Chronic Illness: Type 1 Diabetes, Insulin, and Sarah's Challenges

This assignment addresses the case of Sarah, a 5-year-old diagnosed with type 1 diabetes. It explains the rationale behind her insulin prescription (NovoRapid), relating it to the pathophysiology of the disease and the body's inability to produce insulin. The solution details the onset, peak, and duration of action for NovoRapid, along with proper administration timing. It defines and explores the causes, symptoms, and treatment of hypoglycemia. The assignment also determines the appropriate insulin pen needle length and injection sites for Sarah, justifying these choices based on her age and condition. Furthermore, it covers the necessity and timing of blood glucose level (BGL) testing. The document concludes by discussing the daily physical and potential emotional challenges Sarah might face due to her condition, emphasizing the importance of diet, activity, and emotional support for managing type 1 diabetes. References to relevant medical journals and books are included.

Chronic Illness and
Disability

Table of Contents
ASSESMENT QUESTION.............................................................................................................3
REFERENCES................................................................................................................................8

ASSESMENT QUESTION
Question 1)
Explain why Sarah has been prescribed insulin. Relate to the pathophysiology of type 1
diabetes and the mechanism
Sarah has been prescribed for insulin as her reports have depicted that she is suffering
from type 1 diabetes. It has also been analysed that her body was not able to make insulin which
have made her condition even more severe. Pathophysiology of Type 1 Diabetes refers to
infiltration and destruction of insulin secreting beta cells in the pancreas (Falvo and Holland
(2017). It can be said that with the decline of beta cells insulin also declines which develops
problem for patients health condition.
Sarah has been prescribed with type 1 insulin as it is considered as part of treatment as
her body could not make insulin of her own so, they need to keep her blood sugar level within
the healthy range. Also, diabetes is not a single disorder, it represents the series of metabolic
conditions that are associated with hyperglycaemia which is caused by the defects of insulin
secretion or there is a defect in the insulin action of Sarah (Zaccardi, F and et.al., 2016). This can
result in various serious complications in Sarah so, she have been prescribed with insulin in order
to minimise the defects which can worsen her health.
Question 2)
a) What is the onset, peak and duration of action for NovoRapid insulin
Onset of action for NovoRapid mainly occurs within 10-15 min of injection and its
maximum effects only existing till 3 hours. Whereas peak of action for NovoRapid insulin works
till 3 to 5 hours after site of injection.
b) When should NovoRapid be administered in relation to food and why?
NavoRapid is required to be administered just before 10 to 15 before the meal. This is
because it helps in avoiding low blood sugar level.
Question 3
a) Define hypoglycaemia
It is the situation in which blood sugar level of individual declines to below normal levels
(Jacob and et.al., 2016). It might cause because of high insulin rate in body or diabetic
medication that could reduce body sugar level.

b) What causes hypoglycaemia?
It might cause because of high insulin rate in body or diabetic medication that could
reduce body sugar level (Coughlin and Sethares, 2017). Along with this, if individual do not
consumes adequate amount of food after medication then also it could result in hypoglycaemia.
c) What are the symptoms of hypoglycaemia?
Some common symptom of hypoglycaemia are
 Sweating
 Anxiety
 Shakiness
 Hunger
 Headache
 Dizziness
 Moodiness
d) How is hypoglycaemia treated?
Hypoglycaemia is treated with the consumption of around 20 grams fast acting
carbohydrate food such as fruit juice, soft drinks, glucose tablets, sugar candies and others which
can easily be converted into sugar in body (Pinquart, 2017).
Question 4
a) What is the most appropriate insulin pen needle length for Sarah?
The most appropriate insulin pen needle length for Sarah is Micro 4 mm as the age of
patient is 5 year old and doctors can not use bigger size of insulin pen needle this much small
children.
b) Why is this length appropriate?
Micro 4 mm length is appropriate for Sarah as the age group of this patient is below 6
which clearly depicts that medical practitioner can not inject them larger than 6 mm size
according to their age and skin condition.
Question 5
Why does Sarah require a blood glucose level (BGL) test prior to an insulin injection?

