Pharmacology Discussion reply #2- week 5

Just in need of a positive discussion response from a classmate’s initial post with 2 additional unmentioned points on diabetes with 3 references. The focus is on pharmacology and diabetes medications.

RUBIC expectation:
16 (16.00%) – 17 (17.00%)
Response exhibits synthesis, critical thinking, and application to practice settings.

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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.

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Response is effectively written in standard, edited English.

The classmates post:
Thread:
Main Post: Type 2 DM, Insulin Lispro
Post:
Main Post: Type 2 DM, Insulin Lispro
Author:
Karl Cleofe
Posted Date:
October 1, 2020 12:06 AM
Status:
Published
Endocrine System Disorders and the Treatment of Diabetes
The incidence and prevalence of chronic disease Diabetes Mellitus (DM) have been on the rise for many years across the globe. It affects a diverse range of people from childhood to adult, which accounts as a catalyst for other health problems. With the current knowledge of the disease\’s pathogenesis, prediction, and identification, formulating the three types of DM\’s appropriate clinical management has improved. This discussion aims to delineate the pathophysiological differences between the Type 1 DM (T1DM), Type 2 DM (T2DM), and Gestational Diabetes. It will also examine the medication, Insulin Lispro, to control blood sugar, specifically for T2DM.

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Types of Diabetes
Juvenile diabetes or T1DM is a result of a total insufficiency of secretion of insulin. The destruction of cellular-mediated autoimmune B-cells in the pancreas occurs during the prepubescent or pubescent stage. Children and adolescents exhibit ketoacidosis due to defective glucose transport, leading to unsuppressed lipolysis and accumulation of ketone bodies in the blood due to inadequate or absence of insulin secretion (McCance & Huether, 2019a). On the other hand, T2DM is a combination of resistance and insufficient response to insulin action and compensatory secretion of insulin (McCance & Huether, 2019b). This form of diabetes develops gradually over time and goes undiagnosed for many years until the disease\’s classic symptoms are noticed. The risk of developing T2DM increases with age, obesity, and sedentary lifestyle due to the rise in insulin secretion\’s defectivity, leading to insufficient insulin resistance compensation. Lastly, Gestational Diabetes is a result of glucose intolerance and insulin resistance during pregnancy. An increase in insulin sensitivity and insulin resistance are the two main factors of this type of DM as a result of the increasing demands of pregnancy and surge of hormones between the mother and fetus (Plows, Stanley, Baker, Reynolds, & Vickers, 2018).
Treatment for T2DM
The primary goal of treatment for patients with T2DM is to maintain the concentration of blood glucose near or within the normal range. The use of short duration: rapid-acting insulin, insulin lispro, controls the rise of blood glucose postprandial (Rosenthal & Burchum, 2018a). Its composition is identical to human insulin with the difference in the transposition of two amino acids, leading to lesser self-association capability into dimers, leading to its rapid onset of action (Swinnen, Hoekstra, & DeVries, 2009). The onset of insulin lispro is within 15-30 minutes after administration, which can last for 3-6 hours (Rosenthal & Burchum, 2018b). Hence, it can be administered before or after meals and before bedtime with the precautionary measure of checking count blood glucose levels before administration. It is also important that with this medication, a sliding scale on the appropriate unit dosage of insulin should be established based on the patient\’s basal metabolic index (Rushakoff, 2019a). The insulin\’s initial dosage is based on the patient\’s appetite or fasting blood sugar level, after which adjustments are made based on the trend of blood glucose levels (Rushakoff, 2019b). The most common side effects of insulin lispro are hypoglycemia; hence, it is crucial to educate patients to have oral glucose on hand or follow hospital-based protocols and inform the doctor for further evaluation. Furthermore, its administration mode is a subcutaneous injection in the abdomen, thighs, or buttocks that needs to be rotated in every administration to prevent the formation of lipohypertrophy, which can inhibit insulin absorption (Rushakoff, 2019c).
