diabetes mellitus (one of the major type of diabetes)

Importance of Clinical Pharmacy
Clinical pharmacy plays a crucial role in healthcare, offering several distinct advantages over other fields. Here are some key reasons why clinical pharmacy is particularly important:

1. Patient-Centered Care
Clinical pharmacists focus on optimizing patient outcomes through personalized medication management, ensuring that treatments are tailored to individual patient needs.
2. Medication Management
They have expertise in pharmacotherapy, allowing them to manage complex medication regimens, reduce polypharmacy, and prevent medication errors.
3. Adverse Drug Reaction Prevention
Clinical pharmacists monitor for potential drug interactions and side effects, contributing to safer medication practices and minimizing adverse reactions.
4. Education and Counseling
They provide education to patients and healthcare teams about medications, fostering better understanding and adherence to treatment plans.
5. Interdisciplinary Collaboration
Clinical pharmacists work closely with physicians, nurses, and other healthcare professionals, ensuring comprehensive care and enhancing team-based approaches.
6. Cost-Effectiveness
By optimizing drug therapy and preventing complications, clinical pharmacists can help reduce overall healthcare costs associated with hospitalizations and additional treatments.
7. Chronic Disease Management
They play a vital role in managing chronic diseases such as diabetes, hypertension, and asthma, contributing to better long-term health outcomes.
8. Research and Development
Clinical pharmacists are involved in clinical research, helping to assess new medications and treatment protocols, which contributes to advancements in medical knowledge.
9. Regulatory Knowledge
They are well-versed in drug regulations and can help navigate legal aspects of medication use, ensuring compliance and safety.
Conclusion
Overall, clinical pharmacy is essential for improving patient care, enhancing medication safety, and promoting better health outcomes. Its focus on direct patient interaction and collaboration within the healthcare team distinguishes it from other fields in pharmacy and healthcare.



You said:
What is the reason to choose pharmacy practice as mphil in pharmacy
ChatGPT said:
ChatGPT
Choosing to pursue an MPhil in Pharmacy Practice offers several compelling benefits and reasons for career advancement:

1. Specialized Knowledge
An MPhil in Pharmacy Practice provides in-depth knowledge of medication management, patient care, and clinical practices, equipping graduates with the expertise needed to excel in various healthcare settings.
2. Research Opportunities
The program emphasizes research, allowing students to contribute to the field through studies on medication safety, efficacy, and patient outcomes, thus influencing practice and policy.
3. Enhanced Career Prospects
Graduates often have better job prospects in clinical settings, academia, and pharmaceutical industries, as the degree demonstrates advanced

1. Diabetes mellitus Diabetes is a condition that happens when your blood sugar (glucose) is too high. It develops to the effects of insulin properly. Diabetes affects people of all ages. Most forms of diabetes are chronic (lifelong), and all forms are manageable with medications and/or lifestyle changes.

2. Causes of Diabetes Too much glucose circulating in your bloodstream causes diabetes, regardless of the type. However, the reason why your blood glucose levels are high differs depending on the type of diabetes. Other types includes; Insulin resistance Autoimmune disease Hormonal imbalance Pancreatic damage Genetic mutation of diabetes

3. Types of Diabetes mellitus Pre-diabetic Prediabetes is when your blood sugar is higher than it should be but not high enough for your doctor to diagnose diabetes. Prediabetes can make you more likely to get type 2 diabetes and heart disease. Exercising more and losing extra pounds, even as little as 5% to 7% of your body weight, can lower those risks.

4. Types of Diabetes mellitus Type I diabetes Type 1 diabetes is also called insulin-dependent diabetes. It used to be called juvenile-onset diabetes, because it often begins in childhood. Type 1 diabetes is an autoimmune condition. It happens when your body attacks your pancreas with antibodies. The organ is damaged and doesn’t make Your genes might cause this type of diabetes insulin. It could also happen because of problems with cells in your pancreas that make insulin.

5. Types of Diabetes mellitus Type II Type 2 diabetes used to be called non-insulin-dependent or adult-onset diabetes. But it’s become more common in children and teens over the past 20 years, largely because more young people are overweight or obese. About 90% of people with diabetes have type 2.When you have type 2 diabetes, your pancreas usually creates some insulin. But either it’s not enough or your body doesn’t use it like it should.

6. To be continued… Insulin resistance, when your cells don’t respond to insulin, usually happens in fat, liver, and muscle cells. Type 2 diabetes is often milder than type 1. But it can still cause major health complications, especially in the tiny blood vessels in your kidneys, nerves, and eyes. Type 2 also raises your risk of heart disease and stroke. Obesity often causes insulin resistance, so your pancreas has to work harder to make more insulin. But it’s still not enough to keep your blood sugar levels where they should be.

