Question

Discuss the action and use of insulin to control diabetes mellitus.Discuss the action and use of oral hypoglycemic agents to control dm. Identify the major nursing considerations associated with management of patient with dm2 (e.g nutrition, dietary prescription, activity, and psychological consideration).

Answer 1

Insulin is a hormone ,the major action of insulin is,it pushes out the glucose from the blood cells to tissues and the release of glucose takes place and consumed as energy.Simultaneously it controls the release of glucose from the liver in to the blood vessels and maintaining a normal blood glucose level  ( In diabetes the glucose present in the blood cells cannot be pushed out due to lack of insulin and hence it is present in the blood itself, causing a raise in blood sugar level.)

It is used to treat

• Type 1 diabetes
• Diabetic ketoacidosis
• Hyperkalemia along with glucose

One of the commonly used oral hypoglycemic agent are Biguanides.This drug when taken orally reaches the gastrointestinal system and the absorption of glucose by the intestine is decreased ,simultaneously it directly acts on the pancreatic bet a cells to release insulin and control blood glucose.The liver is also inhibited from producing glucose.

The drug is used in

• Type 2 diabetes mellitus

The major nursing considerations are

Nutrition and dietary prescription

• Encourage low carbohydrate ,especially avoid complex carbohydrate diet
• Fruits can be consumed as it contains natural fructose
• Encourage patient to at every three hours once and not to starve
• Vegetables, greens,sprouts,cereals ,pulses,nuts, grains can be eaten
• Avoid alcohol because this interacts with oral antidiabetuc agents and insulin
• Avoid refined sugars,chocolates

Activity

• Encourage a brisk walk of half an hour in the early morning,because this help to control blood sugar and prevent its complications

Psychological considerations

• Encourage patient to stick in a proper dietary and exercise to stay active throughout the life
• Inform patient about its side effects and how to manage it effectively
• can make use of the support group to share their personal experiences