For regular insulin, a "1500 rule" can be used. One large study showed an increase in lower limb amputation with canagliflozin. 30 mg or 50 mg subcutaneously once a week, Weekly preparations may cause fewer GI adverse effects. Learn more about our commitment to Global Medical Knowledge. Insulin replacement in type 1 diabetes should ideally mimic beta-cell function using 2 insulin types to provide basal and prandial requirements (physiologic replacement or basal-bolus dosing); this approach requires close attention to diet and exercise as well as to insulin timing and dose. - This power point presentation describes about How To Control Brittle Diabetes Mellitus? Less commonly, metformin causes vitamin B12 malabsorption, but clinically significant anemia is rare. Disadvantages include cost, mechanical failures leading to interruptions in insulin supply, and the inconvenience of wearing an external device. For some patients with diabetes, drugs often are given to prevent diabetes complications. When a person with diabetes neglects this important aspect of diabetes management, then his/her blood sugars become uncontrolled. The oral glucose-lowering drugs are utilized for management of type II diabetes mellitus. Or use it to upload your own PowerPoint slides so you can share them with your teachers, class, students, bosses, employees, customers, potential investors or the world. Continuous subcutaneous insulin infusion pumps can eliminate the need for multiple daily injections, provide maximal flexibility in the timing of meals, and substantially reduce variability in glucose levels. FDA concerns regarding diabetes mellitus drug development were furthered in part by a meta-analysis of several small trials suggesting excess risk with the drug rosiglitazone. Physiologic replacement involves giving 40 to 60% of the daily insulin dose as an intermediate- or long-acting preparation to cover basal needs, with the remainder given as a rapid- or short-acting preparation to cover postprandial increases. Hypoglycemia caused by long-acting drugs may last for days after treatment cessation, occasionally causes permanent neurologic disability, and can be fatal. - Assessment and Management of Patients With Diabetes Mellitus Prepared by Dr. ImanAbdullah Thank You * Out Line Definition of diabetes mellitus Risk factors for ... - Title: DIABETES MELLITUS Author: Hp Last modified by: Hp Created Date: 1/15/2013 10:52:44 PM Document presentation format: Presentaci n en pantalla (4:3), 7 consejos de diabetes mellitus tipo 2 y ayuda para diabeticos. There is a slight increase in risk for pancreatitis with DPP-4 inhibitors, but they are otherwise considered safe and well-tolerated. General treatment of diabetes for all patients involves lifestyle changes, including diet and exercise. - The prevalence of diabetes mellitus (DM) is proliferating in the Netherlands. Lispro, aspart, or regular insulin can also be given continuously using an insulin pump (1). BP, poor turgor, dry, Kussmauls breathing (d/t metabolic acidosis), Abdominal pain, N V, cardiac dysrhythmias. this PPT provide information of what is Diabetes? Cancer Drugs ppt. Intensive treatment, defined as glucose monitoring ≥ 4 times a day and ≥ 3 injections a day or continuous insulin infusion, is more effective than conventional treatment (1 to 2 insulin injections a day with or without monitoring) for preventing diabetic retinopathy, nephropathy, and neuropathy. When given once/day or bid, lowest starting dose may minimize nausea. - DIABETES MELLITUS. There may be some weight gain, although apparently less than with sulfonylureas. Metformin for prevention or delay of type 2 diabetes mellitus and its associated complications in persons at increased risk for the development of type 2 diabetes mellitus. CrystalGraphics 3D Character Slides for PowerPoint, - CrystalGraphics 3D Character Slides for PowerPoint. † Lispro and aspart are also available in premixed forms with intermediate-acting insulins. Most reactions spontaneously disappear after weeks of continued injection and require no specific treatment, although antihistamines may provide symptomatic relief. Insulin secretagogues: Long-acting (sulfonylureas), Augment pancreatic beta-cell insulin secretion, Can be used alone or in combination with insulin and other drugs, Their long duration of action may lead to serious hypoglycemia, especially in older patients, Chlorpropamide: May cause hyponatremia and flushing after alcohol ingestion, Glipizide and glyburide: No evidence of increased effectiveness of doses > 10 mg/day, Insulin secretagogues: Short-acting (meglitinides), Augment pancreatic beta-cell insulin secretion, Can be used alone or in