Clinical Case of Diabetes

Clinical case of diabetes 1
CLINICAL CASE OF DIABETES
Student’s Name
Institutional Affiliation

Clinical case of diabetes 2
Introduction
Diabetes is a medical condition that is characterized by increased blood glucose above
the normal range. There are two types of diabetes. Type 1 diabetes mainly affects children and is
as a result of low insulin production by beta cells of the pancreas (Marso et al, 2016). The
pancreas is responsible for insulin production. This hormone is responsible for regulating blood
sugar levels by stimulating glucose intake by cells and tissues. It therefore reduces blood glucose
levels back to normal levels in case of a rise. Low insulin production in the pancreas may be due
to low number of beta cells than normal as well as genetic malfunction of insulin coding and
formation. Type 2 diabetes on the other hand mainly affects adults and is as a result of peripheral
resistance of insulin uptake by cells and tissues.
Insulin uptake by peripheral tissues is of importance to induce changes and promote
glucose intake from blood (Atlas, 2015). In type 2 diabetes however there is limited uptake of the
hormone resulting to no changes in the blood sugar levels. Marcel is suffering from diabetes and
there are several nursing implications related to his case. The aim of this discussion is therefore
to critically analyze Marcel’s case study and to describe the necessary nursing interventions and
rationales for his clinical management.
Priorities for Marcel’s medication management
After enough clinical considerations of Marcel’s condition, there was need to establish a
treatment and care plan for the patient. There was need to identify priorities for Marcel’s
medication management including self-management. The treatment plan involves a set of
medications necessary for the management of diabetes. The priorities of medication management
highly depend on the current state of the patient and the severity of the condition (Zinman et al,

Clinical case of diabetes 3
2015). Self-management is an important aspect that should always be applied in the treatment
plan of a diabetic patient. Marcel’s condition was first managed by administration of metformin.
Metformin is an important initial treatment medication for a diabetic patient. It is a first step
clinical medication for the disease. It is under the bigger class of biguanides and works by
antagonizing the effects of glucagon. Glucagon is responsible for increasing blood sugar levels
and therefore if its effects are antagonized there is reduced blood glucose.
Since the diabetic condition of Marcel proved to be very severe and showed little
response to the drug, there was need for introduction of another drug glibenclamide to be orally
combined with metformin. Glibenclamide acts to increase insulin secretion and therefore its
combination with metformin is quite powerful to reverse diabetic effects. Introduction of
synthetic insulin was the last priority medication in managing the condition as it proved to be
quite adamant to the primary treatment. Self-medication is important as in Marcel’s case since it
enables the patient manage their condition even at home. The patient should be educated on the
routes of administration of the various drugs in order to promote effectiveness in treatment
(Neal, 2017).
Nursing interventions and rationales
Nursing interventions and rationales form an important nursing aspect in the management
of diabetes. Self-management is always included in the nursing plan to achieve the best
outcomes possible. Marcel’s self-management of his condition involves being educated by the
nurse on how to monitor his blood glucose levels. Continuous blood glucose monitoring by the
patient is important to ensure that the condition is suppressed and to monitor any hypoglycemic
effects of the medication in place (Fuchsberger et al, 2016). Since marcel opted for the use of