Zach Forbes Case Study Sample

• Subject Name : Nursing

Type 1 Diabetes Mellitus - Answer 1

Type 1 diabetes mellitus is also known as juvenile diabetes which is characterized by the destruction of beta cells because of autoimmune processes which untimely results in the deficiency of insulin. Characterization of type- 1 diabetes is done by knowing the presence of islet cells, antibodies against insulin or anti-glutamic acid decarboxylase. Eventually, patients suffering from this disease need insulin therapy. The damaged utilization of glucose and deficiency of insulin reduces the expression of multiple genes which is important for target tissues to act in response in general to insulin for example glucokinase situated in the liver as well as the GLUT 4 which belongs to the class of glucose transporter within adipose tissue. Insulin deficiency also causes impaired metabolism of lipid, protein and glucose (Habtamu, W. B., 2015). Therefore, it was necessary for doctors to prescribe insulin to Zach.

Autoimmune destruction of beta cells results in the secretion deficiency of insulin that leads to disturbances in metabolism. In addition to this, alpha cells of the pancreas also work abnormally and overproduction of glucagon occur in patients suffering from type- 1 diabetes. This leads to elevated levels of glucagon which exacerbate defects in metabolism due to deficiency in insulin. Less amount of insulin also causes lipolysis which is uncontrollable and increase fatty acid levels within plasma in the free state which represses the metabolism of glucose. These factors also reduce gene expressions necessary for normal insulin production. This explains the major derangement in the metabolism which ultimately ends in deficiency of insulin (Habtamu, W. B., 2015).

Type 1 Diabetes Mellitus - Answer 2

According to the studies which have been conducted, it is known that NovoRapid flexpen has noteworthy therapeutic actions on patients with diabetes. NovoRapid is given to the patients in their subcutaneous tissues with the help of injections, previously to their meals before 5-10 minutes. However, the amount of dosage is kept variable considering the patient’s diet, weight and blood sugar sustainability. NovoRapid is quickly absorbed within the blood and starts to show its effect very quickly. It is durable for 10-20 minutes with the greatest duration of 1-3 hours (Jia et al., 2017). Insulin aspart is believed as bolus insulin because it provides the body with a very high amount of insulin in less course of time to act as the discharge of endogenous insulin after meals from the pancreas. By providing the patients with NovoRapid, avoidance of hypoglycemia episodes can also be done (Park et al., 2016). Insulin aspart plus is linked to lower hypoglycemia (Blum, 2016).

Without proper insulin supply, there can be dangerous implications such as headache, increased thirst, fatigue and blurred visions. This could be due to high levels of glucose in the bloodstream. And if this problem is not treated than the automatic breakdown of fat starts to happen in place of glucose for the requirement of the energy. This process enhances the level of ketone acids within the blood and this condition could be life-threatening. For the long run, high blood sugar levels amplify the risk of diabetes and heart strokes (Hermansen, Bohl & Schioldan., 2016).

Type 1 Diabetes Mellitus - Answer 3

The person who was administered with NovoRapid needs continuous monitoring because the doses play a very vital role in controlling glycaemia. Blood glucose level testing should be performed before and after giving the insulin as it helps to track the amount of glucose in the blood. By doing this, we can also check its effect on the patient (Heise et al., 2013). The onset of the NovoRapid is very quick that’s why it is important to take into account the patient’s blood glucose level because the appropriate dose of the insulin should be provided and if overdosed than severe complications can occur. NovoRapid in 10- 15 minutes after administration lower down the level of blood glucose. Rise and downfall in the level can also be seen after injecting insulin and this is why monitoring of blood glucose is necessary to see how the body of the patient is responding with accordance to the medication (Heise et al., 2013). Hence, it was important to test Zach’s blood glucose level before and after administering the first NovoRapid insulin injection in the hospital setting.

