NURS 6521 Diabetes and Drug Treatments

NURS 6521 Diabetes and Drug Treatments

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

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

NURS 6521 Diabetes and Drug Treatments
NURS 6521 Diabetes and Drug Treatments

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.

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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 Diabeteshttps://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 primers1(1), 1-22.

Foretz, M., Guigas, B., & Viollet, B. (2019). Understanding the glucoregulatory mechanisms of metformin in type 2 diabetes mellitus. Nature Reviews Endocrinology15(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 Lancet383(9933), 1999-2007.

Metformin, a biguanide antihyperglycemic medication, lowers blood glucose in patients with type 2 diabetes with minimal risk of hypoglycemia. The most common side effects include diarrhea, nausea, and vomiting. Extended-release metformin (Glucophage XR) *, a once-daily tablet using the patented Gel Shield Diffusion System release mechanism, may be better tolerated than immediate-release metformin (Glucophage). This retrospective chart review examined the overall gastrointestinal (GI) tolerability of both formulations. In this retrospective chart review, patients switching from immediate-release metformin to metformin-XR experienced fewer GI side effects on comparable doses of extended-release metformin. Blonde, Dailey & Mills (2004)

Metformin-induced diarrhea developing in individuals starting the medication has been attributed to changes in the gut microbiome, increased intestinal glucose and bile acid turnover, and increased GLP-1 concentration. Diarrhea usually reduces with time or after dose reduction, which may be followed by gradual up-titration. Metformin-induced weight loss has been hypothesized to result from appetite-modulating effects in the central nervous system, reduction in leptin production from adipose tissues, reduced carbohydrate absorption from the gut, and increased GLP-1 levels. Both side effects most commonly occur either immediately after the introduction of the drug or after a delay of a few weeks. However, the patients in all three cases presented here were on stable doses of metformin for several years before these effects developed. Manoj & Lakshmi (2021)

Reference:

Blonde, L., Dailey, G. E., Jabbour, S. A., Reasner, C. A., & Mills, D. J. (2004). Gastrointestinal  tolerability of extended-release metformin tablets compared to immediate-release metformin tablets: results of a retrospective cohort study. Current medical research and opinion20(4), 565–572. https://doi.org/10.1185/030079904125003278

Links to an external site.

SUBRAMANIAM, K., MANOJ, JOSEPH P., & LAKSHMI. BABU A., (2021). A Common Drug Causing a Common Side Effect at an Uncommon Time: Metformin-Induced Chronic Diarrhea and Weight Loss After Years of Treatment Clin Diabetes 2021;39(2):237–240 https://doi.org/10.2337/cd20-0101

Module 4 Week 5

In this week’s discussion, we are to reflect on differences between types of diabetes. Then, we are to select one type of diabetes to focus on and consider one type of drug used to treat the type of diabetes we selected including proper preparation and administration of this drug.  Then we are to reflect on dietary considerations related to treatment.  Finally, we are to think about the short-term and long-term impact of the diabetes selected, including effects of drug treatments.  Type I diabetes (or juvenile diabetes) is the most common pediatric disease and is usually diagnosed from infancy to the late 30’s (McCance & Huether, 2019). There are two types:  Autoimmune and Nonautoimmune.  In this type of diabetes, a beta cells in the pancreas are destroyed.  Symptoms for diagnosis are polydipsia,  polyuria, polyphagia, weight loss, and hyperglycemia, and intermittent DKA.  The patient is insulin dependent.

Type II diabetes usually affects those people over 40.  Insulin resistance and obesity is associated with type II diabetes.  The pancreas cannot use the insulin produced properly, and there is a reduction in beta cell mass and function (McCance & Huether, 2019).  The cells become resistant to insulin, making an excess of insulin than is necessary to keep blood glucose levels within a normal range.  The symptoms are obesity, dyslipidemia, and hypertension.  The patient experiences polyuria and polydipsia.  There are also recurrent infections, genital pruritus, visual changes, paresthesia, fatigue, and acanthosis nigricans.   The patient is not usually insulin dependent, but may require insulin.

Gestational diabetes occurs during pregnancy.  There is insulin resistance and inadequate insulin secretion.  It is most likely to occur in women who are obese, 25-years-old, have a family history of diabetes, have a history of gestational diabetes, or are of Native American, Asian, or black (these ethnic groups have a higher incidence rate of gestational diabetes (McCance & Huether).

For this discussion I am focusing on type II diabetes mellitus.  Those with this type of diabetes have a mortality rate twice that of the general population.  Complications from this type of diabetes are myocardial infarction, stroke, nephropathy, retinopathy, and peripheral arterial disease and neuropathy resulting in amputation (Laursen et. al., 2017).  One of the drugs used to treat this type of diabetes is in a class of drugs called biguanide named Metformin.  This drug decreases glucose production by the liver, reduces glucose absorption in the gut, and sensitizes insulin receptors in fat and skeletal muscle.  Metformin is slowly absorbed from the small intestine, and is excreted unchanged by the kidneys.  If there is renal impairment, it can produce toxic levels (Rosenthal  & Burchum, 2021).  It can be used alone, or with insulin.  Importantly,  it can be used for patients who skip meals because it does not lower blood glucose.  It can be taken during pregnancy.

Common side effects are decreased appetite, nausea, and diarrhea.  Metformin decreases absorption of vitamin B12 and folic acid, thus causing vitamin B and folic acid deficiencies.  It does not cause weight gain.  It is important to eat healthy meals while taking Metformin, and not skip meals.  Metformin can cause lactic acidosis.   Initial dosing is immediate release 850-1000 mg daily or extended release 500 mg nightly.

References

Laursen, D., Christenssen, K., Christensen, U., & Frolich, A. (2017). Assessment of short and long-term outcomes of diabetes patient education using the health education impact questionnare (HeiQ). BMC Research Notes 10(213).  https://doi10.1186/s13104-017-2536-6

Links to an external site.

McCance, L.L. & Huether, S.E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Rosenthal, L.D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.