Endocrine Drugs and Medications Q 19
Drew is diagnosed with Type I diabetes mellitus. As a nurse taking care of the client, you should know that in his condition:
A. Insulin is produced but is malformed.
B. The beta cells of the pancreas stop producing insulin.
C. The client cannot be treated.
D. Diagnosis is made in clients over age 50.
Correct Answer: B. The beta cells of the pancreas stop producing insulin.
In type I diabetes mellitus, the beta cells stop producing insulin completely. T1DM is characterized by the destruction of beta cells in the pancreas, typically secondary to the autoimmune destruction of beta cells. The result is the absolute destruction of beta cells, and consequentially, insulin is absent or extremely low.
Option A: There is no such pathophysiologic process as malformed insulin. A patient with DM has the potential for hyperglycemia. The pathology of DM can be unclear since several factors can often contribute to the disease. Hyperglycemia alone can impair pancreatic beta-cell function and contributes to impaired insulin secretion. Consequentially, there is a vicious cycle of hyperglycemia leading to the impaired metabolic state. Blood glucose levels above 180 mg/dL are often considered hyperglycemic in this context, though because of the variety of mechanisms, there is no clear cutoff point.
Option C: Clients with type I diabetes can be treated with insulin. Since T1DM is a disease primarily due to the absence of insulin, insulin administration through daily injections, or an insulin pump, is the mainstay of treatment. Metformin is the first line of the prescribed diabetic medications and works by lowering basal and postprandial plasma glucose.
Option D: The diagnosis can be made in clients at any age. Globally, 1 in 11 adults has DM (90% having T2DM). The onset of T1DM gradually increases from birth and peaks at ages 4 to 6 years and then again from 10 to 14 years. Approximately 45% of children present before age ten years. The prevalence in people under age 20 is about 2.3 per 1000.