Type II diabetes
Type II diabetes usually develops when the islets fail to produce enough insulin to overcome insulin resistance in the body. This type of diabetes is treated through metformin or insulin intake. However, the treatment choice depends on the level of HgbA1C in the blood. Insulin treatment is preferred when the level of HbgA1C is above 9 percent. The type of insulin depends on how long one needs the effects of the supplementary hormone to last. In patients with extreme hyperglycemia should be started immediately to lower glucose levels. As Insulin regimen is required in the treatment of various types of diabetes. In all instances of insulin treatment, the dosage should be individualized and balanced with other medical therapy. The insulin therapy may be initiated as augmentation, beginning at 0.3 unit per kg or as replacement starting with 0.6 unit per kg. For Maria’s condition, I would choose long-acting insulin, especially Insulin detemir, which would be administered twice daily.
As the incidence of diabetes 2 increases, so does the development of treatment options. I would recommend extended release of metformin which would be taken orally once daily at a dose of 500 mg for one week. According to (haha), the extended-release is the most preferred formulation of metformin for patients with extreme hyperglycemia because it has better gastrointestinal tolerability compared to immediate release. Maria should know that metformin has some side effects which include diarrhea, nausea, heartburn, physical weakness, and abdominal pain. In some patients, metformin may cause the blood glucose level to drop too low leasing to hypoglycemia. This happens to patients who take insulin. If the metformin cannot work for Maria, I would advise insulin therapy as an alternative treatment choice. Insulin therapy lowers the blood glucose level thus treating diabetes.
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