Western Sydney University 401209 Type 1 Diabetes Case Study Analysis

This assignment presents a detailed case study of a patient, Sarah, diagnosed with type 1 diabetes. The solution addresses key aspects of the condition, including Sarah's symptoms (increased appetite, excessive thirst), the diagnosis (glucose and ketones in urine), and the prescribed treatment (insulin). The assignment explores the action and administration of NovoRapid insulin, including its onset, peak, and duration, as well as the importance of administering it before meals. It also examines the causes, symptoms, and treatment of hypoglycemia. The assignment further delves into the rationale for insulin administration in type 1 diabetes, the appropriate needle length for insulin injections, and the necessity of blood glucose level testing. It also covers the appropriate injection site and angle, the need for post-injection blood glucose monitoring, and the physical and emotional challenges faced by individuals with type 1 diabetes. The solution references multiple sources to support its claims and recommendations.

Type 1 Diabetes
Student's Name:
Student's ID:

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Table of Contents
Answer 1................................................................................................................................2
Answer 2................................................................................................................................2
Answer 3................................................................................................................................3
Answer 4................................................................................................................................3
Answer 5................................................................................................................................4
Answer 6................................................................................................................................4
Answer 7................................................................................................................................5
Answer 8................................................................................................................................5
Answer 9................................................................................................................................6
References............................................................................................................................7

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Answer 1
Sarah has increased appetite along with excessive thirst, which are the symptoms
of type 1 diabetes. After the test the urine, the doctors found that the presence of
glucose and ketones. She has prescribed insulin in order to decrease the level of
sugar in her bloodstream and permit glucose to enter the cells to create energy.
Insulin initiates its action by binding to a glycoprotein receptor on the surface of the
cell (Zaccardi, Webb, Yates & Davies, 2016). Diabetes can be caused due to
genetic factors, and Sarah's mother has an autoimmune disease. Type 1 diabetes
can create severe damage to heart, eyes or kidneys. Hence, insulin has been
prescribed to reduce the effect of type 1 diabetes.
Answer 2
The onset of action for NovoRapid insulin is 10-20 minutes, the peak is 1 to 3
hours, and the duration of insulin is 3 to 5 hours (Bullock & Manias, 2017).
NovoRapid should be administered before the meal, and the meal can be taken
within 5 to 10 minutes after injecting the insulin. It is administered before the meal
because of the faster onset of action, but it could be given immediately after food.
In the given case study, Sarah has been prescribed to administer insulin three
times per day because she has 25.0 mmol/L blood glucose level.

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Answer 3
Hypoglycemia is referred to as the low level of blood sugar or blood glucose in the
body (Driscoll, Raymond, Naranjo & Patton, 2016). Hypoglycemia can be caused
due to various reasons:
 It occurs when people with diabetes do not follow a proper diet and exercise
 When the level of blood sugar falls underneath 4 mmol/L
 When a person takes a too high dose of medicine such as insulin
The major symptoms of the disease are fatigue, sweating, feeling weak, hungry,
pale and loss of consciousness. Hypoglycemia can be treated by drinking or eating
15-20g of slower acting carbohydrates or by taking fast-acting carbohydrate. Then,
it is required to test the blood after 15-20 minutes to check the blood sugar level.
Answer 4
Sarah has type 1 diabetes, therefore, it is essential to administer insulin because
the immune system destroys the beta cells in the pancreas. Without adequate
insulin, the rise of blood sugar level can cause a severe effect. The most suitable
insulin pen needle length for Sarah is 4mm and should be administered at a 90
degree to the surface of the skin (Blackwell & Wheeler, 2017). 4mm is suitable
because human skin is 1.6 to 2.4mm thick, and it allows low pain on injection. 4mm
needle is appropriate to all age patients because it is less likely to put Sarah at
risks.

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Answer 5
Sarah required a blood glucose level (BGL) test before the insulin injection
because after reviewing by the doctor, it was found that her BGL was 26.0mmol/L
and blood ketone level was 1.6mmol/L, and the other symptoms were within the
usual level. The pediatric doctor based on her symptoms has done the BGL test
and identified that her ketone level in blood was normal. In order to prevent any
complication or wrong medication, it is compulsory to test blood glucose level of
the patient as per the Australian Diabetes Education Association (Davis, Kuriakose
& Clements, 2019).
Answer 6
Administering insulin is a must for the life of Sarah as she has type 1 diabetes. The
body failed to produce insulin in case of type 1 diabetes. The appropriate site on
Sarah's body to inject the NovoRapid insulin is abdomen as it is the fat layer under
the skin. Abdomen is a suitable site for administering insulin because it is less
painful and helps to enter insulin into the bloodstream quickly (Punthakee,
Goldenberg & Katz, 2018). Moreover, NovoRapid is rapid acting insulin, so the
abdomen is perfect for Sarah. 90-degree injection angle with fold skin is
appropriate for Sarah because it causes less pain and correctly injects the insulin
(Kalra, Hirsch, Frid, Deeb & Strauss, 2018).

