NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

discussion.

The purpose of this discussion is to give you the opportunity to apply your understanding of the module topic. By reviewing the posts of other students, you will gain further understanding of all the posted questions.

Please respond to ONE of the following questions:

Diabetics are at increased risk for skin disorders, including infection. What is the etiology and pathophysiology of these disorders? How can these be prevented?

A patient tells you that they were diagnosed with metabolic syndrome but they don’t know what that means. In layman’s terms explain the syndrome and potential complications. How is metabolic syndrome managed? NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

• How does obesity contribute to insulin resistance in Type 2 DM?
• A leading cause of blindness worldwide is diabetic retinopathy. Describe the pathophysiology and progression of this complication. Hos is retinopathy treated?
• Go to www.diabetes.org and review the Research and Practice section. Share current research or research findings not yet in your text.
• Endocrine SystemIn this first week, you will be focusing on diabetes–the 2 major types, clinical manifestations, and pharmacological/non-pharmacological treatments. You will also be introduced to our case study patient, Loretta, as you begin to look at the clinical presentation and management of a patient with poorly controlled diabetes.Learning ObjectivesAfter completing this week, you should be able to:Articulate the similarities and differences between type 1 and type 2 diabetes mellitus.
• Compare and contrast the management of type 1 and type 2 diabetes mellitus.List types of acute and chronic complications associated with type 1 and type 2 diabetes. NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient
• Apply the criteria for metabolic syndrome to a case study patient.Course Objectives 1 through 4 are addressed this week.Course ObjectivesAfter completing this course, you should be able to:Explain the basic physiologic and pathophysiologic mechanisms of common morbidity problems. (Aligns with Program Outcome #6)Identify the physiologic adaptive responses associated with selected altered states. (Aligns with Program Outcomes #6, 7)Relate subjective and objective data to selected pathophysiologic processes. (Aligns with Program Outcome #6)Examine current scientific investigations regarding pathological states. (Aligns with Program Outcomes #6, 7) NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

Required Materials:  Required Text & Publications:  Huether, S. E., & McCance, K. L., (2020). Understanding Pathophysiology. (7th ed.). Mosby ISBN-13: 978-0-323-63908-8    Recommended Texts & Other Readings:   American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). American Psychological Association. ISBN-13: 978-1-4338-3217-8 NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

What is diabetes Mellitus?Diabetes Mellitus is a chronic condition whereby the body cannot metabolize glucose and this leads to hyperglycemia.  The pancreas of diabetes patients produce too little or no insulin.  Insulin help observe glucose from the blood to supply cells of the body with needed glucose and this helps to reduce the level of glucose in the bloodstream.  There are four types of diabetes such as type one, type two, gestational and diabetes due to other causes (Huether & McCance, 2020).  Type one diabetes is early onset due to genetic link or autoimmune disorders. NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

Type two diabetes is late onset of diabetes due to inactivity, unhealthy diet and being overweight.  Gestational diabetes is high glucose levels during pregnancy which usually subside after giving birth.  Other factors can also cause diabetes like being on certain medications like steroids.Etiology of diabetic skin disorders and infections    Elevated glucose level can lead to many skin disorders and eventually infections.Pathophysiology  of diabetic skin disorders and infections    When glucose levels are high it causes fatty deposits to form inside of blood vessels and over time this makes blood vessels narrow and hardens (Goyal et al, 2010) NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

This eventually lessens blood flow and leads to dry skin, skin disorders and infections.How can diabetics’ skin disorders and infections be prevented?    Diabetics need to maintain blood glucose levels in normal ranges through medication administration, diet and exercise to prevent skin disorders and infections.  Diabetics need to monitor blood glucose levels frequently through diagnostic test such as a fasting plasma glucose test, random blood glucose test, oral glucose tolerance test, capillary whole blood glucose monitoring and glaciated hemoglobin testing.  A normal fasting plasma glucose is less than or equal to 126. NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

