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Diabetes mellitus is a major world health problem. Treatment and management of diabetics is a very significant issue for governments, society and both pharmacists and pharmaceutical companies.

1. Why is the disease given the name diabetes mellitus? How does diabetes mellitus differ from diabetes insipidus?

2. Individuals with the diabetes mellitus are classified into two main groups. What are they and what is the basis of the classification system used?

3. How are patients diagnosed as diabetics? What treatment options are most used to manage this condition?

4. What changes in the metabolism of glucose and fat (triglycerides) are observed in this disease? What symptoms might a diabetic show as a result of these metabolic changes and why do these occur?

5. Two overnight fasting patients, A & B, were each given a dose of 75g of glucose at time zero. Their blood glucose levels were measured at 0, 30, 60, 90, 120 and 240 minutes after ingestion of the glucose using a glucose specific assay. The brief procedure for this assay is: –
a. Add 5.0 ml of assay reagent to sufficient tubes for the assay
b. Add 0. 1 ml of each glucose standard to a tube of assay reagent
c. Add 0. 1 ml of each test serum to a tube of assay reagent.
d. Mix the contents of each tube and read the absorbance at 625 nm.
The results obtained are shown in the two tables below.

Table 1 – standards
Glucose standard (mmol/L) Absorbance @ 625 nm
0 0.02
3 0.21
6 0.43
9 0.65
12 0.83

Table 2 – patient results
Time (min) Absorbance-Patient A Absorbance-Patient B
0 0.26 0.47
30 0.51 0.63
60 0.25 0.8
90 0.23 0.76
120 0.24 0.63
240 0.3 0.58

Plot a standard graph of absorbance at 625 nm against glucose concentration You must use Excel. (I give you the answer below (chart))

Determine the concentration of glucose in each patient serum sample and plot glucose concentration against the time over which the samples were obtained. (Also, I give you the answer below)

Series 1: concentration of patient A Series 2: concentration of patient B

The result of glucose concentration(mmole/L) for both patients A&B
Time (min) Absorbance-Patient A
Conc.
(Series 1) Absorbance-Patient B
Conc.
(Series 2)
0 0.26 3.55167394 0.47 6.6084425
30 0.51 7.19068413 0.63 8.93740902
60 0.25 3.40611354 0.8 11.411936
90 0.23 3.11499272 0.76 10.8296943
120 0.24 3.26055313 0.63 8.93740902
240 0.3 4.13391557 0.58 8.20960699

Q: Comment on the results for the two patients in a table above. (Answer this question please)

6. What potential long-term problems would a pharmacist need to be aware of when advising a diabetic client?