PHAR1811 Foundations Of Pharmacy


1.Why is Diabetes Mellitus called that?

What is the difference between Diabetes Mellitus and Diabetes Insipidus, you ask?

2.Diabetic Mellitus sufferers are divided into two main groups.

They are what? What is the basis for the cCassification system used?

3.How is Diabetic Diagnosis Made?

Which Treatment Options are Most Effective to Manage This Condition?

4. What changes in the Metabolism (glucose and fat) can be observed in this condition?

These Metabolic Changes can cause Diabetic symptoms. Why do they occur?

5.Determine the concentration of glucose in each patient serum sample and plot the Glucose Concentration against time.

6.What potential long-term problems would a pharmacist need to be aware when advising a Diabetic client?


1.The short form of diabetes mellitus (DM) is called “diabetes”.

It was derived from the Latin and Greek words ‘diabetes (short for diabetes mellitus) and’mellitus (short for siphon, passing through), respectively.

This word was first used in English medical language language in 1425 as ‘diabetes’. In 1675, Thomas Williams used “mellitus”, which is a synonym for diabetes, to signify the sweet taste in urine (Lakhtakia 2013, 2013).

DM can be characterized by high blood sugar, increased hunger, thirst, and excessive urination. Diabetes insipidus, on the other hand, is usually caused by a deficiency or genetic defect.

Treatment for DM includes insulin injections and lifestyle changes. Insipidus requires desmopressin and diuretics (Smith & Vermaak 2009).

The majority of DM cases fall into one of two broad categories based on their pathophysiology.

The first is type I DM, which is caused by insulin deficiency.

Type II DM can be caused by insulin resistance, or insufficient insulin secretion.

In the latter case, hyperglycemia can be observed, which can cause tissue damage.

Type I DM (also known as juvenile onset DM) is characterized by complete insulin deficiency in the blood.

This usually happens before age 20.

Type II DM is characterized by either a deficiency in insulin or an inability to activate glucoreceptors.

Type II DM is usually a result of age and occurs in people over 60 years old (American Diabetes Association 2009b).

3.DM refers to elevated blood sugar levels. This is done by estimating the plasma glucose level at different times of day.

The World Health Organization (WHO) states that DM is defined as elevated blood sugar levels. A person with fasting glucose levels between 6.1 and 6.9 mmol/litreor 110 to 125 mg/dlitre is considered to have impaired fasting glucose. However, a person who has blood glucose levels greater than 7.8 mmol/litreor140 mg/dlitre but less than 11.1mmol/litre or 200mg/dlitre two hours before taking 75 g of oral glucose loading, is thought to have impaired glucose tolerance

Glycated hemoglobin should be checked in order to determine if an individual is at risk of developing diabetes mellitus (Selvin et. al., 2010).

DM is an incurable metabolic condition that can be controlled by lowering blood glucose levels.

The anti-hyperglycaemic medications can be managed by lifestyle changes such as diet control and exercise.

Here are some drugs that are used clinically to manage DM.

Combinations of the drugs mentioned above

It is important to have a routine estimate of glycated hemoglobin (Hb1AC), in order to manage the DM (Zarowitz et. al., 2015).

Management of DM can be helped by lifestyle and dietary changes.

4.DM refers to a blood deficiency in insulin.

A lack of insulin can cause abnormalities in the metabolism carbohydrate, protein, and fat.

Insulin’s main functions are:

Increased glucose uptake

Storage and glucose use increases

Protein synthesis is increased

Fat storage is increased

The insulin function is affected in diabetic patients.

Diabetes mellitus, or a lack of insulin, causes changes in carbohydrate metabolism.

Insulin sensitive tissue such as adipose tissues and muscles has a decreased ability to absorb glucose.

Encourage the production of glucose in the blood and block the removal.

Glycogenolysis is increasing

Glycogen synthesis has been reduced

Glycolysis in relapse

Following changes in lipid metabolism can be caused by insulin deficiency

Lipolysis has increased

Reduced ketones are removed and ketone bodies are produced more.

Patients can experience a variety of biochemical and physical changes due to metabolic alteration in their metabolism of carbohydrates or lipids.

These are just a few of the many (Do et. al. 2012).

Impaired carbohydrate metabolism can cause symptoms

Impaired lipid metabolism can cause symptoms

Polyuria, Polydypsia, and Polyphagia

Ketone body formation results in ketourea

Low pH stimulates the respiratory center and promotes rapid, deep breathing

Negative nitrogen balance causes muscle wasting

Acidosis can lead to coma

Atherosclerosis is caused by high cholesterol.

Table 1: The symptoms of altered metabolism in diabetics

5.Comment on the results of the two patients

The serial dilutions were used to create the standard plot of glucose concentration.

