Discussion: Diabetes and Drug Treatments NURS6521 Week 5

Discussion: Diabetes and Drug Treatments NURS6521 Week 5 Discussion: Diabetes and Drug Treatments NURS6521 Week 5 Photo Credit: [Mark Hatfield]/[iStock / Getty Images Plus]/Getty Images 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. Discussion: Diabetes and Drug Treatments NURS6521 Week 5 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/ ORDER NOW FOR CUSTOMIZED AND ORIGINAL NURSING PAPERS 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 “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! Submission and Grading Information – Discussion: Diabetes and Drug Treatments NURS6521 Week 5 Grading Criteria To access your rubric: Week 5 Discussion Rubric Post by Day 3 of Week 5 and Respond by Day 6 of Week 5 To Participate in this Discussion: Week 5 Discussion: Diabetes and Drug Treatments NURS6521 Week 5 Example Discussion Approach Submitted Discussion Week 5 — ONE COLLAPSE Diabetes mellitus is a metabolic disease that affects over 30 million people in the United States (McCance & Huether, 2019). There are different types of diabetes, and each type is classified by its cause. The two primary forms of diabetes are type one and type two. Type-one usually has an onset in childhood and is also called juvenile diabetes. In type one, the body destroys pancreatic cells that produce insulin. Type-two diabetes usually occurs in middle-aged adults when the body develops insulin resistance to blood glucose levels. Gestational diabetes occurs in pregnancy due to an increase in cortisol, placental hormones, and glucose passing between the mother and fetus (Rosenthal, & Burchum, 2018). All three factors increase the body’s need for insulin. In the United States, type-two diabetes is the most common form. Being obese puts individuals at risk of developing type-two diabetes. Type-two diabetes is detected by measuring someone’s fasting blood glucose level. In some instances, a person may be able to avoid medications if they change their diet and implement an exercise routine. This is only possible if the person is considered pre-diabetic (McCance & Huether, 2019). Metformin is the drug that is recommended for initial treatment if there are no contraindications. Metformin is an oral drug that is taken with meals, and it lowers blood glucose levels and increases tissue response to insulin (Rosenthal, & Burchum, 2018). However, if the patient has contraindications to metformin, they may require insulin therapy. Depending on the patient’s hemoglobin A1C levels, they may require insulin therapy in conjunction with oral medications like metformin (American Diabetes Association, 2018). If the patient fails to reach specific glucose level goals, only taking metformin may not be sufficient. Patients with type-two diabetes must carefully monitor their blood glucose levels throughout the day so that they can eat a diet accordingly to match their glycemic treatment goals (Rosenthal, & Burchum, 2018). Monitoring blood glucose levels and working for glycemic control is something that diabetic patients need to do for the rest of their lives. Metformin is not recommended in patients with reduced kidney function and requires monitoring of the patient’s glomerular filtration rate. Type-two diabetes is a prevalent disease in the United States, but it is very manageable. References American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes—2018. Diabetes Care, 41(Supplement 1) , S73–S85. Retrieved from http://care.diabetesjournals.org/content/41/supplement_1/s73.full-text.pdf McCance, K. 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. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier. Discussion Post – TWO Diabetes and Drug Treatments Diabetes mellitus (DM) is a chronic, metabolic disease characterized by elevated levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. The most common type of DM is type 2 (T2DM). It is the most prevalent form, and it is when the body becomes resistant to insulin or does not make enough insulin. Type 1 diabetes mellitus (T1DM), also known as juvenile diabetes or insulin-dependent diabetes, is the most common type of diabetes mellitus in children and adolescents, it is a chronic condition in which the pancreas produces little or no insulin by itself. Although type 1 diabetes is named juvenile diabetes, this disease may develop at any age (Bimstein et al., 2019). Also, gestational diabetes mellitus (GDM), which is the presence of high blood glucose levels with the onset or detected for the first time during pregnancy, as a result of increased insulin resistance (Lorenzo-Almorós et al., 2019). Type 1 Diabetes To prevent complications of diabetes, it requires a comprehensive plan such as glycemic control. Insulin is a priority therapy for individuals with type 1 diabetes. The starting insulin dose mostly based on weight, with doses ranging from 0.4 to 1.0 units/kg/day of total insulin with higher amounts required during puberty (American Diabetes Association, 2018). Also, it is essential to correspond to insulin dosage to carbohydrate intake. Closely monitoring carbohydrate intake is a must. Continuous subcutaneous insulin infusion uses a portable infusion pump connected to an indwelling subcutaneous catheter. The four types of insulin used include regular, lispro, aspart, and glulisine. Insulin lispro (Humalog) is a type of insulin used to help treat T1DM that is short-duration insulin administered with meals to control the postprandial rise in blood glucose. This insulin is formulated as clear solutions, and given by subcutaneous (subQ) route or via insulin pump and given with an intermediate- or long-acting agent in people with type 1 diabetes to provide glycemic control between meals and at night. Insulin lispro has a shorter duration of action but has a faster effect than regular insulin because structure molecules of insulin lispro