Type 1 Diabetes Mellitus - Answer 4

Diabetes can affect the quality of life, sense of control, psychological and mental well- being of a child. Management of this disease can be done if self- care techniques could be performed with understanding the diabetes impact on a child's life (Sparapani, Jacob & Nascimento, 2015). Zach is a 15-year-old boy who is recently diagnosed with type-1 diabetes mellitus. After being discharged from the hospital he may face various complications which could affect his life severely if he is not able to control his disease by taking regular medication, doing exercise and diet. Due to uncontrollable diabetes, he might not be able to take up certain kinds of job which require more physical input. He might also not be able to perform his best for a longer time period even if he has the capabilities. He also has to control his diabetes by being very regular with his medications, testing of blood sugar, exercising and eating. This could take a toll on his mental health as these will cause limitations to his ability to participate in social activities and work. He might have to rely more on his family members and friends for their help which could negatively affect their lives also (Vanstone et al., 2016).

There will be physical influences on his health, mood and mental abilities. He may feel emotional, irritable and angry at times when the blood sugar level is low. He may also feel hopeless, vulnerable and frustrated as he will not be unable to manage his blood sugar. He may in addition to this, experiences impacts on his life socially when he has to turn down invites for social events or he may feel different from his family members and friends. He might have conflicting wishes, insecurities, pain, prejudices, rejections, fears, inadequate knowledge and shame about his disease. He may also feel bad about living with diabetes (Sparapani, Jacob & Nascimento, 2015). Therefore, Type 1 diabetes mellitus could negatively impact Zach’s living.

References for Type 1 Diabetes Mellitus

Blum A. K. (2016). Insulin use in pregnancy: An update. Diabetes Spectrum : A Publication of the American Diabetes Association, 29(2), 92–97. https://doi.org/10.2337/diaspect.29.2.92

Habtamu, W. B. (2015). Classification, pathophysiology, diagnosis and management of diabetes Mellitus. Journal of Diabetes and Metabolism, 6(5),1-9. 10.4172/2155-6156.1000541

Heise, T., Hövelmann, U., Brøndsted, L., Adrian, C. L., Nosek, L., & Haahr, H. (2015). Faster-acting insulin aspart: Earlier onset of appearance and greater early pharmacokinetic and pharmacodynamic effects than insulin aspart. Diabetes, Obesity & Metabolism, 17(7), 682–688. https://doi.org/10.1111/dom.12468

Heise, T., Zijlstra, E., Nosek, L., Rikte, T., & Haahr, H. (2017). Pharmacological properties of faster-acting insulin aspart vs insulin aspart in patients with type 1 diabetes receiving continuous subcutaneous insulin infusion: A randomized, double-blind, crossover trial. Diabetes, Obesity & Metabolism, 19(2), 208–215. https://doi.org/10.1111/dom.12803

Hermansen, K., Bohl, M., & Schioldan, A. G. (2016). Insulin aspart in the management of diabetes mellitus: 15 Years of Clinical Experience. Drugs, 76(1), 41–74. https://doi.org/10.1007/s40265-015-0500-0

Jia, J., Wu, J., Wu, Y. & Hu, L. (2017). Clinical efficacy and safety of NovoRapid flexpen in treatment of gestational diabetes mellitus. Biomedical Research, 28 (19): 8553-8556

Park, J. H., Shin, S. Y., Shim, Y. J., Choi, J. H., & Kim, H. S. (2016). Multiple daily injection of insulin regimen for a 10-month-old infant with type 1 diabetes mellitus and diabetic ketoacidosis. Annals of Pediatric Endocrinology & Metabolism, 21(2), 96–98. https://doi.org/10.6065/apem.2016.21.2.96

Sparapani, V., Jacob, E., & Nascimento, L. C. (2015). What is it like to be a child with type 1 diabetes mellitus?. Pediatric Nursing, 41(1), 17–22.

Vanstone, M., Rewegan, A., Brundisini, F., Dejean, D., & Giacomini, M. (2015). Patient perspectives on quality of life with uncontrolled type 1 diabetes mellitus: A systematic review and qualitative meta-synthesis. Ontario Health Technology Assessment Series, 15(17), 1–29.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help