Tuesday, November 19, 2019
Putting the person with diabetes first the team approach in holistic Essay
Putting the person with diabetes first the team approach in holistic assessment and management of diabetes mellitus. The module - Essay Example His cholesterol is high, as is his blood pressure. He is on Lipitor 80mg at night, has no foot ulcers or skin sores. He is also on metformin and sulfonylureas for his blood glucose maintenance. He does his best to comply with his regular medication, mostly his oral anti-diabetic medicines. His HbA1C is however persistently rising and he may need to be put on insulin for the next few months if his blood sugar would not be managed better. He has a strong support system through his wife and children. He is also intelligent and has a good understanding of his disease, however he is in denial about the long-term complications which may relate to his disease. This paper will discuss the appropriate and effective nursing management of this patient, considering mostly the importance of holistic assessment, self-management, and team approach in securing improved patient outcomes. Body The regulation of blood sugar levels are based on negative feedback which seeks to secure homeostasis for the body (Matthews, et.al. 2008). Blood glucose levels are monitored by the pancreas, mostly through cells called the Islets of Langerhans. In instances where the blood glucose would decrease near or below threshold levels, especially during exercise or prolonged lack of food, the Alpha cells of the pancreas discharge the hormone glucagon (Matthews, et.al. 2008). ... f glycogen or through the normal process of food ingestion, another hormone ââ¬â insulin ââ¬â is released from the beta cells of the pancreas (Brill 2011). Insulin allows the liver to convert the glucose into glycogen through the process of glycogenesis, thereby prompting majority of the bodyââ¬â¢s cells to use glucose found in the blood transported through the GLUT4 transporter (Powell 2007). This process would then lead to decreased blood sugar levels. As insulin attaches to the receptors found on the surface of the cells, the GLUT4 transporters bind to the plasma membrane through exocytosis. This would assist in the diffusion of glucose within the cell (Powell 2007). Glucose enters the cell and through phosphorylation, it is transformed into Glucose-6 Phosphate. This process helps maintain the concentration gradients, allowing glucose continued entry into the cell (Woodruff and Saudek 2005). The insulin gives the signal to the different systems, allowing metabolic contr ols to be maintained. In the case of Diabetes Mellitus type 1, non-production or insufficient production of insulin causes high blood glucose levels; and type 2 is often caused by a reduced responsiveness to insulin by the body tissues (Dubois and Bankauskaite 2005). There is insulin resistance, in other words. If unmanaged, diabetes, would persistently cause blood sugar levels to rise, with the glucose remaining within blood circulation, not absorbed or delivered by the cells (Dubois and Bankauskaite 2005). It can then lead to a variety of complications. The deficiency of insulin or the insensitivity of the receptors to insulin has a major role to play in the manifestation of diabetes. Individuals ingest and digest carbohydrates and through the actions of the enzymes within the digestive tract are
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