Sample Answer for NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS 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 Discussion Diabetes and Drug Treatments PEER POSTS
Title: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Introduction
Generalized anxiety disorder is a very common mental health condition in elderly patients. It involves a persistent feeling of anxiety, fear, and excessive worrying about everyday issues and situations without any obvious reasons that further interferes with activities of daily living. It is not same as the occasional episodes of anxiety in stressful conditions but it lasts for more than six months and activities of daily life feels as a constant state of worry, fear and dread. It is most common in women than men. Causes involves family history, or external causes such as traumatic events, stressful environment, chronic medical health conditions etc. which places an individual at risk for developing generalized anxiety disorder. Treatment usually involves psychotherapy such as cognitive behavioral therapy alone or in combination with antidepressants medications such as SSRIs, SNRIs, benzodiazepines, Buspirone etc (Rosenthal & Burchum, 2021, p. 243).
Summary on Patients Scenario
I am going to discuss a scenario of a patient at my previous workplace who presented with symptoms of generalized anxiety disorder. Janet is a 69-year-old female who presented to her primary care provider with her concerns of getting anxious and worrying before going to public places, experiencing stress before doing any kind of work. She worries all of the time for small things and just can’t seem to relax. For example, she will start worrying about the grocery shopping a day ahead, get anxious if the household chores are not finished on time or if her husband gets little late coming home from work. She also states that no matter how hard she tries to remain calm, she is unable to control the worrying which has impaired her sleep, feeling tired, trouble with concentrating when doing any activity, feeling her heart is beating fast, shortness of breath at times, being impatient with others, restless feeling etc.
As per the patient she had previously experience symptoms of becoming anxious and worrisome at times but has started to get worse in last couple of months and has been interrupting with her activities of daily living. Patient has a history of hypertension, diabetes, arthritis, hyperlipidemia and age related impairment in liver and kidney function. Patient was on lisinopril 10mg daily, hydrochlorothiazide 25 mg, metformin 1000mg twice daily, PRN ibuprofen (Naproxen 250mg Q 8hrs) for arthritis, atorvastatin 20 mg for hyperlipidemia, and OTC multivitamins supplements.
Patient was diagnosed with generalized anxiety disorder. Patient was recommended to manage the symptoms with nondrug approaches such as cognitive and behavioral therapies; relaxation training and as the non-drug approaches alone wasn’t happening to help alleviate her symptoms, patient was further prescribed paroxetine/Paxil 10mg once/day.
Paxil is a selective serotonin reuptake inhibitor. It works by increasing the amount of a chemical called serotonin which further aids in improving individual’s mood and reduces symptoms of depression, anxiety, and other mental health conditions. It has a half-life of 21 hours which means 50% of drug is eliminated from a person’s body within 21 hours and it undergoes metabolism via hepatic CYPP4502D6 and excreted 2%, 62% metabolized over 10 day post-dosing period via urine and 36% excreted via feces. Paxil inhibits CYP2D6 thereby inhibiting its own metabolism, and potentially doubling following dosage by 50% leading to serious complications.
Pharmacokinetic and Pharmacodynamic factors that altered anticipated response to a drug.
As Pharmacodynamics and pharmacokinetics determines the clinical effects of drug therapy, it is critical to understand these processes before prescribing and administering medications in order to achieve the greatest benefit at the lowest risk and make necessary adjustments in the dosage based on patient’s physiology and lifestyle. Patient in the scenario is the elderly person and the age related physiological changes such as increased body fat, decreased muscle mass, decreased body water and changes in the liver, kidney function as well as in the Central nervous system places the patient at risk for adverse drug reactions. Pharmacokinetics is a movement of drugs through the body and involves drugs absorption, distribution, metabolism, and excretion which is affected due to patient’s age and altered function of liver, and kidneys. As the half –life of Paxil is 21 hours for a normal healthy person with no age related impairment, patient in this scenario is an older person with altered liver and kidney function which was causing patient to retain high levels drug in the blood and needed drug dosage adjustment to prevent drug toxicity and adverse reactions related to it (Prabina et al., 2022). Pharmacodynamics involves how the biological processes in the body respond to drug, which also has been altered due to patient’s age as evidenced by, about 2 weeks later patient went to Emergency Room as she was experiencing neurocognitive decline which was ruled out as serious complication of Paxil induced hyponatremia due to the syndrome of inappropriate ADH secretion.
Factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes
Factors such as patient’s age, lower body mass index, gender (female), and pathophysiological changes due to comorbidities have greatly altered the therapeutic effectiveness of the drug. Patient in the scenario has a history of diabetes and hypertension which has led to impairment/altered in the patient’s liver and kidney function which is affecting patients pharmacokinetic processes as patient is unable to clearly metabolize and excrete the drug in a desired time and leading to excess accumulation further resulting in Paxil associated hyponatremia which is life threatening in older patients.
Some of the risk factors that has patient at risk for developing hyponatremia are her age, gender (female), low body mass index, low plasma sodium levels and is on diuretics, and ibuprofen for managing arthritis pain. Drug to Drug interactions such as SSRIs and NSAIDs has also leaded to SSRI-induced SIADH. Patient presented with symptoms of hyponatremia such as neurocognitive decline, fatigue, lethargy, gait instability and confusion which can be prevented with appropriate monitoring of this electrolyte levels and dose adjustment (Tomar et al., 2021).
Personalized plan of care based on these influencing factors and patient history with GAD.
Interprofessional holistic approach with the active involvement of patient to manage individual health conditions by designing appropriate drug therapy action plan is key in patient compliance and following the set goals to achieve desirable results.
Knowing your patient’s medications and medication history
Medication reconciliation of currently taking drugs and over the counter drugs/herbal supplements are critical at initial assessment in preventing drug-to drug interactions and associated adverse effects.
Implement Individualize therapy plan
Laboratory evaluation of liver and renal function should be done to assess its function which could further be helpful in implementing safe dosage.
Minimize dose and total number of drugs. Start low, go slow. Reevaluate indications for continued drug use.
Recognize that any new symptom may be an adverse drug effect
Patient’s naproxen and hydrochlorothiazide should be discontinued due to potential drug interaction with Paroxetine thereby preventing serious complication of hyponatremia.
Monitor patients plasma sodium levels before initiating paroxetine therapy and after 1, 2, 4, 6, and 12 weeks of therapy to prevent serious complications of prescribed drugs which in this scenario is paxil.
Patient should be educated on side effects such as headache, nausea, difficulty concentrating, sleepiness, nervousness, dry mouth, sweating, tremors, dizziness and neurocognitive decline symptoms associated with hyponatremia and when to seek immediate care.
Instruct patients to maintain compliance and take their antidepressants regularly, without missing a dose to maintain its therapeutic effect.
Educate patient to avoid abrupt discontinuation of SSRIs can cause withdrawal syndrome and symptoms show up within days to weeks of the last dose and persist for 1 to 3 weeks. Symptoms include dizziness, nausea, tremor, anxiety, sensory disturbances, dysphoria and headache (Rosenthal & Burchum, 2021, p. 218).
Patient should be assessed for any difficulty in swallowing as Paxil should be taken whole, ensure that patient does not crush, chew, or cut.
Advise patient to avoid grapefruit or grapefruit juice as it is a CYP2D6 inhibitor whereas paroxetine is CYP2D6 substrate thereby preventing increase paroxetine exposure and associated adverse reactions (FDA, 2023)
Patient should be instructed to remain alert when doing activities that are dangerous such as driving as it may cause drowsiness or blurred vision in some people depending on their reaction to this drug.
Conclusion
It is not always easy to predict a patient’s risk of developing adverse reactions hence it is very important to understand the pharmacodynamic and pharmacokinetic process to safely prescribe choice of medication, dose, formulation, regimen, based on individualized patient’s pathophysiology, psychology, and other medications to achieve maximum benefit at the lowest risk.
References
Grapefruit Juice and Some Drugs Don’t Mix. U.S. FOOD and DRUG ADMINISTRATION. (n.d.). Retrieved January 16, 2023, from https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix
Prabina, S., Kamron, F., & Abdijadid, S. (2022, July 19). Paroxetine. Continuing Education Activity. National Library of Medicine. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK526022/
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Rosanne, M., & Leipzig. (n.d.). Avoiding adverse drug effects in elderly patients . Cleveland Clinic Journal of Medicine. Retrieved January 16, 2023, from https://www.ccjm.org/content/ccjom/65/9/470.full.pdf
Tomar, L. K., Patra, P., & Nigam, A. (2021, June 17). A study to understand the pattern of hyponatremia in patients using selective serotonin reuptake inhibitors and serotonin dopamine antagonists. Industrial Psychiatry.org. Retrieved from https://www.industrialpsychiatry.org/article.asp?issn=0972-6748;year=2021;volume=30;issue=1;spage=113;epage=117;aulast=
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 “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
I read your interesting post and was happy to learn about short-term complications when metformin is used with insulin and other diabetic medication.