aggregate are less than regular insulin molecules. The effects usually begin within 15 to 30 minutes of subQ injection and continue for 3 to 6 hours. Due to the rapid onset, insulin lispro can be administered immediately before eating, or even after eating (Rosenthal & Burchum, 2018). Short-Term and Long Term Impact There are both short-term and long-term complication of Type 1 diabetes if not managed properly. Most diabetes complications are due to poor blood glucose control. A short-term diabetes complication is hypoglycemia, which occurs when insulin levels exceed insulin needs or overdose. Hypoglycemia is when the blood glucose level goes below 70 mg/dl. Treating hypoglycemia is crucial because it can lead to irreversible brain damage, coma, and death. Long-term impact or complication includes microvascular and macrovascular complications to the body, such as diabetic neuropathy or causing plaques to build up. Also, the study shows that sexuality suggests a substantial impact of the disease on morale, especially in women (Mellerio et al., 2015). To conclude, support is vital to boost morale. Additionally, avoiding short-term complications, and doing proper planning, long-term complication of T1DM can be avoided. References American Diabetes Association. (2018). Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes—2018 . Diabetes Care, 41(Supplement 1) , S73–S85. Retrieved from http://care.diabetesjournals.org/content/41/supplement_1/s73.full-text.pdf Bimstein, E., Zangen, D., Abedrahim, W., & Katz, J. (2019). Type 1 diabetes mellitus (juvenile diabetes) – A review for the pediatric oral health provider. The Journal of Clinical Pediatric Dentistry, 43 (6), 417-423. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.17796/1053-4625-43.6.10 Lorenzo-Almorós, A., Hang, T., Peiró, C., Soriano-Guillén, L., Egido, J., Tuñón, J., & Lorenzo, Ó. (2019). Predictive and diagnostic biomarkers for gestational diabetes and its associated metabolic and cardiovascular diseases. Cardiovascular Diabetology , 18 (1), 140. https://doi-org.ezp.waldenulibrary.org/10.1186/s12933-019-0935-9 Mellerio, H., Guilmin-Crépon, S., Jacquin, P., Labéguerie, M., Lévy-Marchal, C., & Alberti, C. (2015). Long-term impact of childhood-onset type 1 diabetes on social life, quality of life and sexuality. Diabetes & Metabolism , 41 (6), 489–497. https://doi-org.ezp.waldenulibrary.org/10.1016/j.diabet.2014.12.006 Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers . St. Louis, MO: Elsevier. Sample Response to Discussion Post TWO I enjoyed your summary of Type I Diabetes. Type I Diabetes can seem like such a scary disease because it is an autoimmune destruction of pancreatic ??cells which results in a deficiency of insulin secretion (Hemmingsen, Richter & Metzendorf, n.d.). To adjust the needed levels of insulin in the body, this is usually corrected with subcutaneous injections of short-acting insulin (Hemmingsen et al, n.d.). With diligent carb counting, glucose monitoring and short-acting insulin administration hypoglycemia can still occur. Long-acting insulins have recently been developed to help address hypoglycemia in T1D and to help make monitoring easier for the patient. These insulins are known as Detemir, Glargine U100, Degludec, and Glargine U300 (Hemmingsen et al, n.d.). The mechanism of action for these insulins differs slightly, but it is believed that the longer action and the less pronounced insulin peak will enable both improved glycemic control and reduced risk of hypoglycemia (Hemmingsen et al, n.d). With T1D the options have been limited for many years, and the risks are severe with short-acting insulins. The possibility of other options proves promising. References: Hemmingsen, B., Richter, B., Metzendorf, M., & Hemmingsen, B. (n.d.). (Ultra?)long?acting insulin analogues for people with type 1 diabetes mellitus. Cochrane Database of Systematic Reviews , 12. McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2019). Pathophysiology: The biologic basis for disease in adults and children . St. Louis: Elsevier. Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers . St. Louis, MO: Elsevier. NURS_6521_Week5_Discussion_Rubric Grid View List View Excellent Good Fair Poor Main Posting 45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 35 (35%) – 39 (39%) Responds to some of the discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Post: Timeliness 10 (10%) – 10 (10%) Posts main post by day 3 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) Does not post by day 3 First Response 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 15 (15%) – 16 (16%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 13 (13%) – 14 (14%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. Discussion: Diabetes and Drug Treatments NURS6521 Week 5 0 (0%) – 12 (12%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. Second Response 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings. Responds fully to questions posed by faculty. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of learning objectives. Communication is professional and respectful to colleagues. . Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. Discussion: Diabetes and Drug Treatments NURS6521 Week 5 12 (12%) – 13 (13%) Response is on topic and may have some depth. Responses posted in the discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. . Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) – 11 (11%) Response may not be on topic and lacks depth. Responses posted in the discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited. Participation 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days. 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) Does not meet requirements for participation by posting on 3 different days Total Points: 100 Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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