Question

A nurse is monitoring the laboratory values of a client who has diabetes mellitus and is taking insulin. Which of the following results indicates a therapeutic outcome of insulin therapy?

Answer 1

The therapeutic outcome of insulin therapy is indicated by a significant decrease in blood glucose levels after an insulin dose, helping to determine appropriate insulin responsiveness and dosage. Maintaining normal glucose levels while avoiding hypoglycemia is key to effective diabetes management.

Step-by-step explanation:

The laboratory values that indicate a therapeutic outcome of insulin therapy for a client with diabetes mellitus are normal or near-normal blood glucose levels post-meal (postprandial glucose) or fasting blood glucose levels. During an insulin tolerance test, a patient is given an intravenous dose of insulin and subsequently, their blood glucose is monitored. A therapeutic outcome would be evident if there is a significant decrease in blood glucose levels in response to the insulin. Achieving normal blood glucose levels after consuming a meal, as noted within 1.5 hours, suggests that the insulin injections are effective in allowing transport and storage of glucose, thus lowering blood glucose levels appropriately.

However, it is crucial to avoid hypoglycemia or excessively low blood sugar levels. Constant hyperglycemia may indicate an inadequate response to insulin therapy or the presence of insulin antagonists. In contrast, hypoglycemia might suggest an overadministration of insulin dosage. Renal function also plays a role in glucose regulation and must be considered.

For a client with type 2 diabetes, hormone resistance might indicate a decreased response to insulin, whereby body cells become resistant to insulin, leading to persistently high blood glucose levels. The addition of insulin therapy may sometimes be necessary to facilitate glucose uptake by these resistant cells.

Answer 2

A therapeutic outcome of insulin therapy for a client with diabetes mellitus is indicated by normalized blood glucose levels, typically within 1.5 hours after eating. Continuous hypoglycemia suggests the insulin dosage might be too high, whereas hyperglycemia indicates potential insulin resistance.

Step-by-step explanation:

The therapeutic outcome of insulin therapy in someone with diabetes mellitus is indicated by the normalization of blood glucose levels. When insulin therapy is effective, blood glucose will decrease to a normal range shortly after eating, usually within 1.5 hours. This demonstrates that insulin facilitates the uptake and storage of glucose by the body's cells, which helps to decrease blood glucose levels following a meal that contains carbohydrates. However, if severe and persistent hypoglycemia occurs, this could suggest that the dosage of insulin is too high and needs adjustment. Conversely, high blood glucose levels, or hyperglycemia, may indicate insulin resistance, where target cells do not respond adequately to insulin, as can be seen in some cases of type 2 diabetes.