Sarah require blood glucose level test prior to insulin injection as this test will aware
medical practitioners about the health condition of Sarah. After this test only, doctors will be
able to finalise amount of insulin which are required to be injected in Sarah. It will also required
to check effectiveness of diabetic medication over blood sugar level patient (Kaushansky and
Dodson McNeeley, 2017).
Question 6: a) What is an appropriate site on Sarah’s body to inject the NovoRapid
insulin?
Abdomen and back of upper arm are the best site on Sarah's body to inject the
NovoRapid insulin as the area is safe and quick reactive according to the age of child.
b) What injection angle is appropriate for Sarah?
45 degree angle to the pinched- up skin would best angle for Sarah to inject insulin over
her abdomen and back of upper arm.
c) Why are these appropriate for Sarah?
Back of upper arm and Abdomen is best for Sarah to inject insulin chances of infection is
less at these areas which depicts that it is safer for her. 45 degree angle is basically chosen for
leaner children which shows that it would be easier for medical practitioner to inject injection
with the health condition of Sarah.
Question 7: a) When would Sarah’s BGL need to be tested after administration of
NovoRapid?
Sarah's BGL is required to be tested in cumulative 7 days after administration of
NavoRapid as it will aware medical about the actual improvement in health condition of Sarah
that whether her sugar level is under control or not (Carel, 2018).
b) Why would a BGL be required at that time?
It would not be possible for doctors to provide treatment to Sarah on the basis of single
test thus regular based check up will help them prescribing right treatment to Sarah (Vanneste, B.
G and et.al.,2015).
Question 8: Discuss the daily physical challenges of living with type 1 diabetes that Sarah
may face.

There are various physical challenge which have to be faced by Sarah such as how many
times does she have to take insulin injection as considering her age as a factor. In such cases
patient may have low glucose level which lead towards weakness (Baena, 2017). For Sarah
diabetes 1 is considerer as she have hallmark symptoms of polyuria/ polydipsia, and
approximately one-third present with DKA. Sarah must have controlled diet and should avoid
sugary product in order to maintain blood pressure (Stepanova, De Avila and Afendy, 2017).
Hyperglycaemia should be checked and given under the guidance of doctor and should no be
overdose for 5 year old children. Sarah may face physical challenges due to high level of BGL
and cannot do physical activities for long period of time. Sarah must have proper sleep and has to
plan her day to day activities to maintain BGL level.
Question 9: Discuss potential emotional impacts of living with type 1 diabetes that Sarah
may face.
Sarah is a 5 year old girl who is suffering from diabetes which directly placing emotional
impact over the girl as she have look after many things before executing her regular based
activities. Some major impact which might be faced by her are continuing her previous sports
activities, dealing with insulin injection every day, think before eating every food item as it
might contain sugar, have to go through regular based blood sugar health check up as they are
part of her regular based lifestyle (Rolland, 2019).

REFERENCES
Books and Journals
Baena, R. (2017). Recognition and Empathy in Illness and Disability Memoirs. Christina
Middlebrook’s Seeing the Crab and Harriet McBryde Johnson’s Too Late to Die
Young. DIEGESIS. 6(2).
Carel, H. (2018). Illness: The cry of the flesh. Routledge.
Coughlin, M. B., & Sethares, K. A. (2017). Chronic sorrow in parents of children with a chronic
illness or disability: an integrative literature review. Journal of pediatric nursing. 37.
108-116.
Falvo, D. , & Holland, B. E. (2017). Medical and psychosocial aspects of chronic illness and
disability. Jones & Bartlett Learning.
Jacob, D and et.al (2016). Synthesis and identification of FITC-insulin conjugates produced
using human insulin and insulin analogues for biomedical applications. Journal of
fluorescence. 26(2). 617-629.
Kaushansky, D, Cox, J., Dodson, C., McNeeley (2017). Living a secret: disclosure among
adolescents and young adults with chronic illnesses. Chronic illness. 13(1). 49-61.
Pinquart, M. (2017). Systematic review: bullying involvement of children with and without
chronic physical illness and/or physical/sensory disability—a meta-analytic comparison
with healthy/nondisabled peers. Journal of pediatric psychology. 42(3). 245-259.
Rolland, J. S. (2019). Families, health, and illness. Handbook of health social work. 331-357.
Stepanova, M., De Avila, L., Afendy, M. (2017). Direct and indirect economic burden of chronic
liver disease in the United States. Clinical Gastroenterology and Hepatology. 15(5).
759-766.
Vanneste, B. G and et.al., (2015). Chronic radiation proctitis: tricks to prevent and
treat. International journal of colorectal disease. 30(10). 1293-1303.
Zaccardi, F and et.al., (2016). Pathophysiology of type 1 and type 2 diabetes mellitus: a 90-year
perspective. Postgraduate medical journal. 92(1084), 63-69.