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who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.
Type 1 diabetes which is sometimes called juvenile or insulin-independent is when the pancreas produces little to no insulin. It can be seen as an autoimmune disease because the immune system mistakenly attacks the insulin-producing beta cells of the pancreas (Diabetes UK The Global Diabetes Community, 2019). Since these patients are not producing enough insulin, they are insulin-dependent for the rest of their lives, and most patients wear an insulin pump (Mayo Clinic, 2018). Type 1 is normally diagnosed during pediatric years or people younger than the age of 30 (Diabetes UK The Global Diabetes Community, 2019).
Type 2 diabetes which is also called adult-onset or non–insulin-dependent diabetes, is different from type 1 because in type 2 the body loses the ability to respond to insulin (Thompson & Romito, 2018). This causes the body to become insulin resistant because the body is not using insulin in the right way (Thompson & Romito, 2018). The pancreas soon becomes overworked and makes less insulin leading to insulin deficiency. Type 2 diabetes can be treated with insulin and medications, it can also be prevented if caught early and by lifestyle modifications such as in food, diet, and behaviors. Type 1 diabetes is not preventable (Diabetes UK The Global Diabetes Community, 2019).
Gestational diabetes (GDM) occurs during pregnancy. A hormone made by the placenta in the womb keeps the body from using insulin the way it should (Cedars-Sinai, 2019). Glucose builds up in the body and is not absorbed by cells leading to this disorder. GDM normally goes away after the birth of a baby. Women who are overweight are more prone to developing this disorder, and their children are at an increased risk of developing type 2 diabetes (Cedars-Sinai, 2019). Making sure to get blood work done routinely, sticking to proper diet, exercise, medications, and insulin injections can control and prevent developing GDM (Cedars-Sinai, 2019).
I selected Aspart (Novolog) insulin pen as the drug of choice for GDM. To prepare this drug I would show the pregnant patient how to administer this drug. First, I would instruct the patient to check their blood sugar pre-meals. If the blood sugar is above 150, right before their meal then the patient should follow the range dose of insulin to give that is prescribed to the patient. If the patient plans of eating all of their food then the patient will be told to give the required dose 15 minutes before or after the meal (University of Iowa Hospitals & Clinics [UIHC], 2019). If the patient only eats half then wait till after the meal to administer insulin.
The patient will be told that in pregnancy the best place to administer insulin is in the abdomen because this is where insulin gets absorbed the fastest in the bloodstream (UIHC, 2019). It should be injected at least 2 inches away from the belly button. To use the pen I would instruct the patient to remove the cap of pen and clean with alcohol, apply needle, prime the pen by selecting 2 units making sure to see drops so you know its working right. After this, select the appropriate dose needed for the patient, point the pen towards the abdomen site and push down to inject (UIHC, 2019). The dietary considerations would consist of a balance of legumes, sweet potatoes, salmon, eggs, fruits, broccoli, green leafy vegetables, fish liver oil. Berries, whole wheat products, and lean cooked meats (Cedars-Sinai, 2019). The patient would be told to stay away from processed, sugary, and fried foods.
A short term effect that may not be talked about with GDM is the cost. On average women living with GDM spend up to two-thousand dollars more than women living without GDM (Xu et al., 2015). This is related to the cost of medications, frequent doctor visits, and symptoms of hyperglycemia that the patient experiences. This is why making sure to take insulin, following a proper diet, and exercise program can help decrease these cost and prevent developing type 2 diabetes in the long-term for patient and child. If the patient develops type 2 diabetes after pregnancy this can lead to obesity, stroke, and heart attack if not properly controlled (Diabetes UK The Global Diabetes Community, 2019). It is clear that following and living a balanced diet regardless of the type of diabetes diagnosed with can help control, and prevent detrimental effects on the body and allow to live a satisfying life.
References
Cedars-Sinai. (2019). Gestational Diabetes. Retrieved from https://www.cedars-sinai.org/health-library/diseases-and-conditions/g/gestational-diabetes.html
Diabetes UK The Global Diabetes Community. (2019). Differences Between Type 1 and Type 2. Retrieved from https://www.diabetes.co.uk/difference-between-type1-and-type2-diabetes.html
Mayo Clinic. (2018). Type 1 Diabetes. Retrieved from https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011
Thompson, E., & Romito, K. (2018). Diabetes: Differences Between Type 1 and 2. Retrieved from https://www.mottchildren.org/health-library/uq1217abc
University of Iowa Hospitals & Clinics. (2019). Insulin use during pregnancy. Retrieved from https://uihc.org/health-topics/insulin-use-during-pregnancy
Xu, T., Danielli, L., Yu, K., Ma, L., Silva Zolezzi, I., Detzel, P., & Fang, H. (2015). The short-term health and economic burden of gestational diabetes mellitus in China: a modelling study []. BMJ Open, 7(12). Retrieved from https://bmjopen.bmj.com/content/7/12/e018893
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