Background and Purpose
In their 2019 article, Patricia Keresztes and Annette Peacock-Johnson review the pharmacologic treatment of Type 2 Diabetes (T2D) and provide instructions for healthcare professionals, particularly nurses, on their use in treating patients. The authors first emphasize that T2D is one of the most widespread diseases in the United States and the seventh leading cause of death (Keresztes & Peacock-Johnson, 2019). Keresztes & Peacock-Johnson (2019) argue that while lifestyle management remains one of the primary ways of T2D treatment, the pharmacologic method of therapy is another primary treatment method. Hence, nurses should familiarize themselves with the primary drugs used in T2D treatment, including special considerations, adverse effects, and mechanisms of action. Thus, the authors provide specific instructions on how nurses inject these drugs and when patients should take them.
Findings
The article reviews the nine groups of drugs used to treat T2D. With metformin as the primary type, although associated with B12 deficiency, Biguanides are one of the most effective drugs. Second-generation sulfonylureas, including glimepiride, glipizide, and glyburide, are the oldest and least expensive drugs after metformin (Keresztes & Peacock-Johnson, 2019). They are usually prescribed during the early stages of T2D (Keresztes & Peacock-Johnson, 2019). These medicines cause a higher risk of hypoglycemia, cardiovascular mortality, weight gain, skin rashes, and other adverse effects.
The third group is meglitinides which include nateglinide and repaglinide. Although they are less effective than sulfonylureas, they present a lower risk of hypoglycemia (Keresztes & Peacock-Johnson, 2019). Thiazolidinediones (glitazones) include pioglitazone and rosiglitazone and also present a lower risk of hypoglycemia (Keresztes & Peacock-Johnson, 2019). They entail several adverse effects, such as a bone fracture in women, weight gain, edema, and increased risk of pregnancy. The other groups of drugs include:
- Alpha-glucosidase inhibitors.
- Dipeptidyl peptidase inhibitors.
- Glucagon-like peptide one receptor agonists.
- Sodium-glucose cotransporter two inhibitors (canagliflozin, ertugliflozin).
- Human amylin analog (pramlintide).
Each of these groups contains specific instructions on the injection, special considerations, and adverse effects. The authors also mention the importance of combination therapies and recommend that nurses be informed about them (Keresztes & Peacock-Johnson, 2019). As such, the authors present a concise and comprehensive summary of the different drugs legalized by the FDA and provide valuable instructions that nurses should consider while treating T2D patients.
Reference
Keresztes, P., & Peacock-Johnson, A. (2019). Type 2 diabetes: A pharmacologic update.AJN, American Journal of Nursing, 119(3), 32–40. Web.