When it comes to different types of diabetes, they all involve problems with producing insulin or reacting to insulin production. Type 1 diabetes is also known as juvenile diabetes because the disease presents itself in the adolescent months. More people have Type 2 diabetes, which is diagnosed at any age and not as prevalent in teenagers, such as Type 1 diabetes. It is interesting to note that patients with Type 2 diabetes that keep firm control of their blood glucose are at a higher risk for hyperglycemia, weight gain, and death. Unfortunately, long-term patients with Type 2 diabetes have an increased risk of stroke, amputations, and retinal damage (Rosenthal & Burchum, 2021). There are as many as 35% of individuals diagnosed with Type 2 diabetes who do not achieve appropriate blood glucose when on Metformin. Metformin is provided in tablets and helps reduce blood glucose levels after meals and has shown to decrease A1c levels as much as 2% in type 2 diabetics. Metformin is also known as sulfonylureas, which were first presented in the 1950s and caused insulin to be excreted by the pancreas (Li et al., 2020). When patients cannot produce insulin, such as with Type I diabetes, the practitioner should not prescribe Metformin because it does not benefit the patient. Patients should be started on 500 mg and increase to 2000 mg as needed, and as the patient can tolerate the medication. The extended-release form of Metformin decreases the risk of gastrointestinal side effects and is usually the best option for patients. Since diarrhea can be a side effect of Metformin, a high-fiber diet is ideal (Flory & Lipska, 2019). References Flory, J., & Lipska, K. (2019). Metformin in 2019. JAMA, 321(19), 1926. https://doi.org/10.1001/jama.2019.3805 Li, L., Guan, Z., Li, R., Zhao, W., Hao, G., Yan, Y., Xu, Y., Liao, L., Wang, H., Gao, L., Wu, K., Gao, Y., & Li, Y. (2020). Population pharmacokinetics and dosing optimization of metformin in Chinese patients with type 2 diabetes mellitus. Medicine, 99(46), e23212. https://doi.org/10.1097/md.0000000000023212 Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s Pharmacotherapeutics for Advanced Practices Nurses and Physician Assistants (2nd ed.). Elsevier
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