Sample Answer for NURS 6521 Diabetes and Drug Treatments Included After Question
Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations.
For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.
Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
- Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
- Select one type of diabetes to focus on for this Discussion.
- Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
- Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.
BY DAY 3 OF WEEK 5
Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.
BY DAY 6 OF WEEK 5
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
A Sample Answer For the Assignment: NURS 6521 Diabetes and Drug Treatments
Title: NURS 6521 Diabetes and Drug Treatments
Diabetes is primarily a disorder of carbohydrate metabolism that also disrupts protein and lipid metabolism as a result of a defect in insulin secretion, insulin action, or both. It is characterized by sustained hyperglycemia that leads to polyuria, polydipsia, ketonuria, and weight loss (Rosenthal & Burchum, 2021).
Classification of Diabetes
Diabetes is classified into type 1 diabetes mellitus, type 2 diabetes mellitus, gestational diabetes, and juvenile diabetes. Type 1 diabetes is due to autoimmune beta cell destruction, usually leading to absolute insulin deficiency. Gestational diabetes is any degree of glucose intolerance that is first recognized during pregnancy and may persist after pregnancy (American Diabetes Association, 2019). Juvenile diabetes is type 1 diabetes commonly seen in children and adolescents. The incident rate increases from birth and peak between 10-14years (Bimstein, Zangen, Abedrahim, &Katz, 2019).
Type 2 diabetes accounts for 90-95% of all diabetes. It is as a result of relative insulin deficiency and insulin resistance. Patients with type 2 diabetes are capable of insulin synthesis but the liver, muscles and adipose tissue exhibits insulin resistance because the cells are less able to take up and metabolize the glucose available to them. The risk of developing type 2 diabetes increases with age, obesity, and lack of physical activity. Type 2 diabetes is associated with a strong genetic predisposition. It occurs more in certain racial and ethnic subgroups such as African American, American India, Hispanic/Latino, and Asian American (American Diabetes Association, 2018).
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Drug Used for Type 2 Diabetes
Metformin classified as biguanide is the drug of choice for initial treatment of type 2 diabetes in combination with a reduced-calorie
diet and exercise. Metformin increases glucose uptake by inhibiting glucose production in the liver, reduces glucose absorption in the gut, and sensitizes insulin receptors in target tissues. Metformin is effective, safe, inexpensive, and may reduce the risk of cardiovascular events and death. It can be used alone or in combination with other drugs. Common side effects are decreased appetite, nausea, and diarrhea. The dose is titrated to minimize the severity of gastrointestinal side effects (American Diabetes Association, 2018).
Metformin is available as immediately released tablets, extended-release tablets, and an oral solution. The recommended initial dose for immediate-release tablets and oral solution is 500mg twice or 850mg once daily taken with meals. The extended-release tablets are taken once daily with the evening meal to enhance absorption due to gastrointestinal transit time at night (Rosenthal & Burchum, 2021).
Impact of Type 2 Diabetes and Drug Therapy on Patients
Acute life-threatening consequences of type 2 diabetes are hypoglycemia and nonketotic hyperosmolar syndrome. Long term complications include retinopathy with a potential loss of vision, nephropathy leading to renal failure, peripheral neuropathy with risk of foot ulcers and amputation, impotence, heart disease, and stroke (American Diabetes Association, 2019).
Metformin leads to vitamin B12 and folic acid deficiencies. Vitamin B12 deficiency can contribute to peripheral neuropathy. Also, severe lactic acidosis can occur in patients with significant renal impairment due to the accumulation of metformin (Rosenthal & Burchum, 2021)
References
American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment:
Standards of medical care in diabetes-2018. Diabetes care,41(Suppl.1, S73-S85. doi:10.2337/dc18.S008. Retrieved from https://care.diabetesjournals.org/content/diacare/41/supplement_1/S73.full.pdf.
American Diabetes Association. (2019). Classification and diagnosis of diabetes: Standards of
medical care in diabetes-2019. Diabetes Care, 42(Suppl.1), S13-S28. doi:10.2337/dc19.S002. Retrieved from https://care.diabetesjournals.org/content/42/Supplement_1/S13
Bimstein, E., Zangen, D., Abedrahim, W., & Katz, J. (2019). Type 1 diabetes mellitus (juvenile
diabetes): A review of pediatric oral health provider. The journal of clinical pediatric Dentistry, 43(6),417-423. doi:10.17796/1053-4625-43.6.10. Retrieved from https://www.proquest-com.ezp.waldenulibrary.org/docview/2330603107?accountid=14872
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice
nurses and physician assistants (2nd ed.). St. Louis, MO: Elsevier.
