Pharmacologic Highlights

Medication or Drug Class

Dosage

Description

Rationale

Insulin

Varies with severity to maintain blood glucose of 80-140 mg/dL

Hormone; hypoglycemic

Hormonal supplement to replace deficient or absent levels of insulin

Antidiabetics

Varies with drug

Four groups of medications besides insulin are available in the treatment of diabetes mellitus: sulfonylureas, alpha-glucosidase inhibitors, biguanides, thiazolinediones

Varies by drug. Sulfonylureas: stimulate release of insulin from beta cells of pancreas; alpha-glucosidase inhibitors: slow carbohydrate breakdown in small intestine; biguanides: decrease hepatic glucose output, enhance peripheral glucose uptake; thiazolinediones; decrease insulin resistance

Exenatide (Byetta)

5 mcg SC bid within 1 hr before meals in the morning and evening

Incretin mimetic agent

Mimics glucose-dependent insulin secretion, suppresses elevated glucagon secretion, delays gastric emptying; used to improve glycemic control for type 2 diabetics

Independent

If the patient has recently been diagnosed with DM, explain the disease process, the goals of management, and strategies to limit complications. Use simple explanations, answer questions, and provide written information for the patient to refer to between teaching sessions. In addition to general information on the disease process and reinforcement of collaborative teaching about medications and nutrition, the patient needs specific information about foot care.

Explain that all cuts and blisters need to be cleaned and treated with an antiseptic preparation. If a cut or blister begins to appear infected (warmth, pain, swelling) or has drainage, encourage the patient to notify the primary healthcare provider immediately. Teach the patient to avoid constricting clothing such as constricting stockings, garters, girdles, or elastic slippers. If the patient needs to be on bedrest, encourage her or him to keep bed linens loose over the feet and legs. Instruct the patient to avoid very hot baths if peripheral neuropathy causes decreased temperature sensation.

If the patient is a child or teenager, recognize that a diagnosis of DM changes a family permanently. Parents usually expect their child to be healthy and often react with shock and disbelief. The impact on the child depends on the child's age. School-age children may be impressed with the new "condition" and may be challenged by the new skills it involves. Adolescents, in comparison, may feel unfairly victimized and respond by becoming depressed, resistant, uncooperative, or insecure. Work with the entire family to support their adaptation to the illness. Introduce the family to other families with the same problem. If the problems are abnormal, make a referral to a counselor.

Supplements For Diabetics

Supplements For Diabetics

All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.

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