With equation Y = 0.08X + 0.016, a straight line curve was obtained.

Figure 2: Different absorbances from blood samples of patients A and B were calculated. Line charts (Figure 2) illustrate the results.

Figure 1: Standard plot of Absorbance vs. Glucose concentration

Figure 2: Comparison of glucose concentrations for patient A and B

Comment: Plasma glucose concentrations at rest are normally 6.1 mg/L.

Postprandial glucose tests should not be performed if the blood glucose level after 2 hours is 7.8mMol/L.

Figure 2 shows two patients’ postprandial glucose tests.

Patient A has higher blood sugar levels and is above the allowed limits until the end of the test.

Patient B, on the other hand, has maintained control of blood glucose levels (Martin and al. 2012).

This shows that patient A has lower blood insulin levels and is not able to metabolize glucose.

This means that Patient A has diabetes mellitus.

You can confirm it by repeating the test (American Diabetes Association, 2014b).

6.DM is a chronic condition that affects patients on a variety of levels.

The pharmacist should inform the patient about the disease and the complications it can cause.

The pharmacist must advise patients on lifestyle changes and treatment options.

Patients should be informed that DM is a progressive and lifelong condition that requires lifestyle changes.

The pharmacist must emphasize the importance of medication therapy and remind patients to follow prescribed medication therapy.

McCord (2006).

While advising patients, the pharmacist should stress the importance of lifestyle changes such as healthy eating, exercise, quitting smoking, and quitting alcohol consumption.

Treatment in DM requires a controlled diet.

The pharmacist should emphasize the importance of proper dietary intake of fat, carbohydrate, and protein.

The body’s blood glucose levels are directly affected by carbohydrate intake.

The daily carbohydrate intake should be maintained constant in accordance with the level of daily activity.

Saturated fatty acids can increase the risk of obesity and cardiac disease. It is best to advise patients with DM to limit their intake.

It is also a good idea to increase fiber intake as it helps with fullness and decreases hunger.

It slows down the absorption fats and carbohydrates, thereby reducing the risk of hyperglycemia (Katz 2014).

Physical activity: DM patients can benefit from regular exercise and appropriate caloric intake.

However, the pharmacist must be careful when advising patients about exercise to prevent exhaustion and hypoglycemia (Balk and colleagues 2015).

Tobacco and smoking: Continuous smoking can increase your chances of developing hypertension or other cardiac problems. The pharmacist should warn patients that this could lead to a rise in cardiac complications in DM patients.

The pharmacist should inform DM patients that even if blood glucose levels are controlled, alcohol consumption can have a significant impact on blood glucose levels (Smith 2009).

Refer to

American Diabetes Association (2014).

Diabetes mellitus: Diagnosis and classification.

Diabetes care, 37 (Supplement 1) pp. S81-S90.

American Diabetes Association (2014).

2014 Standards for medical care in diabetes.

Diabetes care, 37 (Supplement 1) pp. S14-S80.

Balk, E.M. Earley A., Raman G., Avendano E.A. Pittas A.G. and Remington P.L. (2015)

A systematic review of the Community Preventive Services Task Force’s combined diet and exercise promotion programs to prevent type II diabetes in persons at higher risk.

Annals, 163(6), 437-451

Do, G.M. Jung, U.J. Park, H.J. Kwon E.Y. Jeon S.M. McGregor, R.A. Choi, M.S.

Resveratrol reduces diabetes-related metabolic changes by activating AMP?activated Protein Kinase and its downstream targets, in db/db mice.

Lines and dots in diet and diabetes.

The Journal of nutrition, 14(4), pp. 567S-570S.

Diabetes mellitus: The history.

Sultan Qaboos University Medical Journal 13(3), p.368.

Martin, R.J. Ratan, R.R. Reding, M.J., and Olsen T.S. (2012).

Higher blood glucose levels than the normal range are associated with more severe strokes.

Stroke treatment and research, 2012.

The Clinical Impact of a Pharmacist. Managed Diabetes Mellitus Drug Treatment Management Service.

Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy 26(2) pp.248-253.

Selvin, E. Steffes M.W. Zhu H. Matsushita K. Wagenknecht L. Pankow J. Coresh J. and Brancati F.L. 2010, 2010.

Glycated hemoglobin and diabetes in adults who are not diabetic.

New England Journal of Medicine 362(9), pages 800-811.

Diabetes Mellitus, Diabetes Insipidus.

General Surgery (pp.

Diabetes Mellitus, Diabetes Insipidus.

General Surgery (pp.

Treatment patterns for type 2 diabetes mellitus in US nursing home residents.

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