A Sample Answer 2 For the Assignment: NURS 6521 Diabetes and Drug Treatments
Title: NURS 6521 Diabetes and Drug Treatments
Diabetes mellitus is a group of metabolic diseases that manifest with hyperglycemia caused by defects in insulin secretion, insulin action, or both. Type 1 diabetes results from autoimmune destruction of pancreatic B cells (ADA, 2020). Type 2 diabetes is a progressive disorder characterized by increasing insulin resistance and diminishing insulin secretory capacity. It is frequently associated with obesity (ADA, 2020). Gestational diabetes refers to any level of glucose intolerance with onset or first recognition during pregnancy (ADA, 2020). Juvenile diabetes occurs in children. It is characterized by the body’s inability to produce insulin secondary to autoimmune destruction of the beta cells in the pancreas.
Glipizide is an antidiabetic drug, under the class of sulfonylureas, used to treat Type 2 diabetes. Its main effect is to increase insulin secretion from pancreatic beta cells. It also reduces the rate of hepatic glucose production and increases insulin receptor sensitivity (Correa et al., 2020). The recommended starting dosage of Glipizide is 5 mg/d, with up to 15 mg/d given as a single dose. However, when higher daily dosages are required, they should be divided and given before meals. The maximum recommended total daily dose is 40 mg/d. For maximum effect in reducing postprandial hyperglycemia, it should be ingested 30 minutes before breakfast because absorption is delayed when the drug is taken with food. (Correa et al., 2020) It is contraindicated in patients with significant hepatic or renal impairment because of a high risk for hypoglycemia.
The short-term impact of type 2 diabetes includes hypoglycemia, which is associated with sulfonylurea medications and missing meals. A patient may develop hyperosmolar hyperglycemic nonketotic syndrome, characterized by very high blood glucose (Papatheodorou et al., 2018). The long-term impact includes complications such as nephropathy, diabetic retinopathy, diabetic neuropathy, and macrovascular disorders (Papatheodorou et al., 2018). The complications occur due to high glycemic levels, which damage small blood vessels causing microvascular complications and large vessels causing macrovascular complications.
References
American Diabetes Association. (2020). 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2020. Diabetes care, 43(Supplement 1), S14-S31. https://doi.org/10.2337/db16-0806
Correa, R., Rodriguez, B. S. Q., & Nappe, T. M. (2020). Glipizide. In StatPearls [Internet]. StatPearls Publishing.
Papatheodorou, K., Banach, M., Bekiari, E., Rizzo, M., & Edmonds, M. (2018). Complications of Diabetes 2017. Journal of diabetes research, 2018, 3086167. https://doi.org/10.1155/2018/3086167
A Sample Answer 3 For the Assignment: NURS 6521 Diabetes and Drug Treatments
Title: NURS 6521 Diabetes and Drug Treatments
Hey Melissa thanks for sharing the informative post. I agree with you on how diabetes II is highly prevalent in about 90-95% of people. It is the 7th leading cause of death in the United States and number one cause of chronic kidney disease leading to kidney failure, lower-limb amputations and adult blindness. Proper management of symptoms by developing appropriate plan of care is critical to prevent short and long term complications associated with diabetes. I too agree with you on insulin and oral diabetic drugs, along with diet and lifestyle changes are the cornerstones of treatment for diabetes. Metformin is one of the most preferred choices of drug therapy in managing symptoms of type II diabetes, if the diet modifications and exercise doesn’t help in keeping the blood glucose levels under control. Now in people with this type of diabetes the liver may not detect the levels of glucose in the blood and instead of regulating glucose production, releases more glucose despite of adequate blood glucose levels.
So the role of metformin is to sensitize the liver to circulating insulin levels and reduces hepatic glucose production. However metformin should be used in caution in patients with renal dysfunction as it can cause a rare side effect known as lactic acidosis which causes buildup of lactic acid in the blood and can be sometimes fatal. Also patients on metformin should be monitored for appropriate renal function and vitamin B12 levels as patients on metformin for a longer time is at risk of developing Vitamin B12 deficiency. So patients should be assessed in routine wellness checkup for symptoms of feeling tired, short of breath and feeling dizzy at times which could possibly indicate low levels of vitamin B12. Also it is recommended to start patient with the lower dosage of metformin and gradually increase the dosage as tolerated. Also patients are instructed to take their antidiabetic drugs with food to prevent its adverse reactions such as nausea, vomiting, diarrhea, flatulence, weakness, lack of energy and strength.
A Sample Answer 4 For the Assignment: NURS 6521 Diabetes and Drug Treatments
Title: NURS 6521 Diabetes and Drug Treatments
The World Health Organization defines diabetes as a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces (American Diabetes Association, 2022 ). Insulin is a hormone that regulates blood glucose. The number of people being diagnosed with diabetes continues to raise as the Centers for Disease Control report released in 2018 showed that 7.3 million Americans, or 11.3% of the population. There are several types of diabetes with the most common including type 1 diabetes, type 2 diabetes, juvenile, and gestational diabetes. These types differ from each other significantly hence this makes it easy for physicians to make correct diagnoses.
