-producing beta cells in the
pancreases started secreting more
insulin (Forslund et al., 2015)
Obesity, prediabetic
symptoms
sedentary
lifestyle
Fast food or
high sugar /fat
containing food
family
history
cells become impaired
to meet the demand of
Give rise to diabetes
mellitus and affected
other organs

Diagram of pathophysiology
Figure: pathophysiology of diabetes
Source : (Forslund et al., 2015)

Symptoms:
 Excessive Urination
 Excessive Thirst
 Dry Mouth
 Fatigue
 Increased Hunger
(Papademetriou et al., 2017)
 Loss Of Consciousness
 Blurry Vision
 Excessive Sweating
 Slurred Speech
Figure : diabetes
Source :
(Papademetriou et al.,
2017)

Affected body organs and
complications
 Diabetes dramatically
increases the risk of heart
disease (Nowotny et al.,
2015).
 High blood pressure and
narrowing the blood vessels
 diabetic retinopathy
 diabetic neuropathy or nerve
disorders
Figure : affected body
part
Source : (Nowotny et al.,
2015).

Treatment
Medications of diabetes:
 Biguanides ( metformin)
 Thiazolidinedione(Rosiglitazone)
 Alpha-glucosidase inhibitors
( acarbose)
 Dopamine agonist
 DPP-4 inhibitors
Other interventions:
 Exercise
 diet modifications
Figure : medications
Source : (Nowotny et al., 2015).

METFORMIN
 DESCRIPTION : biguanide anti-
hyperglycemic agent used for treating
blood glucose level. It improves glycemic
controls by decreasing hepatic glucose
since work on liver and decrease glucose
absorption as well as glucose mediated
uptake (Nowotny et al., 2015).
 Associated condition :
Diabetes mellitus ii and polycystic ovary. Figure : affected body
part
Source : (Nowotny et al.,
2015).

Mode of action and
pharmacodynamics of metformin
 Pharmacodynamics: the drug decreases hepatic glucose
production, increase uptake of peripheral glucose which
improves insulin sensitivity. Unlike the drug such as
sulfonylureas, metformin doesn't produce hypoglycemia and
hyperinsulinemia. With the influence of the drug, the insulin
secretion remain unchanged while plasma insulin decreases.
 Mechanism of action: It is unique from any other classes of
oral antihyperglycemic drugs. Asmat, Abad and Ismail
(2016), highlighted that metformin inhibits the mitochondrial
complex I. Another study highlighted that it inhibits hepatic
gluconeogenesis in a redox-dependent manner. Therefore, it
reduces the production of hepatic glucose and maximizes
hepatic cytosolic redox state.

Pharmacokinetics of metformin
 Absorption: it administrated under fasting condition, where absorption is 50% to
60% and without food 40% lower mean peak plasma concentration..
 volume of distribution : It is less likely to bind to the GI tract when administrated
intravenously (Koivusalo et al., 2016).
 metabolism : Metformin is negligibly bound to plasma proteins and does not
undergoes hepatic metabolism metabolism.
 route of elimination: no biliary excretion and in oral administration 90% of the
drug eliminated via renal route.

Route of administration and side
effects
 Route of administration : oral in majority of cases , in few cases they uses.
 toxicity: Acute oral toxicity
 Indication: it is indicated as an adjunct to diet and exercise for improving
glycemic control.
 Contraindication: infection, pituitary hormone deficiency, alcohol
intoxication, liver problem and heart attack.
 Side effects: Diarrhea, drowsiness, weakness, dizziness, malaise
(Koivusalo et al., 2016)
 Precautions:
Age , sex and any other associated health conditions is required to evaluate
before administrate the drug to the patient.