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A Sample Answer 2 For the Assignment: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Title: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
According to the Center for Disease Control (CDC) 11.3% or 37.1 million people in the United States have diabetes mellitus. Major complications of diabetes are neuropathy, heart disease, and hypertension. Diabetes management should be aimed at preventing short and long-term complications.
Different Types of Diabetes
Type I diabetes, also known as juvenile diabetes, because the onset commonly occurs during childhood or adolescence and is abrupt. Type I diabetes occurs when pancreatic beta cells are damaged or destroyed. Pancreatic beta cells produce insulin and when they are damaged or destroyed by autoimmune disease, genetic or environmental factors or viral infections insulin production becomes insufficient. Type II diabetes commonly occurs in middle age and progresses gradually. In Type II diabetes a combination of increased tissue resistance to insulin and impaired pancreatic insulin secretion lead to hyperglycemia. A third type of diabetes is gestational diabetes which occurs during pregnancy and subsides rapidly following delivery. Gestational diabetes causes high birth weights, and hyperinsulinemia in infants (Rosenthal & Burchum, 2021).
Treatment of Type I Diabetes
The mainstay of treatment for Type I diabetes is insulin. Insulin dosing is weight-based and recommended ranges are 0.4 to 1.0 units per kilogram per day (u/kg/day) of total insulin. Higher ends of the dosing range are needed during puberty and if the patient presents with ketoacidosis. American Diabetes Association (ADA) recommendations for initiation of therapy in a patient who is metabolically stable is 0.5 (u/kg/day) (American Diabetes Association [ADA], 2018).
Insulin should be administered with a meal and based on blood glucose levels, carbohydrate consumption, and activity level. While administration of rapid onset insulin should be at meal- time, timing and administration should be individualized (ADA, 2018).
Insulin comes in many forms and prandial dosing insulin should be fast acting to reduce the risk of hypoglycemic episodes. Humalog (insulin lispro) is a fast-acting insulin that can be administered IV, by subcutaneous injection or by a continuous subcutaneous infusion pump. Most short acting insulin is available in a pen that is easy for patients to use correctly and conveniently by dialing the dose into the pen and then attaching a small needle and pressing it into subcutaneous tissue on the stomach, back of the arm, or fatty portion of the thigh. Humalog has a more rapid onset and a shorter duration of action than regular human insulin so when taken with a meal the risk of hypoglycemia is reduced. Onset is within 5 minutes and peak is usually 30 – 60 minutes after administration (Food and Drug Administration [FDA] & Eli Lilly and Company, 2012).
Short and Long-Term Impacts
Individuals who are diagnosed with Type I diabetes face short-term risks of ketoacidosis if glucose levels are not controlled, and hypoglycemic episodes related to insulin therapy (Rosenthal & Burchum, 2021, Chapter 68). They face long-term risks of renal failure, peripheral neuropathy, hypertension, and heart disease. Treatment with ACE inhibitors, angiotensin II receptor blockers, and statin drugs should be considered for long-term disease prevention in adult patients (Gray & Threlkeld, 2019). Treatment with prandial insulin dosing, and balancing carbohydrate intake with activity are key to maintaining safe blood glucose levels.
Conclusion
Type I diabetes is caused by decreased or lack of insulin production and requires close management that includes insulin dosing to prevent long-term disease complications. Humalog is a form of insulin that can be used as part of a comprehensive treatment plan to successfully treat Type I diabetes.
References
American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes – 2018. Diabetes Care, 41(1), 573–585. Retrieved March 30, 2022, from https://doi.org/10.2337/dc18-S008
Food and Drug Administration & Eli Lilly and Company. (2012). Humalog (insulin lispro). FDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/020563s115lbl.pdf
Gray, A., & Threlkeld, R. K. (2019). Endotext [Internet]. MD Text, Inc. https://www.ncbi.nlm.nih.gov/books/NBK279012/
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Elsevier.
A Sample Answer 3 For the Assignment: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Title: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Another treatment option for type 1 diabetes is insulin human inhalation powder (Afrezza). It is a dry powder form of human insulin which is mixed with fumaryl diketopiprazine crystalizing the mixture into microparticles which are easily deliver into the alveolar fluid in the lungs (Heinemann & Parkin, 2018). The mixture is very water soluble making it easy for it to be absorbed into the systemic circulation via the alveolar barrier (Heinemann & Parkin, 2018). This delivery allows for faster onset of action and are short acting (Heinemann & Parkin, 2018). Given the mechanism of action use of inhaled insulin would be contraindicated in patient to with asthma or chronic lung disease (Heinemann & Parkin, 2018).