Type 1 diabetes
Type 1 diabetes is a chronic illness characterized by the body’s inability to produce insulin due to the autoimmune destruction of the beta cells in your pancreas that produce insulin. The damage is permanent. According to the ICD-10, Type 1 diabetes diagnostic criteria include unexplained weight loss, excessive production of urine, experiencing excess thirst, increased appetite, tiredness, and blurry vision as well as mood changes. If the condition is left untreated, it can lead to heart damage, kidney damage, eye damage, foot damage, nerve damage, and oral infections. According to American Diabetes Association, the American diagnostic criteria for type 1 diabetes includes a 2-hour plasma glucose level ≥200 mg/dL (11.1 mmol/L) or during a 75 oral glucose tolerance test (OGTT).
Type 2 diabetes
Type 2 diabetes starts out as insulin resistance. This means your body cannot use insulin efficiently, which causes your pancreas to produce more insulin until it cannot keep up with demand. Insulin production then decreases, which causes high blood sugar. The body is impaired in how it regulates insulin and in the long term, there is a higher presence of sugar in the bloodstream. The symptoms of type 2 diabetes are increased thirst, frequent urination, increased hunger, fatigue, blurred vision, slow-healing sores, unexplained weight loss, numbness or tingling in the hands, and areas of darkened skin, usually in the armpits and neck. If not treated it can lead to kidney damage, eye damage, hearing impairment, sleep apnea, and dementia (DeFronzo et al., 2015). Type 1 diabetes is characterized by the inability of the body to produce enough insulin, the type 2 diabetes is characterized by the inability of the body to utilize insulin hence having high sugar in the blood.
Gestational diabetes
This type of diabetes occurs during pregnancy when insulin-blocking hormones are produced. Gestational diabetes occurs only in people who have preexisting diabetes or have family members who have been diagnosed with the condition. It affects how cells utilize insulin leading to high levels of blood sugar. Pregnancy influences the body significantly and these changes cause your body’s cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body’s need for insulin. Gestational diabetes can go unnoticed as it has limited symptoms only frequent urination and increased thirst. Lack of early intervention can lead to stillbirth, obesity, early term, excessive birth weight, and difficulties breathing.
These three types of diabetes differ significantly in that while type 1 diabetes is characterized by the inability of the body to produce enough insulin, type 2 diabetes is characterized by the inability of the body to utilize insulin hence having high sugar in the blood. The gestational occurs only in pregnant women unlike the other which can occur in anybody.
Selected: Type 2 diabetes treatment
Metformin is the most common type of drug administered to people with type 2 diabetes. The drug works by lowering the glucose level in the liver and improves the body’s sensitivity to insulin so that the body uses insulin more effectively (Foretz et al., 2019). This drug can come comes as a tablet, liquid, and an extended-release tablet which is prepared by obtaining a solution of metformin hydrochloride in water. The tablet is taken with a glass of water before meals. those taking the solution, have to prepare it by adding the extended tablet, they prepare it by measuring the oral liquid with a marked spoon oral syringe, or medicine cup and adding water to make a solution. The liquid is usually taken with meals one or two times a day and the regular tablet is usually taken with meals two or three times a day. The extended-release tablet is usually taken once daily with the evening meal. To help you remember to take metformin, take it around the same time(s) every day. The drug is taken orally.
People diagnosed with type 2 diabetes and prescribed metformin, have to consider some diet patterns. When taking metformin, avoid alcohol since it affects the drug’s effectiveness. Avoid too many refined carbs, especially white bread, white rice, white pasta, candy, soda, desserts, and snacks like chips or crackers (Ley et al., 2014). There are some foods that a patient taking metformin can consider and they include healthy fats, fiber, lean proteins, vegetables, and complex carbs such as brown rice, whole-grain oats, and whole-grain
Short-term and Long effects of type 2 diabetes and metformin
The short-term effects of diabetes type 2 involve developing the complications of hypoglycemia which are low blood sugar and this is linked to some medications such as insulin or a sulfonylurea drug. Other complications involve hyperglycemia which is having too much glucose in the body. Besides, the long-term effects of diabetes include increased risk of developing heart disease, stroke, high blood pressure, narrowing of blood vessels (atherosclerosis), and nerve damage (neuropathy) in limbs.
Taking metformin for a long time can cause vitamin b12 deficiency, lactic acidosis, lower back pain, decreased appetite, difficulty sleeping, and diarrhea.
References
American Diabetes Association. (2022). Statistics About Diabetes. https://diabetes.org/about-us/statistics/about-diabetes
DeFronzo, R. A., Ferrannini, E., Groop, L., Henry, R. R., Herman, W. H., Holst, J. J., … & Weiss, R. (2015). Type 2 diabetes mellitus. Nature reviews Disease primers, 1(1), 1-22.
Foretz, M., Guigas, B., & Viollet, B. (2019). Understanding the glucoregulatory mechanisms of metformin in type 2 diabetes mellitus. Nature Reviews Endocrinology, 15(10), 569-589.
Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2014). Prevention and management of type 2 diabetes: dietary components and nutritional strategies. The Lancet, 383(9933), 1999-2007.