Chronic Metabolic Disorder Essay Example

Type 2 Diabetes Mellitus is a chronic metabolic disorder characterized by hyperglycemia, insulin resistance, and beta-cell dysfunction. Pharmacotherapy is an essential component of the management of Type 2 Diabetes Mellitus. The pharmacological options available for the treatment of Type 2 Diabetes Mellitus include oral antidiabetic agents, injectable antidiabetic agents, and insulin therapy. The selection of pharmacotherapy depends on several factors, such as the patient’s age, disease duration, comorbidities, and the severity of hyperglycemia. a. Oral Antidiabetic Agents: Oral antidiabetic agents are the first-line treatment for patients with Type 2 Diabetes Mellitus. The classes of oral antidiabetic agents include: i. Biguanides: Metformin is the most commonly used biguanide in the treatment of Type 2 Diabetes Mellitus.

It decreases hepatic glucose production and improves insulin sensitivity. Metformin is preferred in overweight or obese patients with Type 2 Diabetes Mellitus. ii. Sulfonylureas: Sulfonylureas stimulate insulin secretion from the beta-cells of the pancreas. They are useful in patients with Type 2 Diabetes Mellitus who have preserved beta-cell function. However, sulfonylureas can cause hypoglycemia and weight gain. iii. Dipeptidyl Peptidase-4 (DPP-4) Inhibitors: DPP-4 inhibitors increase the secretion of insulin and decrease the secretion of glucagon. They are weight-neutral and have a low risk of hypoglycemia. iv. Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors: SGLT2 inhibitors increase glucose excretion in the urine and decrease blood glucose levels. They are useful in patients with Type 2 Diabetes Mellitus who have heart failure or chronic kidney disease. v. Thiazolidinedione’s: Thiazolidinedione’s improve insulin sensitivity and reduce insulin resistance. They are useful in patients with Type 2 Diabetes Mellitus who have metabolic syndrome or fatty liver disease. b. Injectable Antidiabetic Agents: i. Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists: GLP-1 receptor agonists increase insulin secretion and decrease glucagon secretion. They are useful in patients with Type 2 Diabetes Mellitus who have cardiovascular disease or obesity. ii. Amylin Analogs: Amylin analogs slow gastric emptying and decrease appetite. They are useful in patients with Type 2 Diabetes Mellitus who have gastroparesis or weight gain. c. Insulin Therapy: Insulin therapy is required in patients with Type 2 Diabetes Mellitus who have inadequate glycemic control despite the use of oral antidiabetic agents or injectable antidiabetic agents.

a. Insulin therapy: Insulin therapy is the most effective way to lower blood glucose levels and can be used alone or in combination with other drugs. Insulin therapy requires careful monitoring and dose adjustments, and can cause hypoglycemia and weight gain. b. GLP-1 agonists: GLP-1 agonists can be used as add-on therapy to insulin or in place of insulin to reduce the risk of hypoglycemia and promote weight loss. c. SGLT-2 inhibitors: SGLT-2 inhibitors can be used as add-on therapy to insulin to improve glycemic control and reduce cardiovascular and renal risks. d. Combination therapy: Combination therapy with two or more drugs with different mechanisms of action can improve glycemic control and reduce the risk of adverse events. For example, a combination of metformin and a GLP-1 agonist or a DPP-4 inhibitor can be used to achieve glycemic control.