References
Heinemann, L., & Parkin, C. G. (2018). Rethinking the Viability and Utility of Inhaled
Insulin in Clinical Practice. Journal of Diabetes Research, 2018, 4568903.
https://doi.org/10.1155/2018/4568903
A Sample Answer 4 For the Assignment: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Title: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Thank you for your response. I am glad you brought Afreeza to the discussion board. I have heard of inhaled insulin and seen it in recommendations but have not explored it as an option for therapy. On reading about Afreeza I realize the reason we do not actually see it being used very often is because of cost which is prohibitive for most patients. I also noted that concerns associated with Afreeza include acute bronchospasm, throat and lung irritation, and hypoglycemia. I will ask the physicians and APRNs I work with what their thoughts are on Afreeza prescribing as it does seem like an option patients would like to have for diabetes management. Thanks again!
References
Mohanty, R. R., & Das, S. (2017). Inhaled Insulin – Current Direction of Insulin Research. Journal of clinical and diagnostic research : JCDR, 11(4), OE01–OE02. https://doi.org/10.7860/JCDR/2017/23626.9732
A Sample Answer 5 For the Assignment: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Title: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Great job on your discussion! It was very thorough and informative. I liked that you included information about Humalog (insulin lispro) and the different ways it is available and the methods it can be administered as well. I was wondering if you can expand on the cost-effective way it can be available for people who have no insurance or are limited on funds?
I would personally like to learn more about how we as health care providers can help those less fortunate in affording certain medications or treatments so that their health does not decline due to financial difficulties. Upon my research I have learned that the insulin pens although convenient, are more expensive than the vials. There are pros and cons to each of them for example the pens are about 40% more expensive than the vials but are more convenient, easier to store and transport. The pens are also less painful. With the pens the dosage can be more accurate for the doses smaller than five units. However, if a patient is needing more than one type of insulin they cannot be mixed in the pen (Rosenthal et al, 2021).
What are your thoughts on Pramlintide an amylin analog? It has been approved by the Food and Drug Administration (FDA) for use with type 1 diabetes mellitus (T1DM) patients (American Diabetes Association (ADA), 2018). It can help with weight loss as well as requires lower insulin doses.
Nonetheless, there are different options for those with diabetes and we must encourage them to learn about their best fit to prevent any complications. We should also encourage our patients to speak up on how they are feeling and what helps them feel better controlled of their diabetes. Again, great discussion Tracey!
References
American Diabetes Association; 8. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2018. Diabetes Care 1 January 2018; 41 (Supplement_1): S73–S85. https://doi.org/10.2337/dc18-S008
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 6 For the Assignment: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Title: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Hello Ana, Thank you for your response. Great questions! I know Humalog is widely used and covered by most insurance plans and made the assumption that it was cost effective for most patients. Your question prompted me to further research this. Lilly Pharmaceuticals is the maker of Humalog and report that the cost of a five pack of Humalog insulin pens is $530.40. Each pen has 300 units of Humalog insulin lispro so the entire 5 pack provides 1500 units. This compared to Humalog in a vial that contains 1000 units which costs $274.70. None of these costs include needles, supplies for testing, or any other supplies needed for insulin administration.
In summary, the convenience of the Humalog pen increases cost per unit of Humalog by eight cents per unit. I recognized the need to control costs but would also question that the convenience and safety the pen offers may be worth the additional cost if it does not make Humalog use prohibitive for the patient. I believe a futher analysis of incident of misdosing and compliance would be needed to justify the additional cost.
References:
Lilly Pharmaceuticals, (2022). https://www.lillypricinginfo.com/humalog
A Sample Answer 7 For the Assignment: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Title: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Thank you for the informative and well written post. It is also important to note that type I diabetes can occur later in life and is termed LADA or late autoimmune diabetes in adults. In the past ten years, aprroximately 30% of those diagnosed with type I diabetes are over 30 years old. As LADA occurs later in life, it has characteristics of both type II and type I juvenile diabetes in that it shares the same strong genetic link as type II diabetes and shares with type I the polymorphisms of human leukocyte antigen or HLA ( Pieralice & Pozzilli, 2018).
Treating LADA is often dependent on whether or not the patient is completely insulin dependent. In those who are non-insulin dependent and not well controlled with a biguanide, dipeptidyl peptidase-4 (DDP-4) inhibitors have shown promising results (Hals et al., 2021). These medications can also be used as an add-on with insulin in those who are insulin dependent as these medications help to maintain glucose homeostatsis by acting on glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP), decreasing glucagon secretion and increasing insulin secretion (Kasina & Baradhi, 2021).
