Answer

Diabetes Mellitus

Diabetes is a metabolic syndrome that is characterized by high levels of sugar in blood as well as polyphagia, polydipsia and polyuria (Cdc.gov, 2019). Diabetes can be characterized into four classes namely: type 1, juvenile, type 2, and gestational (Cdc.gov, 2019).

 Diabetes type 1 is prevalent in children and can be divided into two; idiopathic and autoimmune. Autoimmune is characterized by the destruction of the beta cells of the pancreas by various immune responses such as B and T cells (Atkinson, Eisenbarth, & Michels, 2014).  The end result is that insulin is low or absent, hence the rise in blood sugars (American Diabetes Association, 2015). Diabetes type 1 has an abrupt onset and is also associated with viral infections such as mumps, rubella and cocksackie viruses that induce molecular mimicry immunity. Finally, type 1 is also associated with weight loss, unlike type 2 which is characterized by overweight. Juvenile diabetes is closely associated with type 1, but as the name suggests, has a very early onset. It manifests just as type 1, but with a characteristic nocturnal enuresis.

Type 2 is associated with over individuals aged forty years, obesity and insulin resistance (Jayanthi et al., 2017).  The insulin produced may be low, normal or even elevated. However, the insulin produced is not compatible with the body tissues. This could be due to abnormal insulin molecule, abnormal h-r complexes, abnormal receptors, lack of receptors, insensitivity of the molecule to receptors and finally defective translational mechanisms. Type 2 is also strongly genetically linked. Unlike type 1, type 2 has a slower onset. Finally, gestational diabetes is a type of diabetes mellitus that results in high levels of glucose during the nine month period. However, levels resume to normal after child birth (Cdc.gov, 2019). A common outcome is that they have big babies and poor pregnancy outcomes if the pregnancy is not handled cautiously (Cdc.gov, 2019). 

The treatment of diabetes type two revolves around administration of both insulin and oral hypoglycemic drugs. Depending on the sugar levels in the body, both can be issued. However, therapy begins with oral hypoglycemic treatment first. The most common drug preferred in treatment are the biguanides, specifically metformin. Biguanides work by signaling peripheral storage of glucose into tissues, and preventing hepatic synthesis of glucose during gluconeogenesis (Pernicova & Korbonits, 2014).  Metformin is administered differently depending on the circumstances involved. At times, it is administered alone or with insulin, sulfonylurea or thiazolidinedione. In regards to the adverse effects, metformin causes weight gain since the glucose in the blood is directed to peripheral tissues. Other minor adverse effects associated with metformin are non-specific abdominal symptoms such as nausea, diarrhea and bloating which vary with people (Aroda et al., 2016).  Finally, the major severe adverse effects is vitamin b12 deficiency which cases megaloblastic anemia (Aroda et al., 2016). This may present with headaches, easy fatigability and palpitations. Hence, B12 supplementation through tablets or diet may be recommended. The administration of metformin is normally after a meal, through oral intake. The dose is around 50 mg, but doctors may increase the dosage till normal glucose levels are achieved.

The short term effects of diabetes are majorly the drug effects such as diarrhea, vomiting and weight gain, and the rise in medication costs. On the other hand, the long-term effects associated with diabetes revolve around diet modification and prevention of progression of the disease to kidney failure, retinopathy, cardiovascular disease and neuropathy. A dietician/nutritionist ought to be consulted in order to provide diabetic diet. Additionally, exercises should be conducted in order to reduce weight to reduce the effects of type 2 diabetes. Furthermore, compliance of drugs should also be strongly adhered to; otherwise, complications such as Diabetic ketoacidosis (D.K.A) could occur. Finally, patents with diabetes need to wear good foot wear to prevent the occurrence of the diabetic foot.