discussion w5 635

  

Instructions for DQ Replies to 3 DQS

DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.

1- Each reply should be at least 200 words.

2- Minimum One scholarly reference ( NO MAYO CLINIC/ AHA)

3- APA 6th edition style needs to be followed.

4- Each response should have reference at the end of each reply

5- Reference should be within last 5 years

DQ-1

Diabetes Mellitus (DM) is a group of metabolic diseases characterized by increased blood glucose due to alterations in insulin secretions, insulin actions, or a combination of both pathologies. DM is the leading cause of blindness, amputation, kidney failure, and the seventh leading cause of death in 2015. An estimated 30.4 million diabetes cases were diagnosed in 2015, while 7.2 million were believed to be undiagnosed (Brashers, Jones, & Huether, 2019, p. 684).

Long-term conventional management is, at times, not sufficient to delay progressive complications. This requires that individuals and organizations keep abreast of changing healthcare needs and continually look for ways to provide appropriate care. Knowledge of complementary and alternative medicines (CAMs) is relevant to meeting chronic disease management needs.

Recent studies (Pumthong, Nathason, Tuseewan, Pinthong, Klangprapun, Thepsuriyanon, & Kotta, 2015) suggested that massage is a proven and useful complement to traditional diabetes management. These studies revealed that connective tissue massage improved blood circulation in the lower limbs of patients with type 2 diabetes, which is useful to slow the progression of peripheral arterial disease and improve the cardiovascular system by dilating the blood vessels so that circulation is enhanced. Furthermore, several scientific studies support that massage can improve the immune system by invigorating the nervous system and releasing toxins through improved circulation. Another complementary therapy for DM is acupuncture (Pumthong et al., 2015). Acupuncture is believed to restore and balance energy flow or “qi”. The review conducted by the World Health Organization suggested that acupuncture may help treat different medical conditions, including cardiovascular disease.

Finally, according to Pumthong et al. (2015), herbal remedies are also available to treat DM. Knowledge about herbalism is passed down from generation to generation. Some of these remedies have been proven for centuries to control glycemia. These are examples of natural products that have long been used worldwide in traditional medicine systems to treat diabetes, such as nopal (prickly pear cactus), fenugreek, karela (bitter melon), Gymnema, ginseng, Toradora, chromium, and alpha-lipoic acid.

 References

 Brashers, V.L., Jones, R.E., & Huether, S.E. (2019). Alterations of hormonal regulation. In NS. Rote (Ed.). Pathophysiology: The biologic basis for disease in adults and children (8th ed., pp. 669-712). St. Louis, MO: Elsevier

Pumthong, G., Nathason, A., Tuseewan, M., Pinthong, P., Klangprapun, S., Thepsuriyanon, D., & Kotta, P. (2015). Complementary and alternative medicines for diabetes mellitus management in ASEAN countries. Complementary Therapies in Medicine, 23(4), 617–625. https://doi-org.lopes.idm.oclc.org/10.1016/j.ctim.2015.01.016

DQ-2

Grave’s disease is an autoimmune disease which increases the thyroid’s production by stimulation of TSH receptors (Huijuan et al., 2018). Graves Disease has had an association with low selenium and an incidence of low selenium with an increased risk of Graves’ Disease (Huijuan et al., 2018). Selenium is a trace element antioxidant which is important for healthy thyroid hormone metabolism and function, the decrease in selenium marks a precursor on the initiation, progression, and severity of Graves’ Disease (Huijuan et al., 2018).

Supplementation of selenium does have it’s risks (Xu, Wu, Ying, & Zhang, 2019). When concentrations of selenium become toxic to the body, cells in the body began to undergo premature apoptosis, so an ingestion of an extreme amount of selenium can cause massive apoptosis and a cascate of life threatening events (Xu, Wu, Ying, & Zhang, 2019). However, in one study, the minimum toxic level was indicated between 20-40 µM  and that is when apoptosis occured which indicates that the drug is safe to use with such sensitive levels in the body (Xu, Wu, Ying, & Zhang, 2019). 

