NURS 6521 Wk 6 Assignment Paper
Diabetes and Drug Treatments
Diabetes mellitus is a metabolic disorder that results from impaired insulin secretion with various degrees of insulin resistance that lead to hyperglycemia. The symptoms of hyperglycemia include polydipsia, polyuria, polyphagia, and blurred vision. Terms that were used to describe the two main categories of diabetes are no longer accurate because of the overlap in age groups and treatments between disease types (Merck Manual, 2017). The two classes of diabetes are determined by age of onset (juvenile or adult) or type of treatment (insulin- or non–insulin dependent). This paper will discuss the different types of diabetes, to include Type 1, Type 2, Gestational, and juvenile diabetes. It will detail type one diabetes to include the drugs used for treatment as well as dietary considerations and the short and long-term impact on patients diagnosed with type 1 diabetes NURS 6521 Wk 6 Assignment Paper
Different Types of Diabetes
More than 13,000 youths are diagnosed with diabetes every year, making it one of the most common chronic childhood diseases in the United States (Peterson, Silverstein, Kaufman, Warren-Boulton, 2007). Type 1 diabetes, formerly known as juvenile diabetes, is “a chronic condition in which the pancreas produces little or no insulin” (Merck Manual, 2017). It is an autoimmune disease leading to absolute insulin deficiency resulting in hyperglycemia and its associated manifestations (Hamilton, Knudsen, Vaina, Smith and Paul, 2017). It is the most common type of diabetes seen in children, characterized by the 4Ts (toilet, thinner, thirsty, tired) according to Hamilton et al. (2017). The signs and symptoms can sometimes be non-specific causing a delay or missed diagnosis which can be catastrophic for the child.
Type 2 diabetics can produce insulin, but hyperglycemia occurs as a result of a combination of insulin resistance, where the body does not recognize the secretion of insulin, and relative insulin deficiency, where the beta cells do not produce enough insulin to counteract this resistance. Type 2 diabetes accounts for 1.9% of cases in children, however its incidence is rapidly increasing in adolescents and is associated with the obesity epidemic.NURS 6521 Wk 6 Assignment Paper
Gestational diabetes occurs during pregnancy. Like others forms of diabetes, it affects how the cells use glucose. In gestational diabetes, hyperglycemia affects the baby and the mother. Hyperglycemia can be dangerous for the mother and the baby. It increases the risk of miscarriage, stillbirth and congenital disabilities when glucose is not controlled. Diabetic complications are increased for the mother; they include diabetic ketoacidosis, retinopathy, pregnancy-induced high blood pressure and preeclampsia (Mayo Clinic, n.d.).
Treatment for Type 1 Diabetes and Treatment Options
Type 1 diabetes makes up more than 95% of diagnoses in children and young people under 25 years of age; its prevalence is increasing annually by 3% (Hamilton et al., 2017). Type 1diabetes has historically been more common in patients aged eight to 19 years of age, but type 2 diabetes is emerging in this group “accounting for 8 to 45 percent of new childhood diabetes” (Peterson et al., 2007). Life expectancy for people with type 1 diabetes is likely to be reduced by 5–14 years. Diabetes was the sixth most common cause of death worldwide in 2015, killing 1.6 million people (World Health Organization, 2017). The immediate goal of treatment in diabetes is to correct blood glucose levels and fluid and electrolyte imbalances. The long-term goal is to maintain normal glucose levels. “This requires diabetes education for both child and family regarding insulin administration, carbohydrate counting, and maintaining a healthy lifestyle” (Hamilton et al., 2017). Diabetic education should provide reinforcement on “healthy eating, daily physical activity, insulin and medication administration, and self-monitoring of blood glucose levels” (Peterson et al., 2007) is essential. A proper diabetic diet contains plenty of fruit, vegetables, and carbohydrates with a low glycemic index for optimal glycemic control and general well-being (Hamilton et al., 2017). Insulin can be prescribed based on a daily bolus dosage or a continuous pump. The insulin pump allows for greater flexibility and provides better glycemic control for children (Hamilton et al., 2017). Anyone who has type 1 diabetes needs lifelong insulin therapy (drugs.com, 2017). Insulin use includes rapid-acting, long-acting, and intermediate options NURS 6521 Wk 6 Assignment Paper
Short and Long Term Implications of Type 1 Diabetes
Complications of diabetes include vascular disease, peripheral neuropathy, nephropathy, and predisposition to infection. Heart complications include coronary artery disease (CAD), heart attack, stroke, and hypertension. Diabetes can cause nerve damage (Neuropathy) by injuring the walls of the small vessels. Nerve damage in the lower extremities can lead to amputations. Nerve damage can also affect the gastrointestinal tract (gastroparesis) causing nausea, vomiting, diarrhea, and constipation. In males, neuropathy can cause erectile dysfunction.
Conclusion
Diabetes is a common chronic condition in children that requires the appropriate management and support from an interdisciplinary team of health professionals. Early diagnosis and immediate treatment is imperative to prevent medical emergencies. NURS 6521 Wk 6 Assignment Paper