Diabetes Mellitus type 2

INSTRUCTIONS:

1. Choose a medical diagnosis: I choose Diabetes Mellitus type 2.(Diabetes Mellitus type2 essay)

2. Then choose 1 of the recommended medication management (current management, a new research medication, or alternative therapy) usingone of the following sources:current evidence-based practice (EBP) article, an article from a reputable source, or from current Clinical Practice Guidelines (CPGs).(Diabetes Mellitus type2 essay)

3. COPY each numbered question in the prompt into your response and carefully answer each question.

·       MAIN POST:  an initial, concise (3-5 sentences per question) response by WEDNESDAY @ 1159pm.  Be clear and concise in your responses.  You cannot change your post once submitted and must post in order to see or respond to others’ comments.(Diabetes Mellitus type2 essay)

·       IN-TEXT CITATIONS:  cite all your work for each question.  Review the citation resources in the course material on proper in-text citations. Remember – per APA7 guidelines- it must be clear to the reader ‘where’ the information is coming from at all times. (This means putting one citation at the beginning or end of a paragraph is not appropriate)

4.  REFERENCE LIST: must be within the past 5 years, cited using APA7 format at the end of your posts.(Diabetes Mellitus type2 essay)

o   Appropriate references

§  UpToDate, Lexicomp, MicroMedex, national guidelines, the professional sections of the CDC, FDA, WHO, NIH, or IDSA, and peer-reviewed professional journal articles or Evidence-Based Practice (EBP).

§  If you use Mayo Clinic:  be sure to click on “for Medical Professionals; Clinical Updates”

o   NOT appropriate references (they are more for patients):(Diabetes Mellitus type2 essay)

§  Public websites for the general public: Mayo Clinic, WebMD, Healthline, etc., newspapers, news stations, magazines, etc. If your source is “patient-facing” (addresses the public) then it is NOT a professional reference.

o   TEXTBOOKS– only use if specifically permitted in the prompt.  Also if used, the textbooks cannot be the sole or primary references for any question asked. (As a nurse educator you should go to original current resources)

DISCUSSION QUESTIONS

Primary Post:  Please # each question to correspond with your answer:

Main:

1.    Briefly explain your chosen medical diagnosis.(Diabetes Mellitus type2 essay)

2.    What is your article (from a reputable source) or EBP article about?

3.    Why is this medication important? What data is there to support this drug for the treatment of your diagnosis?

4.    What should nurses know about this drug when administering it (assessment, side effects, labs, evaluation)?

5.    What should patients know while taking this medication (how to take it, contraindications, when to call MD)?

6.    How does this medication and knowledge impact your workplace or personal life?(Diabetes Mellitus type2 essay)

Diabetes Mellitus type2 essay- sample solution

Immuno-endocrinology defines the branch of science, which focuses on how immune systems and the endocrine one interact in connection to the maintenance of normal physiology and contribute various pathophysiological conditions manifestations (Stelzler & Arck, 2016). Many endocrine disorders are now predictable because they are immune meditated. Animal models, as well as human subject studies, stress the importance of alleles in Human Leukocyte Antigen (HLA) like molecules in dictating tissue-specific targeting, which due to loss of tolerance results in organ-specific immunity. Disorders which include but are not limited to Addison’s disease, Grave’s disease, Hashimoto’s thyroiditis, and Type 1A diabetes all emanate from autoimmune tissue destruction. Four stages define the progress of these disorders in general. Stage one commences with genetic susceptibility followed by environmental triggers and then active autoimmunity at step three.(Diabetes Mellitus type2 essay) The fourth and last stage manifests as metabolic derangements with overt disease symptoms (Rosol & Walling, 2017). Moreover, with prescriptions emerges the problem of medication adherence as far as management of patients suffering from chronic diseases which require long term pharmacotherapy consequently, this essay purposes to examine the drug-based treatment of endocrine ad immunity disorders.(Diabetes Mellitus type2 essay)

Causes and Consequences of Noncompliance and Possible Solutions

Cephalosporin

Cephalosporins are broad-spectrum antibiotics prescribed for a variety of bacterial infections. These infections range from urinary tract infections to respiratory tract and skin infections. Prescribing cephalosporin to children below three years constitutes noncompliance with cephalosporin. The second noncompliance cause is oral cephalosporin prescription as first-line therapy. The consequences of cephalosporin noncompliance lead to bacterial resistance. The prescribing physician role can decrease noncompliance if they consult the cephalosporin prescribing guidelines.(Diabetes Mellitus type2 essay)