A normal random blood glucose test is less than equal to 200.  A normal glycated hemoglobin (A1C) is less than or equal to 6.5 %.ReferencesGoyal A, Raina S, Kaushal SS, Mahajan V, & Sharma NL. (2010). Pattern of cutaneousmanifestations in diabetes mellitus. Indian Journal of Dermatology, 55(1), 39–41.https://doi-org.pnw.idm.oclc.org/10.4103/0019-5154…Huether, S. E., & McCance, K. L., (2020). Understanding Pathophysiology, (7th ed.). MosbyDiabetes and skin complications…Reprinted with permission from the American DiabetesAssociation. (2006). InMotion, 16(2), 12–15. NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

the second discussion  is:_A leading cause of blindness worldwide is diabetic retinopathy. Describe the pathophysiology and progression of this complication. How is retinopathy treated?Diabetic retinopathy develops as a result of damage to the small artery in the eyes, especially on the retina.The problem is that the capillary membrane becomes thicker and permeable which allows plasma fluid to leak into the retina. Since the capillaries become thicker, pericyte loss leads to formations of microaneurysms ( Huether & McCance, 2017). Because the blood supply is obstructed, ischemia and hypoxia occurs as well. NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

Another factor that leads to retinopathy is the accumulation of red blood cells that damage the retina as well. Since the retina needs blood supply and oxygen, new blood vessels will develop to provide oxygenation to the retina. Because the blood supply develops quickly and they are frail, they tend to burst easily which results in retinal hemorrhage. Another complication of diabetic retinopathy is diabetic macular edema which results from accumulation of fluids into the macula. The macular edema could result at any stage of diabetic retinopathy and can lead to decrease in visual acuity. NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

The progress of diabetic retinopathy is quicker on type 2 diabetes compared to type 1  diabetes because of non-detection of diabetes and asymptomatic hyperglycemia. There are two stages of retinopathy : stage I or nonproliferative                                                 stage II or proliferativeDuring these stages, hemorrhage and microaneurysm occur because the new blood vessels that formed burst easily. As a result of the hemorrhage, patients will experience visual impairment and deformation of visual image.  Wang et al.( 2018) suggest,  “current treatment strategies for DR aim at managing the microvascular complications, including intravitreal pharmacologic agents, laser photocoagulation and vitreous surgery”. NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

There are few lines of treatment for diabetic neuropathy. The first line is to have a better control of their blood sugar, which means to keep the blood sugar near the normal levels. Additionally, anti-angiogenic therapy, anti- inflammatory therapy, and laser treatment are the other options that are available to treat diabetic retinopathy.     While this disease can be very harmful to a patient’s health and life, there are ways of managing it.                                                             ReferencesHuether, S. E., & McCance , K. L. (2017). Understanding Pathophysiology. Elsevier.Wang, W., & Lo, A. (2018). Diabetic Retinopathy: Pathophysiology and Treatments. International           Journal of molecular sciences, 19(6), 1816. https://doi.org/10.3390/ijms19061816 NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

this is an example of one student response  Hi Kayla,I have enjoyed reading and learning how diabetics are at an increased risk of skin infection. In addition to those that you have mentioned, diabetics are also prone to bacterial infections such as, “styes (infection of the glands of the eyelid), boils, folliculitis (infection of the hair follicles), carbuncles (deep infections of the skin and the tissue underneath) and infection around the nail” (American Diabetes Association (ADA), n.d., p.1).

In addition, according to ADA, common diabetes-related skins condition that diabetic patients are more prone to contracting are acanthosis nigricans, which are tan or brown spots that are common in areas of the neck, armpits, and groin. NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient

There is also necrobiosis lipoidica diabeticorum which causes a change in the blood vessel. Appearance-wise, patients will most likely see a dull red spot that would appear as a shiny scar in any area of the skin. Even though none of these skin conditions are life-threatening, they do require skin management and a physician’s supervision for any severe changes (ADA, n.d., p.1). It is very important to educate these on the importance of skincare and monitoring their feet for cuts and sores.

Further, diabetes patients may be educated about avoiding very hot showers and not applying lotion between showers, as for diabetic patients, the lotion has been shown to promote the growth of fungus (ADA, n.d., p.1).ReferencesAmerican Diabetes Association. (n.d.). Skin Complications | ADA. Retrieved November 9, 2021, from https://www.diabetes.org/diabetes/complications/sk… NSG 5003 Week 10 Type 2 Diabetes Mellitus Patient