References
Hals, I. K., Fleiner, H. F., Reimers, N., Astor, M. C., Filipsson, K., Ma, Z., Grill, V., & Bjorklund, A. (2021). Investigating optimal beta-
cell-preserving treatment in latent autoimmune diabetes in adults: Results from a 21-month randomized trial. Diabetes,
Obesity, and Metabolism, 21(10), 2219-2227. Retrieved from https://dom-
pubs.onlinelibrary.wiley.com/doi/full/10.1111/dom.13797
Kasina, S., & Baradhi, K. M. (2021). Dipeptidyl Peptidase IV (DPP IV) Inhibitors. In StatPearls. StatPearls Publishing. Retrieved from
https://pubmed.ncbi.nlm.nih.gov/31194471/
Pieralice, S., & Pozzilli, P. (2018). Latent autoimmune diabetes in adults: A review on clinical implications and management.
Diabetes & Metabolism Journal, 42(6), 451-464. doi: 10.4093/dmj.2018.0190
A Sample Answer 8 For the Assignment: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Title: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Type 1 diabetes occurs from an autoimmune reaction that attacks the insulin-producing cells in the pancreas; creating a shortage of insulin (Kalathil et al., 2018). In type 2 diabetes, the body fails to produce enough insulin or produces insulin but cannot use it. Type 1 diabetes is related to genetics while type 2 is related to lifestyle factors (Wexler, 2022). Gestational diabetes refers to high glucose levels that occur for the first time during pregnancy (Tsakiridis et al., 2021). Gestational diabetes usually disappears after pregnancy. Finally, juvenile diabetes is type 1 diabetes that starts in childhood. The condition is chronic and insulin-dependent because the pancreas cannot produce or produces too little insulin.
Treatment of type 2 diabetes first takes the lifestyle and diet change approach to manage blood sugar. In cases where lifestyle medication has failed to control blood sugar, metformin is the first-line medication recommended for the treatment of type 2 diabetes (Association, American Diabetes, 2020). Metformin is an oral drug that comes in two forms, tablet and solution. For preparation, the medication is taken with meals with a full glass of water. It should not be crushed, chewed, or broken, but swallowed whole. The starting dose is 500 mg x2 daily (Association, American Diabetes, 2020). A diabetic diet is recommended alongside the pharmacological treatment for type 2 diabetes to help maintain normal blood sugar levels (Wexler, 2022). A typical diabetic diet has high amounts of whole foods, little refined sugar and grains, nonstarchy vegetables, and fruits.
Diabetes affects every aspect of a person’s life including social, psychological, and physical. Some of the short-term effects include increased hunger and thirst, confusion, sweating, seizures and health conditions such as hyperglycemia. The psychosocial effects include stress and anxiety and a negative impact on social life. In the long-term, diabetes has serious financial implications and health complications, for example, hypertension, kidney failure, vision problems, and diabetic foot ulcer among others (Association, American Diabetes, 2020). Metformin therapy can have side effects such as diarrhoea and other stomach problems, nausea, and a metallic taste.
References
Association, American Diabetes. (2020). Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2020. Diabetes Care, 43(Supplement_1): S98–S110. https://doi.org/10.2337/dc20-S009.
Kalathil, D., James, S., & Zaidi, R. (2018). Diagnosis and management of type 1 diabetes mellitus. Pharmaceutical Journal, https://pharmaceutical-journal.com/article/ld/diagnosis-and-management-of-type-1-diabetes-mellitus.
Tsakiridis, I., Giouleka, S., Mamopoulos, A., Kourtis, A., Athanasiadis, A., Filopoulou, D., & Dagklis, T. (2021). Diagnosis and Management of Gestational Diabetes Mellitus: An Overview of National and International Guidelines. Obstetrical & Gynecological Survey, 76(6)- 367-381. https://doi.10.1097/OGX.0000000000000899.
Wexler, D. J. (2022). Patient education: Type 2 diabetes: Overview . UpToDate, https://www.uptodate.com/contents/type-2-diabetes-overview-beyond-the-basics.
A Sample Answer 9 For the Assignment: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
Title: NURS 6521 Discussion Diabetes and Drug Treatments PEER POSTS
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.
Grading Rubric Guidelines
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| Scholarliness
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Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations |
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| Performance Category | 5 | 4 | 3 | 2 | 0 |
| Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread) |
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Summarizes what was learned from the lesson, readings, and other student posts for the week. |
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