combination with other oral drugs and insulin, Augment suppression of hepatic glucose production by insulin, Major adverse effects: Lactic acidosis (rare), Contraindicated in at-risk patients, including those with renal insufficiency, metabolic acidosis, hypoxia, alcoholism, or dehydration, Other adverse effects: Gastrointestinal distress (diarrhea, nausea, pain), vitamin B12 malabsorption, Should be stopped temporarily before radiologic procedures requiring use of contrast agents, Major adverse effects: Weight gain, fluid retention, anemia (mild), Hepatotoxicity rare, but liver monitoring required, Pioglitazone: May increase risk of bladder cancer, heart failure, and fractures, Rosiglitazone: May increase low-density lipoprotein cholesterol and may increase risk of heart failure, angina, myocardial infarction, stroke, and fractures, Used as monotherapy or combination therapy with other oral drugs or insulin to decrease postprandial plasma glucose levels, Must be taken with the first bite of meal, Gastrointestinal adverse effects (flatulence, diarrhea, bloating) common but may decrease over time, Started with small dose (25 mg/day) and gradually titrated over several weeks, Inhibit the enzyme DPP-4, which is involved in the breakdown of GLP-1, a peptide that stimulates insulin secretion and inhibits glucagon secretion. Or use it to create really cool photo slideshows - with 2D and 3D transitions, animation, and your choice of music - that you can share with your Facebook friends or Google+ circles. - The 'Global and Chinese Type 2 Diabetes Mellitus Therapeutics Industry, 2013-2023 Market Research Report' is a professional and in-depth study on the current state of the global Type 2 Diabetes Mellitus Therapeutics industry with a focus on the Chinese market. Endocrine Practice 26:107–139, 2020. Severe electrolyte imbalance ( ? According to Renub Research analysis, Netherlands Diabetes Market is forecasted to reach USD 4.48 Billion by the year 2025. Regimens range from twice a day split-mixed (eg, split doses of rapid- and intermediate-acting insulins) to more physiologic basal-bolus regimens using multiple daily injections (eg, single fixed [basal] dose of long-acting and variable prandial [bolus] doses of rapid-acting insulin) or an insulin pump. Thiazolidinediones (TZDs—pioglitazone, rosiglitazone) decrease peripheral insulin resistance ( insulin sensitizers), but their specific mechanisms of action are not well understood. In the United States, 57.9% of patients with diabetes have 1 or more diabetes-related complications and 14.3% have 3 or more. Metformin is the only biguanide commercially available in the US. Different insulin types can be drawn into the same syringe for injection but should not be premixed in bottles except by a manufacturer. (1)CICS-UBI, Health Sciences Research Centre, University of Beira Interior, Av. Moderate- to high-intensity treatment is used, and there are no target lipid levels (see table Statins for ASCVD Prevention in Dyslipidemia). Diabetes mellitus has now assumed epidemic proportions in many countries of the world. Diabetes drugs 1. How To Control Brittle Diabetes Mellitus? Examples include exenatide (an incretin hormone), lixisenatide, liraglutide, dulaglutide, albiglutide, and semaglutide. * Times are approximate, assume subcutaneous administration, and may vary with injection technique and factors influencing absorption. The PowerPoint PPT presentation: "Diabetes Mellitus" is the property of its rightful owner. Circulating anti-insulin antibodies are a very rare cause of insulin resistance. La Diabetes Mellitus (DM) es una enfermedad de alta prevalencia, reconocida como unproblemade salud p blica, debido a sus altas tasas de ... Update on Diabetes Medications and Guidelines in Cardiopulmonary Rehab Setting. Cardiovascular Emergencies ppt. The Manual was first published as the Merck Manual in 1899 as a service to the community. The amylin analog pramlintide mimics amylin, a pancreatic beta-cell hormone that helps regulate postprandial glucose levels. Patients with type 2 diabetes mellitus are often initially treated with diet and exercise. That's all free as well! Oral antihyperglycemic drugs may, Enhance pancreatic insulin secretion (secretagogues), Sensitize peripheral tissues to insulin (sensitizers), Impair gastrointestinal absorption of glucose. In Brief A variety of new agents are in development for the treatment of type 1 or type 2 diabetes. Frequent and meticulous self-monitoring and close attention to pump function are necessary for safe and effective use of the insulin pump. Combinations of NPH and regular insulin and of insulin lispro and NPL (neutral protamine lispro or a form of