Corticosteroids

Corticosteroids relief inflamed body tissues by reducing the swelling, redness, allergic reactions, and itching. They are used to treat and manage skin problems, asthma, and severe allergies. Kebede & Mamo (2019) quip that noncompliance in corticosteroids is either deliberate, like when the patient fears its side effects, on misconceptions on the severity of asthma or non- intentional like forgetting, lack of counseling and need to avoid costs. The consequences of corticosteroids noncompliance are poor patient outcomes and increased clinical and economic burden. To overcome the noncompliance challenge, healthcare providers should offer patient education and counsel the patients so that intentional non-adherence becomes a thing of the past.

Sulfonylureas (as an adjunct to insulin therapy)

Sulfonylureas are primarily used to treat T2DM. The causes of sulfonylureas medication can broadly be categorized as either being patient-centered, therapy-related, or emanating from the healthcare system. Patient-centered causes of noncompliance include gender, age, or educational level, and the patient’s belief system (Cutler et al., 2018). Those causes related to therapy are the route of administration, side effects, and duration of medication. At the same time, the availability and accessibility of the doctor constitute the healthcare system’s causes of noncompliance. Notable among the consequences of non-adherence is the fact that noncompliance costs exceed adherence costs besides increased T2DM morbidity, poor quality of the patient’s life, and poor outcomes. Patient education and improving the healthcare system, in general, would overcome the sulfonylurea’s noncompliance.(Diabetes Mellitus type2 essay)

Levothyroxine

Physicians prescribe Levothyroxine for patients with an underactive thyroid or also hypothyroidism. Rajput & Pathak (2017) observe that the main reason for levothyroxine noncompliance is the requirement that the patient takes the drug every day on an empty stomach. The consequences include increased patient symptoms exacerbations, which lower the patient’s quality of life. Again like in so many other noncompliance to prescribed drugs is that patient education on the benefits of compliance holds the key.(Diabetes Mellitus type2 essay)

Defending the Use of Vaccines in Children

In their study, Orenstein & Ahmed (2017) aver that compared to other drug interventions, nothing compares to the outstanding effects of vaccines. Many healthcare providers concur with the duo, as mentioned earlier in that vaccinations have decreased disease, disability, and fatalities. Citing 9 of the vaccine-preventable conditions in the US, all of them have fallen by more than 90%, with some like polio being wholly kicked out. Vaccines protect the individual and the community since once vaccines, the child has no chance of spreading to others within the population.(Diabetes Mellitus type2 essay) While also defending the use of vaccines in children but from a different perspective, Shetty Chaudhuri & Sabella, (2019) underscores the fact that the logic behind vaccines is to mirror the body’s immune system by mimicking an infection. In attacking the immune system beforehand, the vaccine accords the body a chance to have immunological memory, thus preparing the body for future infections. As such, the chief goal of the childhood immunization schedule is to protect children from various immunizable diseases by giving the children immunity long before they get infected with the immunized disease(Diabetes Mellitus type2 essay)

Consider the Physiologic Alterations in Diabetes Mellitus

In T2DM management, reasonable metabolic control is achievable one the patient agrees to effect lifestyle changes demanded of them and adhere to the prescribed medications accordingly. Among these medications are Biguanides, sulfonylureas, GLP 1 agonists, and SGLT2 inhibitors and DPP-4 inhibitors. With a brand name like Diaformin, Physicians prescribe Biguanides to improve insulin sensitivity. Its mechanism of action rests in its ability to release glucose from the liver. The release of glucose slackens from the gut system. Some of Biguanide’s side effects are like having a metallic taste in the mouth, experience muscle cramps, and bloating amongst others. Some of the benefits include having improved insulin sensitivity and a better quality of life for the patient.(Diabetes Mellitus type2 essay)