7. Gestational diabetes Pregnancy usually causes some form of insulin resistance. If this becomes diabetes, it’s called gestational. Doctors often spot it in middle or late pregnancy. Because a woman’s blood sugars travel through their placenta to the baby, it’s important to control gestational diabetes to protect the baby’s growth and development. Doctors report gestational diabetes in 2% to 10% of pregnancies. It usually goes away after birth. But up to 10% of women who have gestational diabetes get type 2, weeks or even years later. Gestational diabetes is more of a risk for the baby than the mother.

8. To be Continued… A baby might have unusual weight gain before birth, trouble breathing at birth, or a higher risk of obesity and diabetes later in life. The mother might need a cesarean section because of an overly large baby, or they might have damage to their heart, kidney, nerves, and eyes.

9. Normal Physiology Diabetes occurs when there is a dis-balance between the demand and production of the hormone insulin. Control of blood sugar When food is taken, it is broken down into smaller components. Sugars and carbohydrates are thus broken down into glucose for the body to utilize them as an energy source. The liver is also able to manufacture glucose. In normal persons the hormone insulin, which is made by the beta cells of the pancreas, regulates how much glucose is in the blood.

10. To be Continued When there is excess of glucose in blood, insulin stimulates cells to absorb enough glucose from the blood for the energy that they need. Insulin also stimulates the liver to absorb and store any excess glucose that is in the blood. Insulin release is triggered after a meal when there is a rise in blood glucose. When blood glucose levels fall, during exercise for example, insulin levels fall too.

11. Pathophysiology of diabetes Diabetes mellitus is a chronic heterogeneous metabolic disorder with complex pathogenesis. It is characterized by elevated blood glucose levels or hyperglycemia, which results from abnormalities in either insulin secretion or insulin action or both. Pathophysiology of type 1 diabetes: In this condition the immune system attacks and destroys the insulin producing beta cells of the pancreas. There is beta cell deficiency leading to complete insulin deficiency. Thus is it termed an autoimmune disease where there are anti insulin or anti-islet cell antibodies present in blood.

12. To be Continued… These cause lymphocytic infiltration and destruction of the pancreas islets. The destruction may take time but the onset of the disease is rapid and may occur over a few days to weeks. There may be other autoimmune conditions associated with type 1 diabetes including vitiligo and hypothyroidism. Type 1 diabetes always requires insulin therapy, and will not respond to insulin-stimulating oral drugs.

13. Pathophysiology of type 2 diabetes This condition is caused by a relative deficiency of insulin and not an absolute deficiency. This mean that the body is unable to produce adequate insulin to meet the needs. There is Beta cell deficiency coupled with peripheral insulin resistance. Peripheral insulin resistance means that although blood levels of insulin are high there is no hypoglycemia or low blood sugar. This may be due to changes in the insulin receptors that bring about the actions of the insulin.

14. Pathophysiology of gestational diabetes Gestational diabetes is caused when there are excessive counter-insulin hormones of pregnancy. This leads to a state of insulin resistance and high blood sugar in the mother. There may be defective insulin receptors.  

15. Complications of diabetes

16. Signs and Symptoms Diabetes symptoms depend on how high your blood sugar is. Some people, especially if they have prediabetes, gestational diabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe. Some of the symptoms of type 1 diabetes and type 2 diabetes are: Feeling more thirsty than usual. Urinating often. Losing weight without trying.

17. To be Continued… Feeling tired and weak. Feeling irritable or having other mood changes. Having blurry vision. Having slow-healing sores. Getting a lot of infections, such as gum, skin and vaginal infections.

18. Etiology of diabetes mellitus The exact cause of most types of diabetes is unknown. In all cases, sugar builds up in the bloodstream. This is because the pancreas doesn't produce enough insulin. Both type 1 and type 2 diabetes may be caused by a combination of genetic or environmental factors. Risk Factors Risk factors for diabetes depend on the type of diabetes. Family history may play a part in all types. Environmental factors and geography can add to the risk of type 1 diabetes.

19. To be continued… Sometimes family members of people with type 1 diabetes are tested for the presence of diabetes immune system cells (autoantibodies). If you have these autoantibodies, you have an increased risk of developing type 1 diabetes. But not everyone who has these autoantibodies develops diabetes. Race or ethnicity also may raise your risk of developing type 2 diabetes. Although it's unclear why, certain people — including Black, Hispanic, American Indian and Asian American people — are at higher risk. Prediabetes, type 2 diabetes and gestational diabetes are more common in people who are overweight or obese.

