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Zach is a boy of 15 years old who experienced some of the complications with his health as he experienced the loss of appetite and excessive thirst. He was playing regular cricket but was not able to perform his best. In a short period, he noticed that he has lost 10 kilograms of weight and going to urinate very frequently. Complications indicated that he is positive with glucose and ketones, so the doctor advised him for insulin treatment immediately. Insulin is given to the patients who need to control blood sugar having type 1 and type 2 diabetes. Here, in this case, Zach was suffering from type 1 diabetes, this is the condition in which does not makes insulin and therefore cannot controls the level of sugar in the body (ASCEND Study Collaborative Group, 2018). This helps in helping move from blood sugar into the blood tissues where the tissues are used for energy.
Type 1 diabetes is the lifelong process in which high levels of blood sugar is accumulated in the body. There is no specific age for diabetes 1, hence it can be caused in any age groups such as adolescents, children, and adults. Beta cells are the special cells that are used to produce hormones in the body. The pancreas is there in the lower part of the human body that is below the stomach. Insulin is given to the patient suffering from diabetes so that blood glucose moves into the cells and then glucose is stored in the cells to produce energy. In the patients suffering from diabetes 1, the pancreas does not or very less produce insulin in the body. Exactly, type 1 diabetes is the autoimmune disorder in which body tissue is mistakenly destroyed by the body. The person suffering from diabetes 1 found that triggers or any other infection cause the human body to mistakenly attack beta cells that make insulin with the help of the pancreas. This disease also tends to get inherited from parents (Tilg, Moschen & Roden, 2017). The symptoms of high blood sugar are that person feels hungry, very thirsty, blurry eyesight, losing weight, tingling in feet, and fequent urination. These all were the symptoms that developed within Zach. For examination and testing, diabetes can be diagnosed using a fasting blood glucose level, Hemoglobin A1C, random blood glucose level, and oral glucose tolerance test. The disease is severe in case the person is suffering from Type 1 diabetes. Regular check-ups are required to monitor blood sugar and unit testing (Zheng, Ley & Hu, 2018).
Zach is given NovoRapid insulin administration about food because this is the injection that is given specifically to patients suffering from diabetes mellitus and who require insulin control for maintenance of blood glucose level due to hyperglycemia. This injection is analog to diabetes and is started to lower the blood glucose level by 10-20 minutes. The injection is given with the combination of long-acting and intermediate-acting insulin preparations (ASCEND Study Collaborative Group, 2018). NovoRapid is asked by the physician to Zach to have continuous infusion in the pump system. Majorly this injection is given intravenously by the healthcare professionals with the close supervision of the doctor. Patients like Zach who are given NovoRapid injection are said to monitor their blood glucose level regularly. For the faster onset of NovoRapid injection, the patient is given this close to the meal be it for 5-10 minutes soon the meal. NovoRapid is administered to the patient soon after the meal instead of giving before the meal. Zach has to consider the proper measures of injecting insulin in his body as he has to pinch the skin between his fingers and push the needle to skinfold and inject it under the skin. This takes around 6 seconds to make sure that the patient has injected insulin (Asmat, Abad & Ismail, 2016).
The rationale for testing Zach’s blood glucose level (BGL) before and after his first NovoRapid insulin injection in the hospital setting is to monitor complications, dosage, and effectiveness of treatment. It is known that around 30% of the hospital admissions are there due to diabetic patients (Fang, Karakiulakis & Roth, 2020). There are high rates of mortality, length of stay, and complications associated with diabetes. Patients like Zach are managed in healthcare settings by monitoring regular blood glucose levels pre and post 2 hours of a meal. The endocrinology team performs many functions to take care of diabetic patients such as the diet of a patient with type 1 diabetes, insulin pump, and assessing factors to hyperglycemia. The dosage of insulin is determined so that there are no chances of a rise in complications due to treatment. The recordings are done by the inpatient staff while admission to the department and at regular intervals till discharge from the department.
There will be lots of physical and emotional impact on the health of Zach. Physical health is affected as Zach has to keep this into notice that insulin is administered, needs guidance for administration, keeps track of dosage is not missed, appetite track, and cautions that his blood glucose level is normal. As per the emotional health of Zach is concerned, he will be quite stressful also overwhelmed by realizing the need to manage everything that the diabetic patient has to manage. However, it is realized that physical health is as important as emotional health to the diabetic patient. He must undergo some of the measures such as meditation to take care of mood swings, deep breathing, listening to music, and doing yoga, progressive relaxation, and taichi. Sometimes, this is the normal condition for feeling down or sad. Stress is not at all good for diabetic patient and this must be informed to the healthcare team (Kharroubi & Darwish, 2015).
ASCEND Study Collaborative Group. (2018). Effects of aspirin for primary prevention in persons with diabetes mellitus. New England Journal of Medicine, 379(16), 1529-1539. https://www.nejm.org/doi/full/10.1056/nejmoa1804988
ASCEND Study Collaborative Group. (2018). Effects of n− 3 fatty acid supplements in diabetes mellitus. New England Journal of Medicine, 379(16), 1540-1550. https://www.nejm.org/doi/full/10.1056/nejmoa1804989
Asmat, U., Abad, K., & Ismail, K. (2016). Diabetes mellitus and oxidative stress—A concise review. Saudi Pharmaceutical Journal, 24(5), 547-553. https://doi.org/10.1016/j.jsps.2015.03.013
Fang, L., Karakiulakis, G., & Roth, M. (2020). Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?. The Lancet. Respiratory Medicine, 8(4), e21. https://dx.doi.org/10.1016%2FS2213-2600(20)30116-8
Kharroubi, A. T., & Darwish, H. M. (2015). Diabetes mellitus: The epidemic of the century. World Journal of Diabetes, 6(6), 850. https://dx.doi.org/10.4239%2Fwjd.v6.i6.850
Tilg, H., Moschen, A. R., & Roden, M. (2017). NAFLD and diabetes mellitus. Nature Reviews Gastroenterology & hepatology, 14(1), 32-42. https://www.nature.com/articles/nrgastro.2016.147%3E
Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global etiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88. https://www.nature.com/articles/nrendo.2017.151
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