Week 7 Case Study for NSG6005 T2DM

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School

South University *

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NSG 6005 A

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Health Science

Date

Feb 20, 2024

Type

docx

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Uploaded by bcruz75

1 Week 7 Case Study - Type II Diabetes Patient Student at South University NSG 6005 Advanced Pharmacology Professor January 1, 2024

2 Week 7 Case Study - Type II Diabetes Patient This paper examines a hypothetical case study involving a patient under close monitoring, persistently overweight with a BMI of 33 despite attempts at weight loss through lifestyle changes. Recently, the patient exhibited polyuria, polydipsia, and an elevated random blood sugar of 164, suggesting potential issues with glucose regulation. While earlier HgbA1c tests indicated values below 6.2%, the latest result surpassed 7%, prompting the initiation of treatment for Type II Diabetes Mellitus (T2DM). The patient, currently medication-free but with a sulfa allergy, raises questions explored in this paper—specifically, the initial choice of medication for T2DM and the rationale behind it, along with essential education on medication management for the patient. Type 2 diabetes, a disorder affecting carbohydrate metabolism, carries significant implications, resulting in sustained hyperglycemia with symptoms like polyuria, polydipsia, and ketonuria, and potential complications such as heart disease, renal failure, blindness, neuropathy, amputations, impotence, and stroke (Rosenthal & Burchum, 2021, p. 397). Formerly known as non–insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes mellitus, the nomenclature is no longer applicable as insulin is commonly used in treatment. Unlike type 1 diabetes, type 2 typically emerges in middle age, progressing gradually with minimal ketoacidosis risk. Initial hyperinsulinemia characterizes symptoms, but insulin release becomes detached from plasma glucose levels, leading to delayed secretion and subnormal peak output, coupled with resistance in target tissues. Over time, hyperglycemia diminishes pancreatic β cell function, reducing insulin production and secretion (Kubota et al., 2000). The elusive causes of type 2 diabetes are suggested to have a genetic role, supported by a study implicating the insulin receptor substrate-2 (IRS-2) gene (Kubota et al., 2000). However, it is established that embracing

3 a healthy lifestyle, incorporating regular physical activity and maintaining a balanced diet, substantially reduces the risk of diabetes, even in the presence of unmodifiable genetic factors (Centers for Disease Control and Prevention [CDC], 2022). 1. What is the first medication you would prescribe? Discuss how you determined which one to give first and how you based this decision on specific factors? This patient's Type 2 Diabetes diagnosis was substantiated by an HbA1c level exceeding 7%, a high random blood sugar of 164, and the presence of symptoms such as polyuria, polydipsia, and polyphagia. Given the confirmed diagnosis and the patient's overweight status despite unsuccessful attempts at lifestyle and nutritional changes, the initial intervention involves prescribing metformin. Classified as a biguanide drug, metformin effectively reduces blood glucose levels by curtailing hepatic glucose production, decreasing intestinal absorption, and improving insulin sensitivity (Corcoran & Jacobs, 2023). Consequently, metformin demonstrates efficacy in lowering both basal and postprandial blood glucose levels (Corcoran & Jacobs, 2023). Metformin stands out as the primary choice for newly diagnosed Type 2 Diabetes (T2DM) patients, and its efficacy extends beyond glucose level control. Particularly advantageous for overweight individuals with Type 2 Diabetes, metformin is weight-neutral, addressing both diabetes and weight management concerns. Its longstanding safe usage and generally well-tolerated side effects distinguish it, with a notably lower risk of hypoglycemia compared to alternative diabetes medications. Additionally, Metformin offers cardiovascular benefits, potentially reducing the risk of cardiovascular events—an imperative consideration given the heightened cardiovascular complications risk in Type 2 Diabetes. Affordability further enhances its appeal, rendering it accessible to a wider population. (Corcoran & Jacobs, 2023).

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