NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments

Type I diabetes mellitus (T1DM) is a chronic autoimmune disease of insulin deficiency and secondary to hyperglycemia due to the destruction of beta cells in the pancreas.  T1DM is the most common type of disease affecting people younger than 20 years and the most common metabolic disease affecting children.  Type 2 diabetes is a chronic metabolic illness characterized by abnormal insulin secretion, resistance to insulin in target tissues, or a decrease in insulin response (Hollier & Hensley, 2018). NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments Juvenile diabetes is not clinically useful as the disease process is similar to TIDM, it was named Juvenile diabetes due to the fact that the illness developed abruptly in childhood or adolescence. Gestational diabetes is diabetes that develops during pregnancy and disappears almost immediately after delivery.  Factors that contribute to gestational diabetes is the placenta produces hormones that antagonize the actions of insulin, the production of cortisol which promotes hyperglycemia, and because glucose passes through the placenta freely from the maternal circulation (Rosenthal & Burchum, 2018) NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments.

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For Type 2 diabetes the first line of drug used are Biguanides because they decrease production of glucose in the liver.  They also decrease absorption of glucose in the intestines and increase insulin sensitivity by increasing glucose uptake and utilization (Hollier & Hensley, 2018).  Metformin is the initial medication of choice to treat hyperglycemia in type 2 diabetes, because of glycemic efficacy, absence of weight gain, tolerability, and favorable costs.  Metformin is initiated at 500 mg BID and increased in increments of 500 mg weekly with a maximum dose of 2000 mg daily, divided into 2 doses (UpToDate n.d.) NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments.  Nonpharmacological management includes weight loss the primary goal in obese patients.  Nutrition plan includes three visits to a registered dietitian on initial diagnosis with follow-up visits semiannually to annually.  Alcohol should be avoided as well as smoking.  Exercise should be included as it helps to increase insulin utilization (Collier & Hensley, 2018).   Medical nutrition therapy (MNT) is the process where the dietary plan is tailored for people with diabetes, based on medical, lifestyle, and personal factors.  It is an integral component of diabetes management and education (UpToDate n.d.) NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments.

Long term treatment goals are improved glycemic control with lowers the risk of microvascular complications in patient with type 2 diabetes.  Every one percent drop in the glycated hemoglobin (A1C) is associated with improved outcomes over the long term.  The goal is to get to an A1C of lower than seven percent.  Target A1C control should be tailored to the individual, balancing the potential for improvement in microvascular complications with the risk of adverse effects of treatment. NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments For example, glycemic targets are set higher for older adult patients with comorbidities who may have little likelihood of benefit from intensive therapy (UpToDate n.d.).  In addition to glycemic control, vigorous cardiac risk reduction should be a top priority for all patient with type 2 diabetes.  Short term treatment goals include glycemic control, improving eating habits, exercise, and weight loss.  A weight loss of 5-10 pounds has shown to improve insulin sensitivity (Collier & Hensley, 2018).  For patients with type 2 diabetes intensive lifestyle modification interventions focus on weight reduction and increasing activity levels to improve glycemic control and decrease the need for glucose-lowering medications. NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments.

References:

Hollier, A., & Hensley, R. (2018). Clinical guidelines in primary care. Third edition. Lafayette, La: Advanced Practice Education Associates, Inc. NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments

Rosenthal, L. D., & Burchum, J. R. (2018).  Lehne’s pharmacotherapeutics for advanced practice       providers.  St. Louis, MO: Elsevier.

UpToDate. (n.d.). Retrieved from https://www.uptodate.com/contents/metforin-in-the-treatment-of-adults-with-type-2-diabetes-mellitus?

Discussion: Diabetes and Drug Treatments

For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments.

Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/

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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. NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments.
• 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. NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments

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!

 

NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments response

I enjoy reading your post and felt it was very educational. According to research onT1 diabetes mellitus treatment and educational strategies to have to keep tight control of blood sugar and as soon as possible to for minimizing any damage which can cause later in life. Something that most people don’t think about. Your focus on the “Long term treatment goals are improved glycemic control with lowers the risk of microvascular complications in patients with type 2 diabetes”. Tight control of sugar may predispose other people with diabetes for example Type 2 for hypoglycemic episodes. According to (kirpitch et al., n.d) the education for Type 2 is not strategizing enough with a patient with diabetes (Kirpitch et al., n.d). in addition, the short and long-term goals impact is based on patient adherence with diet, exercise, awareness and very part is the medication they have been prescribed goals. Thank you very much, Hung. NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments

Kirpitch et al.,(n.d).The 3 R’s of Glycemic Index: Recommendations ,research, and the Real World, Clinical Diabetes.29(4),155-159.Retrieved https://clinical.diabetesjournals.org/content/29/4/155

Standards of Medical care in Diabetes American Diabetes Association. (2019).Clinical Diabetes,37(1)11-34.Retrieved https://clinical.diabeteslournals.org/content/37/1/11    NURS 6521 Week 5 Discussion: Type 2 Diabetes and Drug Treatments