NURS 6501 Diabetes and Drug Treatments

NURS 6501 Diabetes and Drug Treatments

Type 1 diabetes (T1DM) is diagnosed following a lack of insulin production secondary to the destruction of autoimmune pancreatic beta-cells. Type 2 DM is characterized by inadequate insulin secretion secondary to developed insulin resistance by the body cells (Banday et al., 2020). It is often associated with obesity and is much more common than T1DM. Gestational diabetes is specific to pregnancy and applies to diabetes diagnosed during pregnancy. It generally resolves or improves after delivery (Plows et al., 2018). Juvenile diabetes develops during infancy and childhood, and its pathogenesis is similar to T1DM.

Tolbutamide is a first-generation sulfonylurea used to manage T2DM. It is well absorbed and rapidly metabolized in the liver. Its duration of effect is relatively short, with an elimination half-life of 4-5 hours. It is best administered in divided doses to minimize GI side effects. Because of its short half-life, it is the safest sulfonylurea for elderly diabetics (Taylor et al., 2021). Prolonged hypoglycemia is a rare ADR of Tolbutamide. It mostly occurs in patients receiving certain drugs that inhibit the metabolism of tolbutamide, like dicumarol, phenylbutazone, and some sulphonamides. Caution is needed in patients with hypoglycemia, with a reduced caloric intake.

T2DM is associated with poor health outcomes and premature death due to its short and long-term complications. The short-term effects of T2DM include hypoglycemia, which occurs in patients who miss meals or take sulfonylureas like Glimepiride. Long-term complications include those affecting large blood vessels (macrovascular) and small blood vessels (microvascular). Macrovascular complications include coronary heart disease, cerebrovascular disease, and peripheral vascular disease (Papatheodorou et al., 2018). On the other hand, microvascular complications of blood vessel structure and function result in neuropathy, nephropathy, and retinopathy that lead to foot amputations, kidney failure, and cataracts.

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

Papatheodorou, K., Banach, M., Bekiari, E., Rizzo, M., & Edmonds, M. (2018). Complications of Diabetes 2017. Journal of diabetes research, 2018, 3086167. https://doi.org/10.1155/2018/3086167

Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018). The Pathophysiology of Gestational Diabetes Mellitus. International journal of molecular sciences, 19(11), 3342. https://doi.org/10.3390/ijms19113342

Taylor, S. I., Yazdi, Z. S., & Beitelshees, A. L. (2021). Pharmacological treatment of hyperglycemia in type 2 diabetes. The Journal of clinical investigation, 131(2), e142243. https://doi.org/10.1172/JCI142243

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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

Learning Resources

Required Readings

• 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

• Links to an external site.—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)

• Download Mid-Term Summary & Study Guide (PDF)

Required Media

• Speed Pharmacology. (2017). Drugs for Diabetes (Made Easy)

• Links to an external site. [Video]. https://www.youtube.com/watch?v=LWDQyaKVols&t=79s

  Note: This media program is approximately 17 minutes

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!

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