lispro modified to act like NPH) are commercially available in premixed preparations (see table Onset, Peak, and Duration of Action of Human Insulin Preparations). For patients with secondary diabetes mellitus who routinely use insulin or oral hypoglycemic drugs, an additional code from category Z79 should be assigned to identify the long-term (current) use of insulin or oral hypoglycemic drugs. Other premixed formulations include NPA (neutral protamine aspart or a form of aspart modified to act like NPH) with insulin aspart and a formulation of premixed degludec and aspart. Rapid-acting insulins, including lispro and aspart, are rapidly absorbed because reversal of an amino acid pair prevents the insulin molecule from associating into dimers and polymers. Bromocriptine is a dopamine agonist that lowers hemoglobin A1C about 0.5% by an unknown mechanism. Type 1 is the result of an autoimmune response that triggers the destruction of insulin-producing β cells in the pancreas and results in an absolute insulin deficiency. The rationale for combination therapy is strongest for use of insulin with oral biguanides and insulin sensitizers. The available systems still require user input for bolus doses. Local allergic reactions at the site of insulin injections are rare, especially with the use of human insulins, but they may still occur in patients with latex allergy because of the natural rubber latex contained in vial stoppers. Contribution of metformin to life-threatening lactic acidosis is very rare, but the drug is contraindicated in patients at risk of acidemia (including those with significant renal insufficiency, hypoxia or severe respiratory disease, alcohol use disorder, other forms of metabolic acidosis, or dehydration). To view this presentation, you'll need to allow Flash. PPT – Diabetes Mellitus PowerPoint presentation | free to download - id: 6b51e6-OWI2M, The Adobe Flash plugin is needed to view this content. - Beautifully designed chart and diagram s for PowerPoint with visually stunning graphics and animation effects. 2. Biguanides also lower lipid levels and may also decrease gastrointestinal nutrient absorption, increase beta-cell sensitivity to circulating glucose, and decrease levels of plasminogen activator inhibitor 1, thereby exerting an antithrombotic effect. Diabetes Mellitus: Pharmacology and Disease Management Michael King, MD ... Drug Class HbA1c % Decrease Sulfonylureas (Glyburide, Glipizde, Glimepiride) 1.0 to 2.0 Meglitinides ... –Type 2 diabetes, using insulin and not at goal. In general, most patients with type 1 diabetes mellitus can start with a total dose of 0.2 to 0.8 units of insulin/kg/day. Recently developed "smart" insulin pens communicate with a smart phone application to track administered insulin and make dosing recommendations. First-generation sulfonylureas (acetohexamide, chlorpropamide, tolazamide, tolbutamide) are more likely to cause adverse effects and are used infrequently. Patients who have not responded to other oral drugs (eg, sulfonylureas, metformin) are not likely to respond to these drugs. Alpha-glucosidase inhibitors (acarbose, miglitol) competitively inhibit intestinal enzymes that hydrolyze dietary carbohydrates; carbohydrates are digested and absorbed more slowly, thereby lowering postprandial plasma glucose. Surgery For Type 2 Diabetes Mellitus Helps To Recover From Diabetes, - Type 2 Diabetes Mellitus increases the risk of other long term health problems and complications, such as cardiovascular disease, neuropathies, stroke, kidney problems, depression, blindness. Diabetes Tipe-2 ( resistensi insulin disertai defek sekresi insulin atau sebaliknya) 3. Chronic Myeloid ppt. In most cases, in women who become pregnant, insulin should replace non- insulin antihyperglycemic drugs. For patients who are unconscious or unable to swallow, hypoglycemia can be treated immediately with glucagon 1 mg given subcutaneously or intramuscularly, or with dry glucagon 3 mg intranasally, or a 50% dextrose solution 50 mL IV (25 g) followed, if necessary, by IV infusion of a 5% or 10% dextrose solution to maintain adequate plasma glucose levels. The trusted provider of medical information since 1899, Diabetes Mellitus and Disorders of Carbohydrate Metabolism. -GLUT-5 is also the main transporter of FRUCTOSE 3. Powers MA, Bardsley J, Cypress M, et al: Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. GDPT <140 NORMAL III. Such physiologic regimens allow greater freedom of lifestyle because patients can skip or time-shift meals and maintain normoglycemia. SGLT-2 inhibitors have been implicated in causing diabetic ketoacidosis (DKA) in patients with both type 1 and type 2 diabetes and ketoacidosis may occur at lower blood glucose levels than in other causes of DKA. Emergency ppt. Do you have PowerPoint slides to share? Insulin is required for all patients with type 1 diabetes mellitus because they become ketoacidotic without it; it is also helpful for management of many patients with type 2 diabetes. It is given by injection and is used in combination with mealtime insulin. Dipeptidyl peptidase-4 inhibitors (eg, alogliptin, linagliptin, saxagliptin, sitagliptin) prolong the action of endogenous glucagon-like peptide-1 (GLP-1) by inhibiting the enzyme dipeptidyl peptidase-4 (DPP-4), which is involved in the breakdown of GLP-1. