Read the following post written by my colleague and respond by providing recommendations for alternative drug treatments (write about the use Levemir for treatment of Type I Diabetes) and patient education strategies for treatment and management. APA format – minimum of 2 sources (scholarly articles no older than 5 years old).
Diabetes
The primary energy source comes from the blood glucose in the bloodstream and is derived from food intake. Diabetes occurs when your blood glucose level becomes elevated. Type I diabetes is an autoimmune reaction that destroys pancreatic β cells responsible for producing insulin to convert glucose into energy. Compared to type II diabetes, type I can be a sudden onset of symptoms that may include: thirst, frequent urination, bedwetting for children, hunger, unexpected weight loss, mood changes, fatigue and weakness, and blurry vision. Risk factors for developing type I diabetes are still unknown, and management will initiate life-sustaining insulin daily; unfortunately, no cure has been found to date (CDC, 2020). Type II diabetes, on the other hand, is the impairments and underutilization of insulin resulting in hyperglycemia. The primary reason for developing type II diabetes is the insulin resistance observed in the muscles, fats, and liver cells. The second reason is that the pancreas β cells produce insufficient insulin levels to regulate blood sugar levels (Mayo Clinic, 2021). Many risk factors increase the risk of developing type II diabetes. Still, the main risk is being overweight, inactive, family history, blood lipid levels, race and ethnicity (black, Hispanic, Native American, Asian, and Pacific Islanders), and age 45 and older. There is no cure for type II diabetes, but there is evidence that it helps prevent development and remission achievable through cardiovascular exercise, proper nutrition, and weight loss management (Diabetes UK, 2017).
During pregnancy, some women may develop gestational diabetes due to insulin resistance and hormonal changes that alter the pancreatic β-cell production of insulin (CDC, 2019). The symptoms are not easily identifiable, but increased thirst and frequent urination are potential indicators. After delivery, people with gestational diabetes generally return to their average blood sugar levels soon after having the baby. However, they face a greater risk of developing type 2 diabetes as they age. Risk factors increase if they develop polycystic ovarian syndrome, previous pregnancy with 9 pounds or more of delivered child weight, obesity, and physically inactive (CDC, 2019).
Type 1 Diabetes
Among patients with type 1 diabetes, tight glycemic control of less the 7% A1C is still the gold standard of treatment. The management of type 1 diabetes can avoid short and long-term health impacts. Like cardiovascular diseases, neuropathy, nephropathy, diabetic retinopathy, skin and mouth infections, chronic dry mouth and gum disease, and pregnancy complications like diabetes ketoacidosis, preeclampsia, miscarriage, stillbirth, and congenital disabilities. The American Heart Association recommends a diet that includes 1200 to 1600 calories daily, depending on the activity level for the day (Mayo Clinic, 2021). Meals consist of low-fat milk, fruits, vegetables, whole grain products, legumes, and whole grains as carbohydrates.
Additionally, avoid sugar-sweetened beverages (including fruit juice). There are three components to managing type I diabetes: synthetic insulin, blood glucose monitoring, and carbohydrate counting (Cleveland Clinic, 2022). Insulin has the same effect on blood sugar regulation across all types of insulin, and insulin in its original forms came in two forms. Basal insulin has been administered by a daily injection or by inhaling the vapor. This has now been discontinued. Insulin directly lowers glucose levels by increasing uptake into muscle and fatty tissue and reducing the release of glucose from the liver. NovoLog is a rapid-acting insulin that helps lower blood sugar spikes after meals and can be taken 15 minutes before a meal (NovoLog, n.d.). The onset of Novolog is 10 to 15 minutes peak level is attained in 1-3 hours with a duration of 3 to 5 hours per dosage (Cleveland Clinic, n.d.).