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Answer 7
Sarah's blood glucose level needs to be tested after administered NovoRapid
when any signs of allergy will occur like rash or hives. Blood Glucose level is
required to test at that time because NovoRapid insulin can cause low blood sugar
to the body. Therefore, the doctors recommended to test BGL to check blood
glucose level and can be prevented or treated on time. It is required to test before
taking food and after exercise. BGL test is required to monitor the effectiveness of
medication of diabetes on the level of blood sugar and identify the sugar or glucose
level in the body after medication (Shetty et al., 2016). Moreover, the test also
helps Sarah to understand the effect of diet and exercise on the sugar level.
Answer 8
Sarah may face several physical challenges in her daily life for having type 1
diabetes. The chronic disease has an intense impact on the lives of the individual,
along with friends or family members. It is a 24 hours task to manage the chronic
illness and ensure that the sugar level is within the limit (Messer, Johnson, Driscoll
& Jones, 2018). Physically, Sarah may face problem in relation to eyes, kidneys,
nerves, heart and blood vessels. She needs to visit the doctor every three months
for a checkup and requires to do exercise daily to reduce stress. Sarah may not
perform well in her physical work, such as playing or studying. She may frequently
become tired, weak, and fatigue, which causes loss of energy.

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Answer 9
Sarah may face emotional challenges due to type 1 diabetes. The stress of living
with the autoimmune disease can change the mood of Sarah rapidly such as
feeling nervous, tired and face difficulty in thinking quickly (King, O., Nancarrow,
Grace & Borthwick, 2019). She may feel irritated with the fluctuation of blood sugar
level. She may also face a mental illness like anxiety, stress and depression that
affect the quality of life of Sarah. The disease increases tension, frustration and
need for emotional support, which may affect the relationship between Sarah and
her parents or friends. Sarah may also fail to control her behavior and may prone
to aggression due to living with type 1 diabetes.

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References
Blackwell, M., & Wheeler, B. J. (2017). Clinical review: the misreporting of logbook,
download, and verbal self-measured blood glucose in adults and children
with type I diabetes. Acta Diabetologia, 54(1), 1-8.
Bullock, S., & Manias, E. (2017). Fundamentals of pharmacology. Pearson Higher
Education AU.
Davis, A., Kuriakose, J., & Clements, J. N. (2019). Faster insulin aspart: a new
bolus option for diabetes mellitus. Clinical pharmacokinetics, 58(4), 421-430.
Driscoll, K. A., Raymond, J., Naranjo, D., & Patton, S. R. (2016). Fear of
hypoglycemia in children and adolescents and their parents with type 1
diabetes. Current diabetes reports, 16(8), 77.
Kalra, S., Hirsch, L. J., Frid, A., Deeb, A., & Strauss, K. W. (2018). Pediatric insulin
injection technique: a multi-country survey and clinical practice implications.
Diabetes Therapy, 9(6), 2291-2302.
King, O., Nancarrow, S., Grace, S., & Borthwick, A. (2019). Interprofessional role
boundaries in diabetes education in Australia. Health Sociology Review, 1-
15.
Messer, L. H., Johnson, R., Driscoll, K. A., & Jones, J. (2018). Best friend or spy: a
qualitative meta‐synthesis on the impact of continuous glucose monitoring
on life with Type 1 diabetes. Diabetic Medicine, 35(4), 409-418.

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Punthakee, Z., Goldenberg, R., & Katz, P. (2018). Definition, classification and
diagnosis of diabetes, prediabetes and metabolic syndrome. Canadian
Journal of diabetes, 42, S10-S15.
Shetty, V. B., Fournier, P. A., Davey, R. J., Retterath, A. J., Paramalingam, N.,
Roby, H. C., ... & Jones, T. W. (2016). Effect of exercise intensity on
glucose requirements to maintain euglycemia during exercise in type 1
diabetes. The Journal of Clinical Endocrinology & Metabolism, 101(3), 972-
980.
Zaccardi, F., Webb, D. R., Yates, T., & Davies, M. J. (2016). Pathophysiology of
type 1 and type 2 diabetes mellitus: a 90-year perspective. Postgraduate
medical journal, 92(1084), 63-69.