Besides patient education of blood sugar self-monitoring and the importance of exercises and weight control, the patient should be aware that these drugs are taken with food directly or immediately after eating with contraindications in kidney or liver damage. Familiar brands like Diamicron and Amary are some of the common brand names for sulfonylureas, which are prescribed inpatient who require more insulin than they are currently secreting. The sulfonylureas MOA is that they stimulate the pancreases to secrete more insulin.(Diabetes Mellitus type2 essay) Lower than normal blood sugar levels, weight gain, and skin rash are some of its risks, with the primary benefit being that more insulin is produced. Patient education includes the necessity of not skipping meals and always taking the drug before mealtime. To block the release of glucose by the liver, Byetta and Victoza should be used as GP-1agonists. The drug’s MOA is blocking the release of liver glucose besides slowing gut glucose release. Among other side effects, the patient may experience nausea and vomiting as well as reflux and constipation. Some of its benefits beyond regulation the blood sugar levels is feeling of fullness which goes a long way n slowing reduction of weight gain. The prescribing physician should administer SGLT2 inhibitors if the goal is to stop reabsorption of glucose by the kidneys.(Diabetes Mellitus type2 essay)

The reason for prescribing SGLT2 inhibitors is to block kidney reabsorption of glucose. Some these inhibitors side effects include dehydration due to increased urination, yeast infections and urinary tract infections. Patient education should also take these drugs with a glass full of water. Common brand names for SGLT2 inhibitors are like Forxiga and Jardiance. The fifth and last of T2DM medication to be disused are DPP-4 inhibitors whose brand names include Nesina and trajenta. The physician prescribes these drugs to the patient if the objective is to stimulate insulin release. The drug’s MOA hinges on the drug’s ability to block the action of the DPP-4 enzyme and, therefore, in effect, block the liver from releasing glucose. Its side effects are headaches, musculoskeletal pain, and headaches. A significant benefit is that the average blood sugar level is achieved. With the option of taking these inhibitors with or without food, patient education should include all the components of a DSM patient education guideline.(Diabetes Mellitus type2 essay)

Conclusion

In conclusion, this paper has explored drug treatment for endocrine and immunity disorders. The essay has examined some drugs like cephalosporin, corticosteroids, sulfonylureas, and Levothyroxine. The paper also recommends some possible solutions to this problem of medical non-adherence. Additionally, the newspaper has defended the use of vaccines in children before exploring the physiological changes in diabetes mellitus. Towards the end, the paper has outlined some drugs used in the treatment and management of T2DM management in the context of reason for their prescribing, the MOA, side effects and benefits as well as the need for patient in each of the five drugs listed.(Diabetes Mellitus type2 essay)

References

Adams, M., Holland, N., & Urban, C. (2014). Pharmacology for nurses: A pathophysiologic approach (4th Ed.). Upper Saddle River, NJ: Pearson Education Inc.

Cutler, R. L., Fernandez-Llimos, F., Frommer, M., Benrimoj, C., & Garcia-Cardenas, V. (2018). The economic impact of medication non-adherence by disease groups: a systematic review. BMJ Open, 8(1), e016982.

Kebede, B., & Mamo, G. (2019). Determinants of non-adherence to inhaled steroids in adult asthmatic patients on follow up in referral hospital, Ethiopia: a cross-sectional study. Asthma research and practice, 5(1), 1-8.

Marín-Peñalver, J. J., Martín-Timón, I., Sevillano-Collantes, C., & del Cañizo-Gómez, F. J. (2016). Update on the treatment of type 2 diabetes mellitus. World journal of diabetes, 7(17), 354.(Diabetes Mellitus type2 essay)

Mohiuddin, A. K. (2019). Risks and Reasons Associated with Medication Non-Adherence. J Clin Pharm, 1, 50-53.

Rajput, R., & Pathak, V. (2017). The effect of daily versus weekly levothyroxine replacement on thyroid function test in hypothyroid patients at a tertiary care center in Haryana. European thyroid journal, 6(5), 250-254.

Rosol, T. J., & Walling, B. E. (2017). Immunopathology of the Endocrine System. In Immunopathology in Toxicology and Drug Development (pp. 649-694). Humana Press, Cham.(Diabetes Mellitus type2 essay)

Shetty, V. U., Chaudhuri, P., & Sabella, C. (2019). The rationale for the Immunization Schedule: Why Is It the Way It Is?

Szymczak I, Pawliczak R (2016). The active metabolite of vitamin D3 as a potential immunomodulator. Scan JImmunol 83(2):83–91.

https://www.ncbi.nlm.nih.gov/