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Heath Professional Essentials - Health Care Assessment Answers

November 02, 2018
Author : Ashley Simons

Solution Code: 1EAG

Question: Health Care Essential

This assignment is related to ”Healthcare” and experts atMy Assignment Services AUsuccessfully delivered HD quality work within the given deadline.

Marketing Case Study Assignment

Diabetes mellitus is a major world health problem. Treatment and management of diabetics is a very significant issue for governments, society and both pharmacists and pharmaceutical companies. Completing this assignment will help you to gain a deeper understanding of diabetes mellitus.

The length ofthis assignment excluding graphs, figure legends and references should be no more than 1000 words. The % of marks allocated to each section is a guide to the word length for that section. Where appropriate references should be included using the Harvard System cited appropriately in the text with correct formatting in the reference list. As a guide a minimum of 4 but no more than about 12 references should be used. You are advised to use references from both primary and secondary sources.

Assignments should be typed and submitted using learn online via the Course Website. Graphs must be thoughtfully incorporated into the text.

Due date/time is 6:00pm 9thJune.

  1. Why is the disease given the name diabetes mellitus? How does diabetes mellitus differ from diabetes insipidus?
  2. Individuals with the diabetes mellitus are classified into two main groups. What are they and what is the basis of the classification system used?
  3. How are patients diagnosed as diabetics? What treatment options are most used to manage this condition?
  4. What changes in the metabolism of glucose and fat (triglycerides) are observed in this disease? What symptoms might a diabetic show as a result of these metabolic changes and why do these occur?
  5. Two overnight fasting patients, A & B, were each given a dose of 75g of glucose at time zero. Their blood glucose levels were measured at 0, 30, 60, 90, 120 and 240 minutes after ingestion of the glucose using aglucose specific assay. The brief procedure for this assay is:-

  • Add 5.0 ml of assay reagent to sufficient tubes for the assay
  • Add 0. 1 ml of each glucose standard to a tube of assay reagent
  • Add 0. 1 ml of each test serum to a tube of assay reagent.
  • Mix the contents of each tube and read the absorbance at 625 nm.

The results obtainedare shown in the two tables below.

Table 1 - standards

Glucose standard (mmol/L) Absorbance @ 625 nm
0 0.02
3 0.21
6 0.43
9 0.65
12 0.83

Table 2 – patient results

Time (min) Absorbance-Patient A Absorbance-Patient B
0 0.26 0.47
30 0.51 0.63
60 0.25 0.82
90 0.23 0.81
120 0.24 0.71
240 0.30 0.68

Plot a standard graph of absorbance at 625 nm against glucose concentration You must use Excel.

Determine the concentration of glucose in each patient serum sample and plot glucose concentration against the time over which the samples were obtained.

Comment on the results for the two patients

  1. What potential long-term problems would a pharmacist need to be aware of when advising a diabetic client?

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Solution: Diabetes Mellitus

Why is the disease given the name diabetes mellitus? How does diabetes mellitus differ from diabetes insipidus?

Diabetes is commonly referred to as diabetes mellitus denoted by high blood sugar level. The reason could be inadequate insulin production or cells of the body are not capable of responding to sugar level with in blood. Diabetes is derived from Greek word meaning ‘to pass something by some means’ and Mellitus is a Latin word meaning ‘sweet’. Excess blood sugar level is represented by word ‘Mellitus’.

Diabetes mellitus has characteristics of high blood sugar, presence of glucose in urine, excessive urination, excessive thirst & hunger. It is related to pancreatic disorder resulting from insulin deficiency within cells. This gives raise to high sugar level within blood stream which is excreted along with urine. An individual has sign of excessive hunger and thirst. In contrast to this, diabetes insipidus is referred to as a hypothalamic disorder due to hypo secretion of vasopressin. It is known for excessive dilute urination in large quantities that results into excessive water intake. It is not related with high sugar level and presence of ketone bodies in urea (American diabetes association, 2013).

  1. Individuals with the diabetes mellitus are classified into two main groups. What are they and what is the basis of the classification system used?

Diabetes mellitus has been categorized into two types- Type I & Type II. The classification is based upon insulin production. Type I is known as insulin dependent diabetes mellitus disorder which occurred due to insulin production deficiency within pancreatic cells. Either beta cells are not able to produce enough insulin or they are absent. Type II is an autosomal disorder which appears at an older age when cells do not absorb sugar from blood stream. It is also known as insulin independent diabetes mellitus (American diabetes association, 2013.