However, in one study it shows that with the supplementation of selenium, there were increased levels of FT4, FT3, TSH, and TRAb levels in patients with Graves’ Disease, but even with selenium supplementation over nine months, there was no significant effective changes in controlling Grave’s Disease when compared to the control group (Huijuan et al., 2018). 

In another study, the conjunction treatment of Graves’ disease with selenium and methimazole showed a decrease of FT3 and FT4 decreased rapidly and TSH rose significantly (Xu, Wu, Ying, & Zhang, 2019).  The study also showed that selenium alone does not have much effect on Graves’ Disease, but when administered in conjunction with methimazole, shows a safe and effective treatment strategy for treating Graves’ Disease when taken as prescribed (Xu, Wu, Ying, & Zhang, 2019). 

So it seems that selenium alone is not a promising alternative treatment, but when combined with current treatment reccomendations, it yeilds greater results than either treatment on its own. 

References:

Huijuan, Z., Junping, W., Liansheng, W., Qiuhong,W., Jing, Z., Shuya C, & Fan, W. (2018). Effects of Selenium Supplementation on Graves’ Disease: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2018. 

https://doi-org.lopes.idm.oclc.org/10.1155/2018/3763565

Xu, B., Wu, D., Ying, H., & Zhang, Y. (2019). A pilot study on the beneficial effects of additional selenium supplementation to methimazole for treating patients with Graves’ disease. Turkish Journal of Medical Sciences, 49(3), 715–722. 

https://doi-org.lopes.idm.oclc.org/10.3906/sag-1808-67

DQ-3

In diabetes, there are a lot of complementary medicines that help decrease blood sugars as they are insulin mimetics (Kesavadev et al., 2017). However, some of these medications have severe contraindications when used in conjuction with other traditional medications (Kesavadev et al., 2017). There are even cross sensitivites between traditional medicines in themselves (Kesavadev et al., 2017). The use of complementary and traditional medications for the treatment of Diabetes remains controversial, especially since supplementation of herbs and supplements can be beneficial, there is a plethora of known side effects, and even more unknown side effects (Abdur et al., 2020). 

One example is Ginseng root, as it is an insulin mimetic which has hypoglycemic actions by decreasing carbohydrate absorption in portal circulation and can also modulate insulin secretion (Kesavadev et al., 2017). Ginseng root has a couple of side effects that also are contraindications to other complementary therapies (Kesavadev et al., 2017). Ginseng root has anticoagulant and antiplatelet interactions which increase bleeding so ginseng root is contraindicated in therapies that break the skin such as acupuncture (Kesavadev et al., 2017). Another important contraindication is if a diabetic is taking ginseng root as a traditional medicine for diabetes, but is also taking a tricyclic antidepressants have a possibility of causing manic episodes and tremors (Kesavadev et al., 2017).

Another example is Cinnamomum zeylanicum, a compound that is similar to procyanidine type-a polymers which are not an insulin mimic but increases insulin sensitivity (Kesavadev et al., 2017). When taking Cinnamomum zeylanicum with gensing root, there is a high chance of hypoglycemia and bleeding disorders (Kesavadev et al., 2017). A rare side effect, but possible, is that taking the two in combination can lead to carcinogenic and hepatotoxic properties (Kesavadev et al., 2017). 

There is a good area to explore in the realm of complementary and traditional medication, but it is important to remember that they are not a equal substitute to standard medical therapies. 

References:

Abdur, R., Dewan,T., Mridula, B., Nikita, R., Kazi, M, Rahman, M., & Golam, H. (2020). A hospital-based study on complementary and alternative medicine use among diabetes patients in Rajshahi, Bangladesh. BMC Complementary Medicine and Therapies, 20(1), 1–9. https://doi-org.lopes.idm.oclc.org/10.1186/s12906-020-03021-3

Kesavadev, J., Saboo, B., Sadikot, S., Das, A. K., Joshi, S., Chawla, R., Thacker, H., Shankar, A., Ramachandran, L., & Kalra, S. (2017). Unproven Therapies for Diabetes and Their Implications. Advances in therapy, 34(1), 60–77. https://doi.org/10.1007/s12325-016-0439-x