Local pharmacists with legally regulated treatment plans work in a variety of settings across Canada – the situation significantly improved over the last decade. These factors lead to variations in the perception of Canadian pharmacy practice, specifically when it is related to diabetes care and treatment.
According to Canadian Journal of Diabetes and Plateau Canadian Pharmacy, almost 75% of Canadian pharmacists work in community pharmacies which often serve as an primary source of contact with the healthcare system for patients – both adults and children – who were diagnosed of diabetes type 1 and type 2. Most diabetes patients need to take medications during lifetime so it was a crucial task to create solid treatment plans so people could get necessary prescription and OTC meds in any pharmacy operating in Canada.
It’s an interesting fact that most Canadian provinces have already introduced the legal obligations allowing local pharmacists for expanding the available healthcare services for diabetes patients. For instance, pharmacists in Ontario province even have the legal right to initiate the diabetes drug therapy and administer special injectable medications for customers with diabetes of both types.
Now let’s take a closer look on how people with different types of diabetes get treatment in Canadian Pharmacies.
Treatment plans for children with diabetes in pharmacies of Canada
Diabetes mellitus is a disease characterized by a chronic increase in the level of sugar (glucose) in the blood. Diabetes mellitus is ranked at first among all endocrine diseases in children. Children with diabetes are relatively acute and, without a proper treatment, tend to get a severe, progressive course. Such a development of diabetes in children occurs due to the intensive growth of the child’s body and increased metabolism.
There are 2 main types of diabetes in children:
- Insulin dependent diabetes (diabetes type 1);
- Non-insulin dependent diabetes (diabetes type 2);
When diabetes type 2 is prevalent among adults, diabetes mellitus (insulin-dependent) prevails among children. Diabetes type 1 is characterized by a very low level of insulin in the blood when a child with diabetes mellitus is dependent on the insulin treatment.
The treatment of diabetes for a child with diabetes type 1 includes physical exercise, diet and the regular use of medications.
Correct organization of physical activity in children with diabetes necessarily involves the use of additional carbohydrates before, during and after physical exercise in accordance with the advice given by your doctor, as well as periodic monitoring of blood glucose concentration.
Almost all Canadian children suffering from diabetes type 1 receive insulin. Due to the introduction of long-acting insulin in the treatment plans in Canada, there is only one injection of insulin is required per day.
Popular Glucagon pills are effective in treating diabetes in adults, but they rarely produce the good results in children. These pills are used in mild forms of the disease or are prescribed as an adjuvant to reduce the number of injections or the dose of insulin. Children and adolescents who are regularly treated, follow the diet restrictions are well developed physically and mentally.
Sometimes Canadian pharmacies cover the treatment plan with Metformin for children and teens with diabetes of both types. Metformin is used to reduce insulin resistance, increase insulin secretion in children and adolescents. This drug acts through insulin receptors on the sensitivity of peripheral tissues to insulin and reduces the level of insulin circulating in the blood flow.
Types of insulin injections for children and adult
- Rapid-Acting Insulin starts working 15 minutes after the injection and lasts up to 4 hrs;
- Short-Acting Insulin starts working 60 minutes after the use and lasts up to 9 hrs;
- Intermediate-Acting Insulin starts working 1-4 hours after the use and lasts up to 10-24 hrs;
- Long-Acting Insulin starts working within a few hours after the use and lasts up to 18-24 hrs;
Advantages of using short-acting insulins in children and adolescents:
- It improves the quality of life for diabetes patients – it is convenient for the use (immediately before meals), can be used after meals, reduce the risk of hypoglycemia and doesn’t affect flexibility of the diet;
- One short-acting insulin injection improves the state of carbohydrate metabolism;
Short-acting insulin injections are shown to children of the first years of life with inconsistent, changing appetite, adolescents in expanding their lifestyle and nutrition, with a tendency to hypoglycemia in late evening and during the nighttime, with an unstable course of the disease and significant fluctuations of the glucose levels.
Canadian treatment plans for adults with diabetes
This disease can cause serious complications, such as vascular diseases and brain damage. It is important at the initial stage to carry out competent treatment of diabetes.
According to Canadian healthcare guidelines, the treatment of a mild type of type 2 diabetes is required in the early stages, when patients feel dry mouth, muscle weakness. At the same time, they retain their normal working capacity. In such cases, the insulin treatment is not required.
Treatment plans with the moderate severity and a profound metabolic disorder occurs. A person is systematically required to administer an insulin or use an anti-depressant drug, only so that a patient is able to digest food according to his/her physiological needs.
Modern treatment methods for adults
Insulin-lowering drugs are divided into several groups according to the mechanism of action. The classes of drugs for diabetes is like this:
- Biguanides (like Metformin);
- Gliptins;
- Meglitinides (Prandin);
- Thiazolidinediones (Glitazones);
- Α-glucosidase inhibitors;
- Insulin;
Metformin (RxList information) is not only an effective remedy for the treatment of type 2 diabetes, but also a medicine that has a prophylactic effect against heart disease. The drug is able to inhibit the growth of tumor cells, as well as slow down aging processes.
Another popular medication for adults with diabetes type 1 and 2 is the group of DPP-4 inhibitors or gliptins.
One of the main advantages of a new class of insulin-lowering pills is the lack of risk of hypoglycemia. In old age hypoglycemic conditions can provoke development of a hypertensive crisis, spasm of coronary vessels with the development of acute myocardial infarction, sudden loss of vision.
Gliptins like Januvia, Janumet and Vipidia can be assigned:
- As a treatment of patients with a newly diagnosed diabetes;
- For people with poor tolerability or contraindications for the appointment of biguanides;
- In the combination with other pills that reduce blood sugar;
Diabetes medications have few side effects, do not cause an increase in body weight, delayed emptying of the stomach. The intake of gliptins is not accompanied by the development of edema. These types of type 2 diabetes can be taken at all stages of chronic kidney disease.
Sources:
- https://www.canadianjournalofdiabetes.com/
- https://www.plateaudrugs.com
- https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
- https://www.medicinenet.com/glucagon/article.htm
- https://www.canada.ca/en/