Question

ST, a 32-year-old patient was diagnosed with type 2 diabetes mellitus after the birth of her first child; her blood sugar was 180 mg/dL. Her serum glucose level has been maintained within the normal range with metformin 500 mg/day.

1. Use the drug cards you created and your textbook to respond to the following questions:
   • Why is ST taking an oral antidiabetic medication rather than insulin?
   • When should metformin not be taken?

Two years later, ST became pregnant again. Metformin was discontinued, and NPH insulin 25 units was prescribed. Since the birth of her second child, she has remained on NPH 25 units/day.

1. • Why was metformin discontinued and insulin prescribed?
   • What is NPH insulin and how should NPH insulin be administered?
   • What should be included in patient teaching?

Answer 1

Why ST taking an oral antidiabetic medication rather than insulin?

Answer :

• Oral antidiabetic drug easy to use and lower cost.
• According to this level of 180 mg , metformin is effective.
• ST patient have type 2 diabetes Mellitus so give metformin oral antidiabetic drug,
• insulin is not given as orally and given only by injection because when given orally insulin is destroyed by acid in the stomach.
• If insulin is given,it will affect the lactation of mother.
• Oral antidiabetic drug is preferred.

When should metformin not to be taken?

• Age 65 or more.
• She had history of cardiovascular disease like acute myocardial infarction.
• Stroke.
• Diabetics ketoacidosis.
• Liver disease.
• Dehydration.
• Alcohol abuse.

Why was metformin discontinued and insulin prescribed?

• Metformin produce birth defects,so discontinue the metformin in pregnancy time.
• Metformin is teratogenic drug.
• Insulin injections is recommended in pregnancy.

What is NPH insulin and how should NPH insulin be administered?

NPH insulin;

NPH InSul in s also 1unouon as sophans nsulin. Inteamediat 4ctig to1 Insulin iven help conto) blaod levels in gegrah with aiabetes. people Neutrel paotaminu HOgadern

Administration of NPH insulin;

Daaw aiu into The Stfainge an The piosc beol dose amount Equal 1 Longer acfuy NpH Thsulin Theck all ai to The NPH Vial. Romone The Syainge fom val. Tujee't to The layu fat Tusk udar sin The

What should be included in patient teaching?

Tell o The patient NPH Tsulen 25 E lalay, wot Exuding hh amout tale Pertienk to come fa 3agulau chectup Ast The