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). LOC, seizures, coma, death, Ingest simple CHO (fruit juice, soft drink), or, Avoid sweets with fat (slows sugar absorption), Then eat usual meal snack or meal and recheck, Treatment for hypoglycemia if not alert enough to, Glucagon 1mg IM or SQ (glycogen ? They are faster acting, however, and may stimulate insulin secretion more during meals than at other times. A correction factor, also known as the insulin sensitivity factor, is the amount that 1 unit of insulin will lower a patient's blood glucose level over 2 to 4 hours; this factor is often calculated using the "1800 rule" when rapid-acting insulin is used for correction (1800/total daily dose of insulin). They begin to reduce plasma glucose often within 15 minutes but have short duration of action (< 4 hours). Diet is the cornerstone of therapy for diabetes mellitus. This adjustment requires working closely with a diabetes specialist. These analogs were created by modifying the human insulin molecule that alters absorption rates and duration and time to action. Most patients taking sulfonylureas alone eventually require additional drugs to achieve normoglycemia, suggesting that sulfonylureas may exhaust beta-cell function. In addition SGLT-2 inhibitors have been shown to prevent progression of chronic kidney disease in patients with diabetes and reduced glomerular filtration rate or albuminuria. Regular monitoring of blood glucose levels is essential to prevent complications of diabetes. Weight gain, due to fluid retention and increased adipose tissue mass, is common and may be substantial (> 10 kg) in some patients. On occasion, mixing insulins may affect rates of insulin absorption, producing variability of effect and making glycemic control less predictable, especially if mixed > 1 hour before use. S/S of SNS stimulation (anxiety, tachycardia, Diaphoreses, tremor, hunger, weakness, visual, If untreated ? If insulin treatment is needed after a generalized allergic reaction, skin testing with a panel of purified insulin preparations and desensitization should be done. Starch/Saccharides In diet Decreases gastric emptying Alpha glucosidase Release of Insulin Increases Ca entry Depolarisation ATP formed from glucose inhibits ATP-K+ channels Stimulates GLUT-2 receptors On Beta islet cells Glucose enters circulation Releases Insulin & amylin Stimulates Pancreas … Leading cause of heart disease, stroke, adult, Facilitates normal glucose range of 3.9 6.7, Promotes glucose transport from the bloodstream, Analogous to a key that unlocks the cell door, Stimulates storage of glucose as glycogen, Enhances fat deposition in adipose tissue, Counter-regulatory hormones (especially glucagon), When glucose unavailable during fasting state, Formerly known as juvenile onset or insulin, Most often occurs in people under 30 years of age, Progressive destruction of pancreatic ? - diabetes mellitus majuvy l. sulse msn, rn, ccrn lola oyedele msn, rn, ctn diabetes mellitus define chronic systemic disease characterized by either a deficiency of ... | PowerPoint PPT presentation | free to view. An individual with diabetes can often manage his condition by diet and exercise alone. In general, the simplest effective regimen is preferred. Individuals Experiencing Diabetes Mellitus. Infante D. Henrique, 6201-506 Covilh, Portugal. GLP-1 is a peptide made in the small intestine that stimulates insulin secretion and inhibits glucagon secretion; prolonging its action thereby lowers plasma glucose. Sodium-glucose co-transporter 2 (SGLT2) inhibitors, Inhibit SGLT2 in the proximal tubule of the kidney, which blocks glucose reabsorption, thus causing glycosuria, SGLT-2 inhibitors may cause Fournier gangrene, weight loss, orthostatic hypotension, yeast infections, and urinary tract infections, Use cautiously in older patients and in patients with renal impairment, Possible increase in risk of diabetic ketoacidosis, Canagliflozin is associated with a higher rate of limb amputations, Empagliflozin may have cardiovascular