preview

Diabetic Case Study

Decent Essays

The American Association of Clinical Endocrinologist (AACE) treatment goals are individualized and aimed at lowering A1C and prevention of hypoglycemia along with decreased comorbidities associated with diabetes. Diabetics who are at an increased risk for hypoglycemia include: a diagnosis of greater than 15 years, advanced macrovascular disease, hypoglycemia unawareness, limited life expectancy and severe comorbidities (Garber, Blonde, Bush, Einhorn, & Garber,et al., 2017). In addition Fowler (2010) notes that those with renal or hepatic dysfunction are at an increased risk for hypoglycemia due to the combination of less endogenous glucose production and longer insulin half life. This combination can result in a rapid lowering of glucose. …show more content…

Pramlintide targets post meal glucose and correlates closely with insulin levels (Fowler, 2010). Pramlintide mechanism of action inhibits gastric emptying and suppresses the release of glucagon in type one and two diabetics. Not only does Pramlintide target post meal glucose, but may have the additive impact to lower weight and total daily insulin dose in both type one and two diabetics (Traina & Kane, 2011). Primary impact is seen on 2 hour post-meal glucose levels by ~ 43 to 90mg/dL, with minimal impact on fasting glucose levels according to Traina and Kane (2011).
Factors Which Contribute To a Patient's Resistance to Beginning Insulin Therapy Numerous factors contribute to patients being hesitant to start insulin therapy. For many starting insulin is seen as a failure on their part to control their diabetes. Moreover, patients may have witnessed poor outcomes resulting in amputations or even death when someone they know has started insulin. Additionally, the fear of injection, lack of adequate insurance coverage, and the frank lack of understanding of the progressive nature of diabetes and the associated benefits of adding insulin all present as barriers. In addition many providers are hesitant to start insulin due to the lack of confidence in the patient, as well as their own personal barriers of the

Get Access