Strategies for Treatment of Diabetic Macular Edema

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Strategies for Treatment of Diabetic Macular Edema

You posted a very fascinating topic about gestational diabetes, which affects many patients every year and the amount of challenges women experience today. Commonly, gestational diabetes is detected after pregnancy; it is typically diagnosed around the 24th week of pregnancy by testing the blood glucose. As per Kim et al. (2019), gestational diabetes is typically caused by hormonal imbalances during pregnancy, among other biological causes, such as reduced pancreatic insulin output. Increased blood sugar levels start when the expectant mother is not able to produce the insulin she requires for pregnancy (Kim et al. 2019). Scientist hypothesizes that the hormones in the placenta of the baby inhibit the activity of the insulin of the mother in her bloodstream, the pancreas produces the insulin, and the placenta blocks it. After birth, women return to normal glucose sensitivity levels Strategies for Treatment of Diabetic Macular Edema

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Patients who have been diagnosed with gestational diabetes are also given various measures in their recovery regimen. Pregnant women are also given education courses to enable them understood about their medical condition. The strategy to avoid hospitalization in pregnant women is to learn more about their situation to prevent future hospitalization and complications (Nguyen et al., 2018)). Midwives globally are qualified to offer guidance and other forms of education programs to manage gestational diabetes through healthy diet and exercise. Pregnant women in the local communities gain guidance about proper maternity diets that can lower blood sugar levels without using pharmacology.

References

Kim, w., Park, S. K., & Kim, Y. L. (2019). Gestational diabetes mellitus diagnosed at 24 to 28 weeks of gestation in older and obese Women: is it too late? Plos ONE, 14(2), 1-16.

Nguyen, C. L., Pham, N. M., Lee, A. H., Nguyen, P. T. H., Chu, T. K., Ha, A. V. V., … Binns, C. W. (2018). Physical activity during pregnancy is associated with a lower prevalence of gestational diabetes mellitus in Vietnam. Acta Diabetalogica, 55(9), 955-962.

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.Strategies for Treatment of Diabetic Macular Edema

Anna Lee C.

Discussion Week 5- Main post

COLLAPSE

Top of Form

Type 1 diabetes comprises approximately 5% of all cases of diabetes (Rosenthal & Burchum, 2021). Type 1 diabetes occurs by an autoimmune reaction in the body that destroys the beta cells in the pancreas that produce insulin. Unlike type 2 diabetes, lifestyle and diet do not cause type 1 diabetes (CDC, 2020). Therefore, those with type 1 diabetes are dependent on insulin. Although some patients with type 2 diabetes may require insulin, medication management for type 1 diabetes differs significantly. It is essential for both the patient and provider to have a clear understanding of the differences as insulin is a very high-risk medication.

There are several types of insulin which are classified as short-acting, rapid-acting, intermediate, long, and ultralong duration (Rosenthal & Burchum, 2021). One newer insulin that was approved by the Food and Drug Administration in September 2015 in two different concentrations is Insulin degludec (Tresiba) (FDA, n.d.). Tresiba differs from all other types of insulins as it has no peak and lasts longer than 24 hours (Rosenthal & Burchum, 2021). Tresiba is only available by route of subcutaneous injection. In those with type 1 diabetes, Tresiba or another long-acting insulin is taken with short or rapid-acting insulin for optimal glycemic control (Rosenthal & Burchum, 2021).

Preparation and administration requires close attention. First, it is pertinent to ensure the insulin pen that is being prepared and administered is the correct type. Tresiba is clear, colorless (Novo Nordisk, 2015). A pen needle must then be applied and the insulin pen must be primed with a couple of units prior to administration to ensure patency of the needle. The dose is then drawn to the correct dosing per units by twisting the dial on the end of the insulin pen. The insulin can then be administered in a subcutaneous site with a slow count to six before removing and disposing of the needle properly (Novo Nordisk, 2015).

Further considerations of Tresiba include it can be taken with or without food. It also must be administered at approximately the same time every day, once daily. Tresiba must be stored in a refrigerator and must never be frozen or in extreme heat (Novo Nordisk, 2015). Like all insulins, it is essential to keep insulin in climate-controlled environments for preservation. In addition, the most common side effect is hypoglycemia. Close blood glucose monitoring is extremely important to monitor the effects as well as proper diabetes management.

Proper diabetes management in those with type 1 diabetes not only requires blood glucose monitoring and insulin regimen adherence, but it also entails a well-balanced diet. A well-balanced diet for those with type 1 diabetes consists of counting and limiting carbohydrates to a consistent amount. Patients with type 1 diabetes should always consult with their provider and registered dietician for guidance and education (UF, n.d.). Also, regular exercise is extremely important for those with any type of diabetes. Increased activity and exercise in those with type 1 diabetes may require lower insulin dosing and/or consuming carbohydrates prior to activity to avoid hypoglycemia (ADA, n.d.).