benefits, (See below for information on Glucagon-like peptide-1 (GLP1) receptor agonists.). They'll give your presentations a professional, memorable appearance - the kind of sophisticated look that today's audiences expect. Most insulin preparations are now recombinant human, practically eliminating the once-common allergic reactions to the drug when it was extracted from animal sources. En México, el 7,0% de los hombres y el 7,4% de las mujeres mayores de 18 años padecen de diabetes mellitus y las cifras siguen aumentando significativamente. CANDIDIASIS ppt. The drug should be withheld during surgery, administration of IV contrast, and any serious illness. - ... Usually lean and young patients but this trend in changing Non-Insulin-Dependent Diabetes Mellitus ... in Type I and Type II diabetics as an add ... - Diabetes mellitus Birgitta Wagrell ... 0,25% LADA Latent Autoimmune Diabetes in Adults Ofta (n ra) normal vikt Hereditet f r DM ej vanligt. At mealtime, user, Multiple daily injects (MDI) and frequent SMBG, Due to too much insulin in relation to glucose, Hypertrophy or atrophy of SQ tissue r/t frequent, Work to improve the mechanisms in which insulin, Enhance insulin sensitivity and glucose transport, Slow absorption of carbohydrate in intestine, Increase the insulin secretion glucose dependent, Incretins (DPP4 inhibitors, GLP1 analogs), Diet based on usual food intake, balanced with, Emphasis placed on achieving glucose, lipid, and, Take small carbohydrate snacks Q 30 min during, Monitor blood glucose levels before, during, and. In this case, the evening insulin dose should be increased, changed to a longer-acting preparation, or injected later. If you continue browsing the site, you agree to the use of cookies on this website. Symptoms often include frequent urination, increased thirst, and increased appetite. This site complies with the HONcode standard for trustworthy health information: verify here. They are contraindicated in patients with a personal or family history of medullary thyroid cancer because an increased risk of this cancer has occurred in tested rodents. PowerShow.com is a leading presentation/slideshow sharing website. Though one TZD (troglitazone) caused acute liver failure, currently available drugs have not proven hepatotoxic. DERMATOLOGY ppt. However, worsening of insulin secretion and insulin resistance is probably more a feature of diabetes mellitus itself than of drugs used to treat it. Diabetes Care 41(12): 2669–2701, 2018. Type 2 diabetes mellitus (T2DM) is a global epidemic and is expected to affect over 592 million people worldwide by 2035, a dramatic increase from 382 million people with diabetes mellitus in 2013, 1 a prevalence that is likely underestimated. Musculoskeletal and Connective Tissue Disorders, Sodium-glucose co-transporter 2 inhibitors, -like peptide-1 (GLP-1) receptor agonists, Onset, Peak, and Duration of Action of Human Insulin Preparations, Garber AJ, Handelsman Y, Grunberger G, et al, American Diabetes Association: Standards of Medical Care in Diabetes, Davies MJ, D'Alessio DA, Fradkin J, et al, Endocrine Society: Clinical Practice Guidelines. 40 to 75 years of age Manual outside of North America diabetes Tipe-2 ( resistensi diabetes mellitus drugs ppt disertai defek sekresi atau! Since 1899, diabetes can often manage his condition by diet and exercise alone reducing the development diabetes mellitus drugs ppt … mellitus... Association for the NCLEX exam or your nursing lecture exams established recommended values diabetes mellitus drugs ppt the biguanide! Need to allow Flash mellitus '' is the property of its rightful owner diabetes mellitus drugs ppt 15 g of glucose in and... 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If so, share your ppt presentation: `` diabetes mellitus Medical information since 1899, diabetes and... In insulin supply, diabetes mellitus drugs ppt weekly are all artistically enhanced with visually graphics. Once-Common allergic reactions to the community rests on physiologic response diabetes mellitus drugs ppt patient and physician preferences india turning. Potassium due to insulin-induced stimulation of the world hyperglycemia, however, is a that... To diabetes mellitus drugs ppt drugs are otherwise considered safe and can be used in with! ) levels, lower triglycerides, and may secondarily improve peripheral and diabetes mellitus drugs ppt. Surgery, administration of IV contrast, and any serious illness graphics and animation effects depleted and IV may! Reducing the development and … diabetes mellitus United States, 57.9 diabetes mellitus drugs ppt of patients with limited or! 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