Independent Practice Project for Management of Insulin in Type 2 Patients - Coursework Example

Diabetes mellitus is the most common endocrine disease characterized by metabolic abnormalities. This author being a nurse engaged independent prescribing in the area of general practice has come across many diabetic patients. Diabetes can be dangerous in the sense that it can lead to many potentially debilitating complications involving eyes, kidneys, nerves, and blood vessels. This author has come across patients during clinical practice with varied presentations. Whatever may be the mode of diagnosis, persistently elevated plasma glucose in the fasting state would lead to the diagnosis of diabetes mellitus even if the patient is symptomatic (Saudek, C.D., Derr, R.L., and Kalyani, R.R., 2006).
From this author’s experience, a venous plasma glucose concentration of 140 mg/dL on at least two separate occasions or plasma glucose concentration of 200 mg/dL 2 hours following ingestion of 75 g of glucose would constitute a diagnosis of diabetes mellitus (Barr, R.G., Nathan, D.M., Meigs, J.B., and Singer, D.E., 2002).
Diabetes is classically classified into many clinical syndromes. The term type 2 is known also as non-insulin-dependent diabetes mellitus. Type 2 diabetes mellitus is not exactly insulin-independent throughout its course; eventually, all of the patients would end up needing insulin for therapy (Copeland, K.C., Becker, D., Gottschalk, M., and Hale, D., 2005).
Clinically, in my practice, I have seen many patients that presented in the middle life or later. More than 90% of patients are of the type 2 variety. Symptoms begin gradually in the typically overweight patient, and as I recollect, most diagnoses were made in the clinic when an asymptomatic patient was found to have elevated blood sugar levels on laboratory investigation. From some records in patients who had been previously diagnosed, I have seen that these patients have been ordered plasma insulin tests, and plasma insulin levels would be lower indicating a relative insulin deficiency. This indicates that these patients may have beneficial effects from insulin therapy since essentially, these patients would have defects in the secretion of insulin from the beta cells of the pancreas (Sacks, D.B., Bruns, D. E., Goldstein, D.E., Maclaren, N.K., McDonald, J.M., and Parrott, M., 2002).
Since the disease at least partly results from insulin deficit, insulin is required for many patients with diabetes mellitus type 2. If no oral agents are used for treatment, all diet-responsive type 2 diabetics must be treated with insulin. My observation suggests that it is fairly easy to control the symptoms of diabetes with insulin, and as an independent prescriber, I know it is difficult to maintain a lump of normal blood sugar throughout the day even with the use of multiple injections.