  1. How are patients diagnosed as diabetics? What treatment options are most used to manage this condition?

Diabetes is diagnosed through a blood test. Early onset of diabetes type II disease is difficult to diagnose because of absence of symptoms. Glucose measuring devices are also used for quick measurement of high sugar level though they are not reliable. The following tests can be performed – hemoglobin A1c, FPG (fasting plasma glucose), OGTT (oral glucose tolerance test), and RPG (random plasma glucose). RPG is generally used during regular health camps or check-ups. If it indicates sugar level 200 mg/deciliter than an individual may be assessed further for diabetes. Diabetic symptoms are also measured such as weight loss, excessive urination and thirst along with high sugar level (American diabetes association, 2013.

Diagnostic criteria for diabetes

A1C Test (mg/dl) FPG Test (mg/dl) OGTT Test (%)
Normal 5 Equals to 99 or below Equals to 135 or below
Diabetes Equals to 6.5 or above Equals to 126 or above Equals to 200 or above

 

  1. What changes in the metabolism of glucose and fat (triglycerides) are observed in this disease? What symptoms might a diabetic show as a result of these metabolic changes and why do these occur?

Blood sugar is controlled in an order to prevent any future complication of diabetes. Physical changes and proper nutrition is required to follow for type I diabetes. Management of type II diabetes includes medication, healthy eating behavior, monitoring & evaluation of sugar level, regular physical activity. Type II diabetes can be managed by adopting health behavior but few requires insulin therapy or medications to control sugar level (Stoneking, 2005). Medications include metformin, sulfonylureas, thiazolidinediones etc. Insulin therapy is given as a last resort. Different types of injections are administered – humulin N, levemir, apidra etc .

Balance between glucose utilization and production keeps plasma glucose within normal range. Insulin is known to regulate glucose level as it function as gluco-regulatory hormone. It prevents hepatic glucose production and high glucose concentration after meal. In contrast to this, glucagon increases glucose production by acting on liver. Insulin concentration promptly rises after carbohydrates ingestion and in reverse glucagon concentration decreases (Giugliano, Ceriellom & Esposito, 2008). In a healthy person, glucose production and utilization rate ranges from 1.8-2.5 mg·kg?1·min?1. Glucose absorption suppressed endogenous glucose production and this accelerates utilization of glucose by muscles and liver. This results into assimilation of exogenous glucose and the glucose concentration within plasma returns to its normal range. During diabetes, insulin deficiency occurs due to islet dysfunction. This causes for high glucagon to insulin ratio and causes high glucose production in liver cells. Insulin converts glucose into glycogen and stores in liver. Any remaining glucose is stored as saturated fat. Glucagon acts by converting glycogen into glucose and releases into blood stream causing diabetes mellitus (Basu, Shah, Nielsen & Rizza, 2004).

Insulin is involved in activation of hexokinase enzyme, phosphofructokinase, glycogen synthase involved in glycogen synthesis in liver while inhibits glucose 6 phosphatase responsible for glycogen breakdown. In a diabetic patient, enzymes involved for glycogen breakdown get activated in absence of insulin or presence of glucagon leading high blood glucose level.

Insulin promotes synthesis of fatty acid by taking up additional glucose from blood. The process occurs in hepatocytes and finally exported as lipoproteins from liver. These lipoprotein becomes source of fatty acids for various tissues such as adipocytes. Fatty acids are used for triglyceride synthesis. Insulin inhibits activity of lipase enzyme involved in release of fatty acids by breakdown of triglycerides within adipose tissue. Inadequate insulin production results into release of fatty acids (Aronoff, Berkowitz, Shreiner & Want, 2004).

As a result of glucose and fat metabolism, diabetic patients have high level of plasma glucose and ketoacidosis. Additional symptoms could be excessive hunger, thirst, lipemia, polyuria etc.

  1. Plot a standard graph of absorbance at 625 nm against glucose concentration. Determine the concentration of glucose in each patient serum sample and plot glucose concentration against the time over which the samples were obtained.

The graph below represents a linear relation between glucose concentration and light absorbance at 625 nm.

Following the Beer’s law the best fit line is calculated from the above graph. It is evident that 8 mmol/L at absorbance value of 0.65 gives the best estimate and further can be used to calculate glucose concentration of two different samples (patient A and patient B). Patient B has high level of glucose in comparison with patient A. A steep increase was observed for patient A after 30 minute time period which starts decreasing after that and becomes somewhat stable. Patient B recorded high glucose concentration even after 60 and 90 minutes and stability was not seen after 2-3 hours. Glucose level above 200 mg/dl shows diabetic symptoms and below it a nondiabetic condition is considered that does not need any medicine except health behavior pattern. Patient B needs an immediate medical assessment for further validation.

  1. What potential long term problems would a pharmacist need to be aware of when advising a diabetic client?

A pharmacist must be aware of the long term side effects of using drugs for diabetes management. He must conveyed a message that maintenance of healthy behavior is an effective treatment therapy rather than adhering to medication. He must be trained enough to motivate people for healthy habits and raise their awareness level.

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