Diabetes Management and Pharmacological Effects

Pharmacological Effects of Herbal Supplements in the Management of Diabetes and Nursing Implications

Management of Diabetes Mellitus

  • Diabetes mellitus is a metabolic disorder.
  • Chronic disorder (Chang et al., 2013).
  • Two types of diabetes to manage.
  • Type 1 diabetes is insulin-dependent.
  • Type 2 diabetes is noninsulin-dependent diabetes.
  • Disease management depends on the type.

Herbal Supplements in the Management of Diabetes Mellitus

  • About 400 herbs have anti-diabetic properties.
  • Controlling glucose (Obiedo & Elizon, 2015).
  • Herbal supplements also regulate glucose absorption.
  • Some herbs control the ????-cell function.
  • Herbs are used in combination therapies.
  • Herbal supplements represent an alternative therapy.

Pharmacological Effects of Herbs to Address Insulin Resistance

  • Licorice controls glucose metabolism activating PPAR-????.
  • Dioscorea decreases the phosphorylation of ERK.
  • Reduces insulin resistance (Chang et al., 2013).
  • Blueberry’s antioxidants neutralize free radicals.
  • Astragalus reduces insulin resistance activating Akt.
  • Gastrodia elata potentially decreases fat accumulation.

Pharmacological Effects of Herbs to Control ????-Cell Function

  • Pandanus amaryllifolius significantly addresses hyperglycemia.
  • Tabernaemontana divaricate improves producing ????-cells.
  • Nymphaea stellate contributes to generating ????-cells.
  • Silybum marianum improves the ????-cell function.
  • Bidenspilosa reduces blood glucose levels.
  • Activating ????-cells (Chang et al., 2013).

Pharmacological Effects of Herbs to Control Glucose Absorption

  • Some herbs control the ????-glucosidase activity.
  • Safflower improves the insulin secretion.
  • Safflower also reduces the ????-glucosidase activity.
  • Laminaria japonica effectively controls glucose absorption.
  • Butyl-isobutyl-phthalate affects the ????-glucosidase activity.
  • Addressed absorption (Chang et al., 2013).

Nursing Implications and Conclusion

  • Herbal supplements add to anti-diabetic therapies.
  • Herbal supplements are comparably safe.
  • Effects are in influencing metabolic pathways.
  • Prescribed herbs decrease the medication dosage.
  • Nurses should focus on drug-and-herb interactions.
  • Herbal supplements improve patient outcomes.

Pharmacological Effects of Metformin Medications in the Management of Diabetes and Nursing Implications

Management of Type 2 Diabetes

  • Associated with impaired glucose tolerance.
  • Disease management requires the pharmacological therapy.
  • Lifestyle interventions are required and recommended.
  • Combination of pharmacological therapies and interventions.
  • Metformin is used to treat diabetes.
  • Recommended medication (Rojas & Gomes, 2013).

Using Metformin for Managing Type 2 Diabetes

  • Metformin is a first-line medication.
  • Commonly used (Napolitano et al., 2014).
  • Early usage of Metformin is expected.
  • Effects on reducing glucose are significant.
  • Monotherapy based on Metformin is possible.
  • Combination therapies should include Metformin.

Pharmacological Effects of Metformin Medications

  • Positive effects (Rojas & Gomes, 2013).
  • Metformin decreases glucose in the liver.
  • The upstream kinase is activated.
  • LKB-1 is also effectively activated.
  • Synthesis of gluconeogenic enzymes is regulated.
  • Effects on gut micro-biome changes.

Effects of Metformin as the Part of the Combination Therapy

  • Metformin should be combined with insulin.
  • Decreases in HbA1c to about 2%.
  • Metformin can be combined with sulfonylureas.
  • Expected effects regarding HbA1c are lower.
  • Oral usage (Napolitano et al., 2014).
  • Metformin is safe, improving metabolic processes.

Possible Adverse Effects of Metformin Medications

  • Gastrointestinal intolerance (Napolitano et al., 2014).
  • Pharmacological effects improve when decreasing doses.
  • Doses should generally be adjusted.
  • Can be administered with meals.
  • Vitamin B12 absorption can become reduced.
  • Rare adverse effects include allergic pneumonitis.

Pharmacology and Drug Interactions

  • Rare interactions (Rojas & Gomes, 2013).
  • Positive outcomes because of rare interactions.
  • Interactions are with morphine, amiloride, procainamide.
  • Pharmacological effects can be decreased.
  • Some interactions cause gastrointestinal side-effects.
  • Dosage of Metformin should be regulated.

Nursing Implications and Concluding Remarks

  • Positive pharmacological effects are proven.
  • Metformin is a pre-diabetes drug.
  • Nurses focus on Metformin’s macrovascular outcomes.
  • The medication is viewed as safe.
  • The low-level toxicity is reported.
  • Actively used in anti-diabetic therapies.

References

Chang, C. L., Lin, Y., Bartolome, A. P., Chen, Y. C., Chiu, S. C., & Yang, W. C. (2013). Herbal therapies for type 2 diabetes mellitus: Chemistry, biology, and potential application of selected plants and compounds. Evidence-Based Complementary and Alternative Medicine, 2013(1), 1-33.

Napolitano, A., Miller, S., Nicholls, A. W., Baker, D., Van Horn, S., Thomas, E.,… Nunez, D. J. (2014). Novel gut-based pharmacology of metformin in patients with type 2 diabetes mellitus. PloS One, 9(7), 1-14.

Obiedo, A., & Elizon, L. (2015). Diabetes mellitus management: Herbal or prescribed medication. CNU Journal of Higher Education, 9(1), 162-172.

Rojas, L. B. A., & Gomes, M. B. (2013). Metformin: An old but still the best treatment for type 2 diabetes. Diabetology & Metabolic Syndrome, 5(6), 1-15.

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