The client was a 71-year-old female who was admitted to the hospital for diabetes. The client had a history of gestational diabetes. According to Keresztes and Peacock-Johnson (2019), about 10 percent of the population in the United States has diabetes mellitus, and type 2 diabetes is prevalent in most cases. Diabetes presents one of the most common diagnoses in causes of ED visits among adults and one of the leading causes of death in the United States (Keresztes and Peacock-Johnson, 2019). Therefore, antidiabetic drugs constitute a significant part of medications prescribed to patients in the United States, and not all nurses are familiar with mechanisms used in antidiabetic drugs and their adverse effects.
The main factors that influence the development of type 2 diabetes, according to Keresztes and Peacock-Johnson (2019), are physical inactivity and obesity caused by uncontrolled dietary intake. The hospitalized patient was morbidly obese with an MBI index of 40.0. The article states that obesity contributes to the development of systemic inflammation, which is associated with the dysfunction of the beta-cell (Keresztes and Peacock-Johnson, 2019). The patient was suffering from fungus infection in the right lower extremity. Moreover, obesity in diabetes creates insulin resistance, as it defects the insulin’s ability to bind to the cell’s receptor. The patient experienced delirium and expressed anxious behavior in complaints about pain in extremities. According to the article, the pain could be caused by adverse effects of antidiabetic drugs, such as α-glucosidase inhibitors, DPP-4 inhibitors, and thiazolidinediones.
In conclusion, the prescription of antidiabetic drugs in type 2 diabetes should be performed considering the patient’s age, physical activity data, and weight. In this case, the patient should be educated about the possible adverse effects of antidiabetic drugs as they all have different intake recommendations based on their work mechanisms. Overall, in cases of diabetes, nurses should educate the patients about the importance of physical activity and control of dietary intake and the impact of weight and obesity on the efficiency of antidiabetic drugs.
Reference
Keresztes, P., & Peacock-Johnson, A. (2019). Type 2 diabetes: A pharmacologic update. American Journal of Nursing, 119(3), 32-40. Web.