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respond to both peers in app format and at least 2 references each 

Respond with at least 2 references each peer apap format

Peer 1

Diabetes and Drug Treatment

Type of Diabetes

Diabetes mellitus is a metabolic disorder that occurs in the body because of a lack or decrease in insulin activity and a decline in insulin secretion. It may involve changes to the body, including cardiovascular complications, kidney disorders, delayed wound healing, and retinopathy. The two subtypes of diabetes are type one diabetes T1DM and type 2 diabetes (T2DM). Most patients with T1DM are treated with insulin, whereas most patients with T2DM are treated with oral hypoglycemics. Over the years, the research and treatment of diabetes have developed in leaps and bounds. There are many options available today for patients suffering from T2DM; however, with so many options, it can be difficult for a clinician to navigate what is best for their patients, what is most affordable, and what has the fewest side effects (Padhi et al., 2020).


One type of drug used to treat the type of diabetes type II 

Sulfonylureas have been used to treat 2D M since the 1950s. Their primary function is to stimulate the release of insulin from pancreatic islets and is only effective if the pancreas is capable of synthesis. They additionally promote insulin release by binding and blocking adenosine triphosphate-sensitive potassium channels in the cell membrane. This allows the membrane to depolarize and permits the influx of calcium, which causes insulin release (Rosenthal DNP ACNP, Laura et al., 2020). Sulfonylureas receptors are broken down into two subtypes, SUR1 and SUR 2. SUR1 is dominant in the brain and beta cells of the pancreas, while SUR2 is mostly present in cardiac muscle and smooth muscle. This is why the extent of the cardiac side effects can differ. They additionally decrease insulin metabolism in the liver and increase sensitivity in the peripheral tissue (Costello et al., 2023).  

They have been divided into first, second, and third-generation drugs. The significant difference between the two is the level of effects and potency. They come in two forms, some being long-acting and others having a much shorter duration.  The first generation includes Chlorpropamide, which is no longer available in the US, and Tolbutamide. The second generation is the most commonly used Glyburide and Glipizide. The third generation involves glimepiride. They all carry with them benefits and side effects. However, glimepiride or Amaryl carries with it the most up to date and research methodology and effects (Kalra et al., 2018).

Proper preparation and administration of this drug.

In preparation, patients should have baseline laboratory data to evaluate kidney and liver function. Ideally, a patient would have a recent A1C level, echocardiogram, and Ultrasound of the kidneys. The kidney diseas

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