Diabetes Mellitus APA 7th Edition (excludes Cover Page, Refe
Diabetes Mellitus APA 7th edition (excludes cover page, references and appendices)
Background: Provide a brief overview of facts about the clinical problem/indication and include any pertinent epidemiologic statistics across the lifespan.
Current Medical/Surgical Treatment Options: Include prescription, over the counter and alternative therapies; briefly summarize lifespan considerations. Consider a chart or table to better describe/explain.
Case Presentation: Brief case presentation (1/2 to 2/3 page) which includes pertinent: demographics, presenting signs/symptoms, H&P, Diagnosis, Treatment, Complications, Outcomes, as they are most relevant to the focused case scenario.
Implications for the Registered Nurse: how will you integrate this knowledge into your practice and what will be the initiatives considered for health promotion and disease prevention.
Paper For Above instruction
Overview of Diabetes Mellitus and Epidemiology
Diabetes Mellitus (DM) is a chronic metabolic disorder characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. According to the American Diabetes Association (ADA), approximately 10.5% of the U.S. population aged 18 and older had diabetes in 2022, reflecting a significant public health concern that spans all age groups from children to older adults (American Diabetes Association [ADA], 2023). Globally, the prevalence of DM continues to rise, driven by factors such as sedentary lifestyles, obesity, and aging populations. The epidemiology of diabetes illustrates its impact across various age groups: in children and adolescents, type 1 diabetes predominates, whereas type 2 diabetes is more common in adults, especially among underserved populations (World Health Organization [WHO], 2023). Children with type 1 diabetes require lifelong insulin therapy, while adults may manage type 2 diabetes through lifestyle changes, medications, or insulin therapy, depending on disease progression and comorbidities. The economic burden of diabetes is profound, involving direct healthcare costs and indirect costs due to lost productivity (Zhao et al., 2020). Consequently, understanding the epidemiology of DM is crucial for implementing targeted prevention and management strategies.
Current Medical and Surgical Treatment Options
Management of diabetes encompasses a wide range of therapies tailored to individual needs and lifespan considerations. Pharmacologic treatments include insulin therapy—vital for type 1 and advanced type 2 diabetes—as well as oral hypoglycemic agents such as metformin, sulfonylureas, DPP-4 inhibitors, and SGLT2 inhibitors for type 2 DM (American Diabetes Association [ADA], 2023). Over-the-counter options include dietary supplements like chromium and cinnamon, though their efficacy remains limited and evidence-based support is inconsistent (Singh et al., 2022). Alternative therapies such as acupuncture and herbal remedies are also utilized by some patients; however, these should be integrated cautiously and under supervision to prevent adverse effects (Khan et al., 2021). Lifespan considerations are paramount: children with type 1 DM require insulin from diagnosis onward, while older adults may need individualized management plans that consider comorbidities and risk of hypoglycemia (Clement et al., 2021). Treatment regimens often include lifestyle modifications—diet and exercise—alongside pharmacotherapy to achieve glycemic control and prevent complications. Emerging technologies, such as continuous glucose monitoring (CGM) and insulin pumps, play a pivotal role, particularly in adolescents and young adults (Bergenstal et al., 2022). A comparative table of these options can enhance understanding for healthcare providers and patients alike.
| Therapy Type | Details | Lifespan Considerations |
|---|---|---|
| Insulin Therapy | Long-acting, rapid-acting, or mixed insulin regimens; essential for type 1 DM; used in advanced type 2 DM | Requires education on administration; continuous monitoring essential |
| Oral Hypoglycemics | Metformin, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors | Often first-line in adults; renal and hepatic function considerations |
| Over-the-counter Supplements | Chromium, cinnamon; efficacy limited | Adjuncts, not replacements for medical therapy |
| Alternative Therapies | Acupuncture, herbal remedies | Require supervision due to safety concerns |
| Technological Advances | CGM, insulin pumps | Enhance lifestyle management and glycemic control in tech-savvy populations |
Case Presentation
A 45-year-old Hispanic male presents to primary care with complaints of increased thirst, frequent urination, and unexplained weight loss over the past three weeks. He reports feeling fatigued and has noticed blurred vision. His past medical history includes obesity and hypertension. Physical examination reveals BMI of 33 kg/m², dry mucous membranes, and slightly elevated blood pressure. Laboratory results show fasting blood glucose of 210 mg/dL, HbA1c of 9.2%, and positive urine glucose. Diagnosis of new-onset type 2 diabetes mellitus is confirmed. The patient is started on metformin 500 mg twice daily, with recommendations for dietary modifications and increased physical activity. He is also referred to a dietitian and begins diabetes education sessions. Over subsequent visits, adherence challenges are addressed, and the treatment plan is adjusted to include SGLT2 inhibitors to improve glycemic control. Potential complications such as diabetic ketoacidosis, retinopathy, nephropathy, and neuropathy are discussed, alongside monitoring strategies and management of comorbidities. The patient's outcomes are monitored through regular HbA1c assessments, renewals of medications, and lifestyle counseling, emphasizing the importance of ongoing management.
Implications for the Registered Nurse
As future registered nurses, understanding the multifaceted aspects of diabetes management is essential. Integrating this knowledge involves comprehensive patient education on disease process, medication adherence, lifestyle modifications, and recognition of early signs of complications. Nurses play a vital role in promoting health and preventing disease through screening programs, lifestyle counseling, and support for self-management strategies. For example, patient-centered education on blood glucose monitoring, insulin administration, and recognizing hypoglycemia or hyperglycemia symptoms enhances safety and efficacy of treatment (Funnell & Anderson, 2020). Moreover, nurses can advocate for community-based interventions targeting at-risk populations, such as promoting healthy eating, physical activity, and regular screening. Implementing culturally sensitive education tailored to diverse populations increases engagement and outcomes. Additionally, nurses should stay updated with technological advancements like CGM and mobile health apps that facilitate self-care (McCarthy et al., 2022). Empowering patients through education and support reduces hospital admissions related to uncontrolled diabetes, decreases long-term complications, and improves quality of life. Consequently, incorporating current evidence-based practices into nursing care plans ensures holistic, preventive, and effective diabetes management.
References
- American Diabetes Association. (2023). Standards of Medical Care in Diabetes—2023. Diabetes Care, 46(Supplement 1), S1–S144.
- Bergenstal, R. M., et al. (2022). Effectiveness of continuous glucose monitoring in type 1 diabetes: A systematic review. Diabetes Technology & Therapeutics, 24(4), 225-232.
- Clement, S., et al. (2021). Management of diabetes in older adults. Diabetes Care, 44(1), 343-352.
- Funnell, M. M., & Anderson, R. M. (2020). Patient empowerment: Myths and misconceptions. Diabetes Spectrum, 33(1), 32-36.
- Khan, M. A., et al. (2021). Complementary and alternative medicine in diabetes: A review. Journal of Diabetes Research, 2021, 6652398.
- McCarthy, M., et al. (2022). Digital health interventions in diabetes care: A review. JMIR Diabetes, 7(1), e32277.
- Singh, A., et al. (2022). Dietary supplements in diabetes management: Evidence and perspectives. Endocrinology & Metabolism, 37(2), 271-283.
- World Health Organization. (2023). Diabetes Fact Sheet. Retrieved from https://www.who.int/news-room/fact-sheets/detail/diabetes
- Zhao, W., et al. (2020). Global economic burden of diabetes and its implications. Diabetes Research and Clinical Practice, 159, 107955.