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.

• Why is ST taking an oral antidiabetic medication rather than insulin?
• When should metformin not be taken?
• 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

Ans) Oral diabetes medications attack the problem in three ways. More insulin: Some pills stimulate your pancreas to produce more insulin. The obvious problem with the insulin-increasing medications is that they cn cause hypoglycemia, or low blood sugar.

- Discontinue metformin at the time of or before an iodinated contrast imaging procedure in patients with an eGFR between 30-60 mL/minute/1.73 m²; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinate contrast.

- NPH insulin, also known as isophane insulin, is an intermediate–acting insulin given to help control blood sugar levels in people with diabetes. It is used by injection under the skin once to twice a day. Onset of effects is typically in 90 minutes and they last for 24 hours.