Diabetic Patient Multifactorial Considerations
Discussion 5: Multifactorial Considerations
A 45-year-old obese female has been diagnosed with Type 11 diabetes but does not want to commence insulin despite the HgbAIC of 8.5. There is a need to consider the cultural, ethical, and legal issues that are devising a comprehensive treatment plan. The illness is inextricable from the context of the patient’s life, comprising the intersections of cultural, political, social, economic, and spiritual factors, which include all determinants of health. The cultural, family, religion, and social influences shape one’s beliefs and attitudes that define health and treatment (Rebolledo & Arellano, 2016). The establishment of a stable patient-care provider relationship is essential in the early development of type 2 diabetes to reveal the cultural values, perceptions, and beliefs that might inhibit or influence insulin therapy. For instance, there are negative perceptions concerning insulin amongst the Hispanics, African Americans, and Asians, which affects the patient’s final decisions concerning pharmacological therapies. Therefore, cultural perceptions should be addressed prior to the development of the treatment plan. Get help with Diabetic Patient Multifactorial Considerations initial discussion.
Even though there is no blueprint for analysis of the dilemma, the mnemonic ETHICAL framework will be applied to offer a systematic technique for acting consistently based on reason instead of emotion in guiding one’s actions. Furthermore, clinicians integrate the bioethical principles in everyday reasoning to respond to explicit dilemmas despite the diversity of their moral traditions. All ethical conflicts faced by a clinician can call for the use of different principles: Autonomy, Beneficence, nonmaleficence, veracity, confidentiality, fidelity, and justice (Dunphy et al. 2019). In this case, the autonomy ethical principle is applicable as it deals with the personal liberty of action, self-determination, and respect. The autonomy principle emphasizes the significance of choice and individual freedom. The principle is the foundation for informed consent, medical decisions, and access to health care. Therefore, the patient should be given options and letting them select their course of action to nurture their wholeness. From a legal perspective, informed consent consists of two elements: the information about the treatment and autonomous agreement. Therefore, in this scenario, the patient should receive and fully understand all information that can affect a reasonable individual’s decision to consent or refuse the treatment.
Type 2 diabetes is considered as chronic illness that necessitates continuing care and education aimed at preventing acute and chronic complications. On initial diagnosis, the female patient should also consult a certified diabetes educator as well as dietitian. Besides, the proposed treatment program will constitute the regular self-monitoring of glucose coupled with medical, nutritional therapy with weight loss plan, regular exercise, and oral glucose-reducing agents/insulin (Ali, 2015). The lifestyle behavior changes will improve glycemic control with repeated and concise direction while exercise and diet therapy should be addressed with explicit instructions (Beaser, 2014). Metformin is used either as monotherapy or a combination of insulin or sulfonylureas as the first-line drug that has been recommended by the ADA and European Association for Diabetes Study (Dunphy, et al., 2019). The initial dosage is 500 milligram once a day with either dinner or breakfast for seven days, then increased to twice with dinner and breakfast. After that, the dosage will be titrated towards the maximum dosage of 2,000 mg/day.
The provision of optimal diabetes care aimed at achieving the desired care outcomes can be somewhat difficult. But, an in depth understanding the sides, culture, values, religious, and social influences, as well as language restrictions, can facilitate the delivery of optimal care. This allows both the patient and provider to accomplish their mutual goals of improved health. Consistent with the autonomy ethical principle, the importance of insulin therapy as part of diabetes management will be a constant discussion introduced at the diagnosis stage (Caballero, 2018). It continues until the patient understands the importance of insulin. With the appropriate information, the patient will most likely ready to commence insulin therapy. In summary, the follow up is the continuing patient education on preventing and treating complications and regular evaluation of the treatment goals. Order Diabetic Patient Multifactorial Considerations discussion from Course Researchers.
References
Ali, M. A. I. (2015). A new approach in Type 2 diabetes mellitus treatment: Evaluation of the beneficial effect of L-cysteine in the treatment of type 2 diabetes mellitus. Hamburg: Anchor Academic Publication.
Beaser, R. S., & Joslin Diabetes Center. (2014). Joslin’s diabetes deskbook: A guide for primary care providers. Boston, MA: Joslin Diabetes Center.
Caballero, A. E. (August 28, 2018). The “A to Z” of managing type 2 diabetes in culturally diverse populations. Frontiers in Endocrinology, 9.
Dunphy, L. M. H., In Winland-Brown, J. E., In Porter, B. O., & In Thomas, D. J. (2019). Primary care: The art and science of advanced practice nursing. Philadelphia, PA: F.A. Davis Company.
Rebolledo, J. A., & Arellano, R. (January 01, 2016). Cultural Differences and Considerations When Initiating Insulin. Diabetes Spectrum : a Publication of the American Diabetes Association, 29, 3, 185-190.