11.0 Endocrine System: glucose regulation and anti-diabetic medications V2
Learning Objectives
- Describe the functions of the pancreas, including endocrine and exocrine functions.
- Understand the differences between diabetes mellitus type 1 and type 2, including the pathophysiology and treatments.
- Compare and contrast the types of insulin, including onset, peak and duration of action.
- Understand the differences between the different types of oral anti-diabetic medications and indications for each type of medication.
- Articulate nursing considerations for each medication class to promote safe medication use.
- Identify the side effects and special considerations associated with antidiabetic medications.
- Identify the considerations and implications of using endocrine system medications across the lifespan
- Apply evidence-based concepts when using the nursing process and clinical reasoning related to medications that affect the endocrine syste
To maintain body homeostasis, the body is dependent on tight control of blood glucose levels. The pancreas is key in glucose regulation as it secretes various hormones and neuropeptides. Other organs have a role, namely the brain, liver and intestines, as well as skeletal muscle. The pancreas maintains blood glucose levels within a very narrow range by the opposing and balanced actions of glucagon and insulin (Roder et al, 2016). If this balance is not maintained, diabetes mellitus can occur.
Diabetes mellitus is divided into two primary types. Type 1 diabetes is characterized by a lack of insulin secretion. Type 2 diabetes is caused by a lack of sensitivity of insulin receptors at the target cells and a deficiency in insulin secretion. Both types can lead to chronic health conditions that can affect cardiovascular and nervous systems (Adams et al, 2018).
Diabetes Mellitus is a disorder of carbohydrate metabolism and symptoms result primarily from a deficiency of insulin, from cellular resistance to insulin or both (Burchum & Rosenthal, 2023). It is the most common endocrine disorder in Canada, as well as globally. The International Diabetes Federation (IDF) has identified diabetes as one of the largest global health emergencies of the 21st century, with high blood sugar the third highest risk factor for premature mortality, after high blood pressure and tobacco use (Diabetes Canada, 2020). Canada has seen rising rates of diabetes with an estimated 9.3% of the population in 2015 having diabetes, and predicted to rise to 12.1 % by 2025 (Diabetes Canada, 2020).
Diabetes can lead to numerous health complications. In particular, end-stage renal disease, blindness and cardiovascular complications. Along with health complications, the impact on an individual’s lifestyle and productivity can be significantly impacted.
In this chapter, you are provided with a basic introduction to the concept of glucose regulation. Unit 11.3, a review of diabetes mellitus is provided. Unit 11.4 and 11.5, medications to treat diabetes is presented, including insulin therapy and oral diabetic medications. At the end of the chapter, critical thinking and decision-making questions are available to test your understanding.
References
Adams, M., Urban, C., El-Hussein, M., Osuji, J. & King, S. (2018). Pharmacology for Nurses. A pathophysiological approach (2nd Canadian ed.). Pearson Canada Inc: Ontario
Burchum, J., & Rosenthal, L. (2023). Lehne’s pharmacology for nursing care (11th ed.). Saunders.
Diabetes Canada (2020). About diabetes – Diabetes Canada
Roder, P., Wu, B., Lui, Y. & Han. W. (2016). Pancreatic regulation of glucose homeostasis. Experimental and Molecular Medicine, 48, e216. https://doi.org/10.1038/emm.2016.6
