Endocrine System Drugs: Diabetes Mellitus

Endocrine System & Diabetes Mellitus Drugs

Learning Objectives

• Describe major classes of drugs used to treat diseases/illnesses of the endocrine system.
• Describe the main nursing considerations related to these groups of drugs.

Core Principle

• "Identify the problem, then focus on treating it."

Major Classes of Diabetes Drugs

• Pancreatics (Insulin)
  • Rapid Acting Insulin
    • lispro (“Humalog”)
    • aspart (“Novolog”)
  • Short Acting Insulin
    • Humulin R
    • Novolin R
  • Intermediate Acting Insulin
    • Humulin N
    • Novolin N
  • Long Acting Insulin
    • glargine (Lantus)
  • Mixtures of Insulin
    • Humalog 50/50
    • Humulin 70/30
• Oral Antidiabetics
  • glipizide
  • metformin

Diabetes Mellitus (DM): Identifying the Problem

• DX: Type 1 or Type 2 Diabetes Mellitus
• Type 1 DM:
  • Problem: Insulin deficient; insulin-producing cells have been attacked/destroyed by the immune system.
• Type 2 DM:
  • Problem: Insulin resistant; body is not making enough insulin, or what it makes does not work properly.

Treatment Strategies

• Type 1 DM:
  • Insulin replacement → goal is to keep blood sugar levels as close to normal as possible.
• Type 2 DM:
  • Diet and Exercise → oral hypoglycemic medication → help promote insulin production.

Insulin Categories

• "BOLUS" insulin: RAPID or SHORT acting
• "BASAL" insulin: LONG acting
• "PRE MIXED" insulin: a mixture of basal and bolus insulin

Case Study: Mrs. Evelyn Thompson

• Patient Profile:
  • Name: Mrs. Evelyn Thompson
  • Age: 78 years old
  • Diagnosis: Type 2 Diabetes Mellitus, Hypertension, Chronic Kidney Disease (Stage 2)
• Current Medications:
  • Humalog (Rapid-acting insulin): 10 units before each meal
  • Lantus (Long-acting insulin): 15 units at bedtime
  • Lisinopril 10 mg daily
  • Metformin 500 mg twice daily
• Blood Sugar Readings:
  • Average 10.0 mmol/L before meals
  • Average 13.3 mmol/L at bedtime

Questions & Answers

• What are the two types of insulin Mrs. Thompson is using, and what are their main purposes?
  • Humalog (Rapid-acting): Used before meals to control blood sugar spikes.
  • Lantus (Long-acting): Works over a longer period to provide a basal level of insulin.
• Why is it important for Mrs. Thompson to take Humalog before each meal?
  • Humalog is rapid-acting, which means it starts working quickly to counteract the rise in blood sugar that occurs after eating. It helps manage postprandial hyperglycemia.
• What is the purpose of Lantus being administered at bedtime? How does this relate to its action as a long-acting insulin?
  • Lantus is a long-acting insulin, so it provides a steady level of insulin throughout the night and day. Administering it at bedtime helps maintain stable blood sugar levels overnight and into the next day, without significant peaks.