20. Diagnosis Majority on minor level we diagnose diabetes from its symptoms but on major level we perform following test’s; 1-Random blood sugar test A blood sample will be taken at a random time. No matter when you last ate, a blood sugar level of 200 milligrams per deciliter (mg/dl) — 11.1 millimoles per liter ( mmol /L) — or higher suggests diabetes. 2-Fasting blood sugar test A blood sample will be taken after you haven’t eaten anything the night before (fast). A fasting blood sugar level less than 100 mg/ dL (5.6 mmol /L) is normal.

21. A fasting blood sugar level from 100 to 125 mg/ dL (5.6 to 6.9 mmol /L) is considered prediabetes. If it’s 126 mg/ dL (7 mmol /L) or higher on two separate tests, you have diabetes. 3-Glucose tolerance test For this test, you fast overnight. Then, the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested regularly for the next two hours. A blood sugar level less than 140 mg/ dL (7.8 mmol /L) is normal. A reading of more than 200 mg/ dL (11.1 mmol /L) after two hours means you have diabetes. A reading between 140 and 199 mg/ dL (7.8 mmol /L and 11.0 mmol /L) means you have prediabetes.

22. Non pharmacological treatment Medical nutrition therapy (MNT), weight management, physical activity, smoking cessation, diabetes self-management education and support, and psychosocial care are essential for achieving treatment goals and improving quality of life among patients with diabetes. Diet management: Adoption of a low glycemic index diet to improve postprandial blood glucose excursions Use of non-nutritive sweeteners to replace sugar for calorie and carbohydrate control Increased consumption of dietary fiber Low-calorie and low-carbohydrate diet for weight management and metabolic control

23. Physical Activity Exercise improves blood glucose control, contributes to weight loss, decreases cardiovascular risk factors, and improves well-being. Strive for moderate to vigorous intensity aerobic activity for 150 minutes or more per week. A short exercise duration of 75 minutes per week of vigorous intensity is appropriate for younger and more physically fit individuals.

24. Emergency treatment for severe hyperglycemia If you have signs and symptoms of diabetic ketoacidosis or hyperosmolar hyperglycemic state, you may be treated in the emergency room or admitted to the hospital. Emergency treatment can lower your blood sugar to a normal range. Treatment usually includes: Fluid replacement You'll receive fluids usually through a vein (intravenously) until your body has the fluids it needs. This replaces fluids you've lost through urination. It also helps dilute the extra sugar in your blood.

25. Electrolyte replacement Electrolytes are minerals in your blood that are necessary for your tissues to work properly. A lack of insulin can lower the level of electrolytes in your blood. You'll receive electrolytes through your veins to help keep your heart, muscles and nerve cells working the way they should. Insulin therapy Insulin reverses the processes that cause ketones to build up in your blood. Along with fluids and electrolytes, you'll receive insulin therapy usually through a vein. As your body returns to normal, your healthcare provider will consider what may have triggered the severe hyperglycemia. Depending on the circumstances, you may need additional tests and treatment.

26. Pharmacotherapy of diabetes mellitus Insulin Insulin is a polypeptide hormone consisting of two peptides chains that are connected by disulfide bonds. Types of Insulin: Ultra-short acting Insulin analogues e.g. Lispro , Aspart , Glulisinė Short acting e.g. Regular soluble insulin Intermediate acting e.g. NPH ( isophane ), Lente, NPL (neutral protamine lispro ) Long-acting insulin analogues: e.g. Ultra-Lente, glargine, detemir Premixed combination: 70/30 of NPH & Regular. 50/50 and 25/75 of NPL and lispro

27. Class Drug Mechanism of action Sulfonylureas Glimepiride Glipizide Glyburide Stimulate insulin secretion Glinides Nateglinide Repaglinide Stimulate insulin secretion Biguanides Metformin Decrease hepatic production of glucose Thiazolidinediones Pioglitazone Rosiglitazone Binds to peroxisome proliferator-activated receptors (gamma) in muscle, fat and liver to decrease insulin resistance Alpha- glucosidase inhibitors Acarbose Miglitol Decrease glucose absorption DPP-4 inhibitors Alogliptin Sitagliptin Increase glucose dependent insulin release, decrease secretion of glucagon SGLT2 inhibitors Canagliflozin Dapaglifozin   Increase urinary glucose excretion GLP-1 receptors agonist Albiglutide Semaglutide Increase glucose dependent insulin release, decrease secretion of glucagon. slow gastric emptying, increase satiety