The use of insulin helps prevent the development of micro- and macro-complications and permitting a near-normal life to the patient with adequate glycemic control. However, insulin therapy should be optimized with healthy lifestyle modalities and proper diet. Increasing daily activities aids in the production and secretion of insulin and promotes weight loss, which helps control the rise of blood glucose levels (Swinnen et al., 2009). Also, a change in diet plays a vital role in glycemic control. The nutritional content of food intake reflects on the patient\’s blood glucose level, where insulin resistance and sensitivity build-up the can lead to the development or worsening of T2DM. Hence, diabetic diet or healthy food choices should be emphasized.
Conclusion
Characterized by high glucose value of Hemoglobin A1C, the pathophysiological process of T2DM is a series of metabolic dysfunction that involves the secretion of insulin, its action, or both (Swinnen et al., 2009c). This symptomatic event can lead to life-threatening consequences for patients. Short-term complications, such as marked hyperglycemia of excessive urination, polydipsia, and weight loss, impair one’s daily living with infection susceptibility (Papatheodorou et al., 2018a). Nephropathy, peripheral neuropathy, and autonomic neuropathy are the long-term complications of T2DM which increases the incidence of stroke, cardiovascular, and peripheral diseases (Papatheodorou et al., 2018b). Thus, it is vital to control the blood glucose level initially, precisely when initially diagnosed. The use of insulin lispro aids in glycemic control in the short-term; however, adhering to medications and lifestyle changes would help improve quality-life adjusted expectancy.
References
McCance, K., & Huether, S. (2019). Pathophysiology the biological basis for disease in adults
and children (8th ed.). St. Louis, MO: Elsevier.
Papatheodorou, K., Banach, M., Bekiari, E., Rizzo, M., & Edmonds, M. (2018, March 11).
Complicatons of Diabetes 2017. Journal of Diabetes Research, 30(8), 61-67.
http://dx.doi.org/10.1155/2018/3086167
Plows, J., Stanley, J., Baker, P., Reynolds, C., & Vickers , M. (2018, October 26). The
pathophysiology of Gestational Diabetes Mellitus. International Journal of Molecular
Sciences, 19(11), 33-42. http://dx.doi.org/10.3390/ijms19113342
Rosenthal, L., & Burchum, J. R. (2018). Pharmacotherapeutics for advanced practice nurse and
physician assistants (2nd ed.). St. Louis, MO: Elsevier.
Rushakoff, R. (2019, January 7). Inpatient Diabetes management . National Center for
Biotechnology Information. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK278972/
Swinnen, S., Hoekstra, J., & DeVries, J. (2009). Insulin therapy for type 2 Diabetes. American
Diabetes Association, 32(Suppl 2), S253-S259. http://dx.doi.org/10.2337/dc09-S318

SAMPLE SOLUTION

I find Karl’s response sufficient in many ways. Firstly, the response defines diabetes as a chronic condition with high prevalence rates globally. Its implications cut across childhood to adulthood and can also act as a source of other opportunistic conditions. This explanation demonstrates the author’s understanding of the condition and goes on to demonstrate the different types| GET AN EXPERT FOR YOUR ASSIGNMENT | in the course outcome expectations, a pathophysiological understanding of both type 1 and 2 diabetes, gestational diabetes and juvenile diabetes have all been explained. Other than explaining the pathophysiology of the different types of diabetes, the risks of developing the condition have also been clearly shown (Demma et al., 2017). The risk has been shown to increase with age and failing to embrace a | GET AN EXPERT FOR YOUR ASSIGNMENT | clearly outlined the primary of treatment for people with type 2 diabetes. The author mentions active insulin dosages dictated by a person’s body metabolic rate. Besides the BMI, the insulin level has also been dictated by a person’s appetite or fasting blood sugar level. As put in the instructor’s requirement, the side effect…

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