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Diabetes management: optimizing roles for nurses in insulin initiation.

Levich BR - J Multidiscip Healthc (2011)

Bottom Line: Clinical nurse specialists possess specific training and skills to provide this level of care, while staff or office-based nurses may be trained by physicians to fulfill a task-specific role.This manuscript reviews the benefits of intensive glycemic control in type 2 diabetes, therapeutic goals and guidelines, advances in insulin therapy, and contribution of nurses in overcoming barriers to insulin initiation and related aspects of diabetes care.Nurses are particularly well positioned to fill the gap and improve efficiency in diabetes-related healthcare by assisting patients with insulin initiation and other aspects of glycemic self-management.

View Article: PubMed Central - PubMed

Affiliation: University of California Davis Health System, Sacramento, CA, USA.

ABSTRACT
Type 2 diabetes is a major public health concern. Screening and early diagnosis followed by prompt and aggressive treatment interventions can help control progression of diabetes and its complications. Nurses are often the first healthcare team members to interact with patients and are being called on to apply their specialized knowledge, training, and skills to educate and motivate patients with diabetes about insulin use and practical ways to achieve treatment goals. Clinical nurse specialists possess specific training and skills to provide this level of care, while staff or office-based nurses may be trained by physicians to fulfill a task-specific role. This manuscript reviews the benefits of intensive glycemic control in type 2 diabetes, therapeutic goals and guidelines, advances in insulin therapy, and contribution of nurses in overcoming barriers to insulin initiation and related aspects of diabetes care. Nurses are particularly well positioned to fill the gap and improve efficiency in diabetes-related healthcare by assisting patients with insulin initiation and other aspects of glycemic self-management.

No MeSH data available.


Related in: MedlinePlus

Approximate pharmacokinetic profiles of rapid- and long-acting insulin analogs as compared with an idealized profile of physiological insulin secretion.44Copyright © 2007 [Lippincott, Williams & Wilkins] Reprinted with permission from Boyle PJ, Zrebiec J. Management of diabetes-related hypoglycemia. South Med J. 2007;100(2):183–194.44
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Related In: Results  -  Collection


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f2-jmdh-4-015: Approximate pharmacokinetic profiles of rapid- and long-acting insulin analogs as compared with an idealized profile of physiological insulin secretion.44Copyright © 2007 [Lippincott, Williams & Wilkins] Reprinted with permission from Boyle PJ, Zrebiec J. Management of diabetes-related hypoglycemia. South Med J. 2007;100(2):183–194.44

Mentions: Older human insulin formulations (eg, neutral protamine Hagedorn [NPH] and regular insulin) are characterized by unpredictable pharmacokinetic and pharmacodynamic time–action profiles that produce variable effects. When the physiological or normal pattern of insulin response to food intake is not reproduced, hypoglycemia and weight gain can occur.41,42 These undesirable effects, in turn, result in a low degree of satisfaction and poor therapy adherence. Fortunately, the choices of insulin formulations and delivery systems have expanded considerably in the last decade.23,43 Insulin analogs were specifically designed to mimic the body’s physiological insulin response (Figure 2).44


Diabetes management: optimizing roles for nurses in insulin initiation.

Levich BR - J Multidiscip Healthc (2011)

Approximate pharmacokinetic profiles of rapid- and long-acting insulin analogs as compared with an idealized profile of physiological insulin secretion.44Copyright © 2007 [Lippincott, Williams & Wilkins] Reprinted with permission from Boyle PJ, Zrebiec J. Management of diabetes-related hypoglycemia. South Med J. 2007;100(2):183–194.44
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3065562&req=5

f2-jmdh-4-015: Approximate pharmacokinetic profiles of rapid- and long-acting insulin analogs as compared with an idealized profile of physiological insulin secretion.44Copyright © 2007 [Lippincott, Williams & Wilkins] Reprinted with permission from Boyle PJ, Zrebiec J. Management of diabetes-related hypoglycemia. South Med J. 2007;100(2):183–194.44
Mentions: Older human insulin formulations (eg, neutral protamine Hagedorn [NPH] and regular insulin) are characterized by unpredictable pharmacokinetic and pharmacodynamic time–action profiles that produce variable effects. When the physiological or normal pattern of insulin response to food intake is not reproduced, hypoglycemia and weight gain can occur.41,42 These undesirable effects, in turn, result in a low degree of satisfaction and poor therapy adherence. Fortunately, the choices of insulin formulations and delivery systems have expanded considerably in the last decade.23,43 Insulin analogs were specifically designed to mimic the body’s physiological insulin response (Figure 2).44

Bottom Line: Clinical nurse specialists possess specific training and skills to provide this level of care, while staff or office-based nurses may be trained by physicians to fulfill a task-specific role.This manuscript reviews the benefits of intensive glycemic control in type 2 diabetes, therapeutic goals and guidelines, advances in insulin therapy, and contribution of nurses in overcoming barriers to insulin initiation and related aspects of diabetes care.Nurses are particularly well positioned to fill the gap and improve efficiency in diabetes-related healthcare by assisting patients with insulin initiation and other aspects of glycemic self-management.

View Article: PubMed Central - PubMed

Affiliation: University of California Davis Health System, Sacramento, CA, USA.

ABSTRACT
Type 2 diabetes is a major public health concern. Screening and early diagnosis followed by prompt and aggressive treatment interventions can help control progression of diabetes and its complications. Nurses are often the first healthcare team members to interact with patients and are being called on to apply their specialized knowledge, training, and skills to educate and motivate patients with diabetes about insulin use and practical ways to achieve treatment goals. Clinical nurse specialists possess specific training and skills to provide this level of care, while staff or office-based nurses may be trained by physicians to fulfill a task-specific role. This manuscript reviews the benefits of intensive glycemic control in type 2 diabetes, therapeutic goals and guidelines, advances in insulin therapy, and contribution of nurses in overcoming barriers to insulin initiation and related aspects of diabetes care. Nurses are particularly well positioned to fill the gap and improve efficiency in diabetes-related healthcare by assisting patients with insulin initiation and other aspects of glycemic self-management.

No MeSH data available.


Related in: MedlinePlus