CHAPTER 21 Endocrine Medications^393
diabetes mellitus is more common in people of Aboriginal, Hispanic, and
African-American descent. People who have emigrated to the West from India,
Japan, and Australian, more likely to develop Type 2 diabetes mellitus than those
who remain in their original countries.
Type 2 diabetes mellitus is considered a milder form of diabetes mellitus
because of its slow onset (sometimes developing over the course of several years)
and because it can usually be controlled with diet and oral medication. Type 2 dia-
betes mellitus is also called noninsulin-dependent diabetes (NIDDM), a term that
is somewhat misleading. Many people with Type II diabetes mellitus can control
the condition with diet and oral medications. However, insulin injections are
sometimes necessary if treatment with diet and oral medication is not adequate.
Uncontrolled and untreated Type 2 diabetes mellitus is as serious as Type 1
diabetes mellitus.
Gestational diabetes mellitus
Gestational diabetes mellitus develops during pregnancy and resolves after
delivery. Gestational diabetes mellitus develops during the second or third
trimester of pregnancy in about 2% of pregnancies and is treated by diet.
However, insulin injections may be required. Women who have gestational dia-
betes mellitus are at higher risk for developing Type 2 diabetes mellitus within
5–10 years.
SIGNS AND SYMPTOMS OF DIABETES MELLITUS
The signs and symptoms of diabetes are polyuria (increased urine output), poly-
dipsia (increased thirst), and polyphagia (increased hunger). Certain drugs
increase blood sugar and can cause hyperglycemia in prediabetic persons. These
include glucocorticoids (cortisone, prednisone), thiazide diuretics (hydrochloro-
thiazide [HydroDIURIL]), and epinephrine. Usually the blood sugar returns to
normal after the drug is discontinued.
INSULIN
Insulin is a protein that cannot be administered orally because GI secretions
destroy the insulin structure. Insulin is therefore administered subcutaneously in
a special insulin syringe (see Chapter 6). The site and depth of the injection
affects the absorption and is greater when given in the deltoid and abdominal