In contrast, poorly controlled diabetes can lead to multiple complications, both short-term and long-term. Examples of short-term complications of type 1 diabetes include hypoglycemia and diabetic ketoacidosis (DKA) (Smith, 2017). Long-term complications of diabetes can include heart disease, kidney disease, neuropathy, increased risk of infections, retinopathy, impaired circulation, and pregnancy complications (Mayo Clinic, n.d.). Both short-term and long-term complications can be dire. Complications of diabetes can ultimately be avoided with proper care and management.Strategies for Treatment of Diabetic Macular Edema

References

American Diabetes Association (ADA). (n.d.). Exercise & Type 1. Retrieved from https://www.diabetes.org/healthy-living/fitness/exercise-and-type-1

Centers for Disease Control and Prevention (CDC). (March 2020). Type 1 Diabetes. Retrieved from https://www.cdc.gov/diabetes/basics/type1.html

Mayo Clinic. (n.d.). Type 1 Diabetes. Retrieved from https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011

Novo Nordisk (2015). Getting Started on Tresiba Flextouch. Retrieved from https://www.novomedlink.com/content/dam/novonordisk/novomedlink/resources/generaldocuments/TresibaIFU.pdf

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2^nd ed.) St. Louis, MO: Elsevier.

Smith, D. (2017). Type 1 Diabetes Complications. Retrieved from https://www.endocrineweb.com/conditions/type-1-diabetes/type-1-diabetes-complications

U.S. Food & Drug Administration (FDA). (n.d.). FDA Approved Drugs. Retrieved from https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&varApplNo=203314

University of Florida (UF). (n.d.). Type 1 Diabetes Nutrition. Retrieved from https://diabetes.ufl.edu/outreach/resources/nutrition/type-1-diabetes/

Diabetes and Drug Treatments

A variety of forms of diabetes are , type 2, type 1, gestational, juvenile diabetes. Each diabetes is managed differently. Based on the diagnosed type of diabetes , it may be an acute or a permanent chronic condition. In both chronic and debilitating cases, diabetes can be safely managed using exercise, diet, and medications to make sure a high quality of life degree (DiMeglio et al., 2018) . Type 1 diabetes is a lifelong disease that is often known as’ juvenile diabetes.The pancreas produces almost zero insulin in this form, that is a predictable hormone that helps glucose to penetrate into the cells to express vitality. This diabetes can be strengthened by different elements, including genetic resources and certain infections. Although type 1 diabetes usually occurs in young people, it may as well occur in adults.

The most known form of diabetes, type 2 diabetes, is a condition that happens whenever a person’s blood glucose commonly known as glucose, is significantly elevated. Blood glucose is the predominant energy source that comes primarily from consuming food. Insulin allows glucose to be used for energy by entering into cells. It is more widely examined in more defined adults, but is also found in young people and older people, owing to growing obesity, physical inactivity, and inadequate routine feeding (Burchum & Rosenthal, 2017). When the body of a mother does not produce and use all the insulin it needs for birth, gestational diabetes can also develop. Without enough insulin, it is difficult for glucose to exit the blood and be turned into energy. Whenever glucose is found in the blood, it is termed as hyperglycemia. There is an obscure explanation for this disease. There are, however, some risk factors that put women at increased risk of developing this form of diabetes. These risk variables include elevated maternal age, stoutness, family history of diabetes,polycystic ovarian disease, and ethnicity.

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The type of diabetes I choose for this discussion is type-2 diabetes. For type-2 diabetes, biguanide is the commonly prescribed oral drug. Glucophage decreases the yield of hepatic glucose by raising the level of insulin in the liver. In the liver, gluconeogenesis is impeded, as in glycogenolysis (Burchum & Rosenthal, 2017). Glycemic regulation is done without rejuvenated insulin discharges, therefore “hypoglycemia” is not developed. Biguanides are usually very durable, although gastrointestinal problems such as looseness of the intestines are common. In the long term, metformin is usually prescribed for kidney disease (Diabetes Care, 2018). In the same way, whenever a patient gets a radiological reading anywhere contrast media is used, this medicine should be preserved. Owing to kidney issues, the patient should be vigilant to the use of alcohol or any other liver affecting the operator. Biguanide medication is taken orally by mouth. It’s a medicine that comes from a drug. This drug should be taken by the patient with evening meals. The standard portion is 500 mg twice daily and can be extended to 500 mg weekly until the desired effect is attained.Strategies for Treatment of Diabetic Macular Edema

Testing may be one of the short term impact with type 2 diabetes. Whenever a patient has hypoglycemia,confusion, headache, numbness and tension can occur in the toes ,fingers, and lips (Burchum & Rosenthal, 2017). The drawn-out results can be something worse than pulverizing. Microvascular conditions that damage the eye veins can be called retinopathy that induces waterfalls. Microvascular complications can impact the kidneys and contribute to kidney failure or even relocation of the kidney. Cardiovascular impairment is a substantial cause for death in type 2 diabetes .

References

Burchum, J., & Rosenthal, L. (2017). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants – E-Book. Elsevier Health Sciences.

Diabetes Care. (2018). Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2018. Diabetes Care.

DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018). Type 1 diabetes. The Lancet, 391(10138), 2449-2462.

Discussion: Diabetes and Drug Treatments

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/

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.Strategies for Treatment of Diabetic Macular Edema
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.

NB: include intro and conclusion