Diabetes and Drug Treatments Discussion Paper

Diabetes and Drug Treatments Discussion Paper

Diabetes and Drug Treatments Discussion Paper

Diabetes is a pancreatic disorder characterized by a deficiency in insulin production or its effect on body tissues. There are four types of diabetes: Type 1, Type 2, Juvenile, and Gestational diabetes. Type 1 diabetes (T1DM) results from autoimmune destruction of pancreatic beta cells (Harreiter & Roden, 2019). Type 2 diabetes (T2DM) is a progressive condition characterized by increasing insulin resistance and diminishing insulin secretory capacity. It is frequently associated with obesity and usually has its onset in adulthood. Juvenile diabetes has its onset during infancy or childhood (Harreiter & Roden, 2019). Gestational diabetes refers to any abnormality in glucose levels identified for the first time during pregnancy. It mostly reverts to normal glucose levels in the post-partum.

Insulin Detemir is a long-acting insulin analog used to treat T1DM. It is long-acting soluble insulin with a duration of action of more than 24 hours (Crisher et al., 2019). Detemir has a dose-dependent onset of action of 1-2 hours. It is preferred over intermediate-acting because it is associated with less hypoglycemia and its weight-sparing effect. Upon subcutaneous injection, detemir binds to albumin through a fatty acid chain, thus resulting in a slow absorption and a prolonged metabolic effect. Initially, it was recommended to administer detemir in the evening (at dinner or bedtime) (Crisher et al., 2019). However, it was established that morning plus evening administration of detemir and insulin aspart at mealtime provided less variable glycemic levels with no, or less, weight gain.

T1DM is associated with various short and long-term complications. Short-term effects include hypoglycemia which occurs due to too much insulin, and diabetic ketoacidosis, which occurs due to deficient insulin (Banday et al., 2020). Long-term effects include microvascular complications such as retinopathy, cataracts, nephropathy, and neuropathy that end in foot amputations. Macrovascular complications of T1DM include heart failure. Effects of drug treatment of T1DM include hypoglycemia, lipohypertrophy (caused by repeated injections at one site), and local allergic reactions (Banday et al., 2020).

References

Banday, M. Z., Sameer, A. S., & Nissar, S. (2020). Pathophysiology of diabetes: An overview. Avicenna journal of medicine, 10(4), 174–188. https://doi.org/10.4103/ajm.ajm_53_20

Crisher, M. A., Giuliano, C. A., & Hartner, C. L. (2019). Insulin Detemir Versus Insulin Glargine in the Hospital: Do Hypoglycemia Rates Differ?. Clinical diabetes : a publication of the American Diabetes Association, 37(2), 167–171. https://doi.org/10.2337/cd18-0065

Harreiter, J., & Roden, M. (2019). Diabetes mellitus – Definition, Klassifikation, Diagnose, Screening und Prävention (Update 2019) [Diabetes mellitus-Definition, classification, diagnosis, screening and prevention (Update 2019)]. Wiener klinische Wochenschrift, 131(Suppl 1), 6–15. https://doi.org/10.1007/s00508-019-1450-4

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Discussion: Diabetes and Drug Treatments

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.
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/
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.

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
• Chapter 48, “Drugs for Diabetes Mellitus” (pp. 397–415)
• Chapter 49, “Drugs for Thyroid Disorders” (pp. 416–424)

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

This article provides guidance on pharmacologic approaches to glycemic treatment as it pertains to treating patients with diabetes. Reflect on the content of this article as you continue to examine potential drug treatments for patients with diabetes.

Document: Mid-Term Summary & Study Guide (PDF)

Required Media (click to expand/reduce)

Speed Pharmacology. (2017). Drugs for Diabetes (Made Easy) [Video]. https://www.youtube.com/watch?v=LWDQyaKVols&t=79s
Note: This media program is approximately 17 minutes.

RUBRIC:

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.

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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%) – 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. 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