A Systematic Review: Clinical Manifestations of Diabetes Mellitus and The Role of Pharmacists in Management of Type II Diabetes

Abstract

Diabetes mellitus is a condition in which the metabolism of carbohydrates, proteins, and lipids is disrupted owing to reduced insulin production, increased glucagon secretion, and the development of insulin resistance in body cells. The prevalence of diabetes in Pakistan varies based on age, gender, and geography. Genetic, behavioral, and environmental factors contribute to the development of type II diabetes. Insulin resistance by the cells and a decreased or inadequate quantity of insulin produced by the beta cells of the pancreas result in type II diabetes, which is characterized by high amounts of proinflammatory cytokines and free fatty acids in plasma. In diabetic individuals, the imbalance between insulin and glucagon production results in an increased amount of glucagon in the blood and hyperglycemia. Insulin resistance develops in response to physical inactivity, steroid use and a high-calorie diet. Glucagon and glucose-dependent insulinotropic polypeptide (GIP) levels also rise. Major consequences of diabetes include diabetic retinopathy, neuropathy, vasculopathy, end-stage renal disease, cardiovascular disease, and stroke. In this review medical therapy including the role of insulin in the management of DM 2 will be discussed. The role of pharmacists in its management will also be focused since tailored patient education is more effective than group sessions in addressing poorly managed diabetes. Among the non-pharmacologic parts of diabetes treatment is teaching patients about the advantages of a healthy diet as well as regular physical activity. In treating type 2 diabetes, bariatric surgery is more effective than medication. Depending on the patient's state, anti-diabetic drugs may either lower insulin resistance or boost insulin secretion.