Factors affecting serum cholesterol levels
Discuss about the Consequences of Breastfeeding on Cholesterol.
The patient named Mavin is a 45-year-old indigenous woman who is presently caring for her husband who has faced leg amputation due to vascular disorders. On close analysis of the different disorders that the patient is going through, it is noticed that she is having a wound that is not healing well at all. This is mainly seen that the person is suffering from diabetes from the past ten years and had not been able to maintain the symptoms well. She is often seen to forget the medications on the right time and therefore, it becomes extremely difficult for the patient to maintain her symptoms properly. When she had visited the healthcare centre, she had quite high values in different tests conducted by the healthcare professionals. Her blood pressure was quite high for about 180/90 that is quite higher than the normal blood pressure of 120/80 (Madiraju et al. 2014). The pulse was 94 that were within the safe range of 60 to 100. The serum cholesterol level was found to be 8.4 mmol/L. The normal value mainly should state below 5.2 mmol/L. when it becomes higher than 6.2 mmol/L, it is considered to be high. So the patient has high cholesterol level. The triglyceride level was found to be above the high level of 5.6 mmol/L and therefore, it becomes extremely important to consider these abnormal tests results while developing care plan and developing medication plans. The HbA1c level is also found to be 8. Researchers are of the opinion that a value of below 65 is extremely important to be set for maintaining proper glucose level in blood (Aroda et al., 2015).
The term HbA1c mainly means glycated haemoglobin. When the protein called hemoglobin present within the red blood cells are attached with glucose present in the blood and carries oxygen throughout the body, it is seen to become glycated. With the help of measuring the glycated hemoglobin, the healthcare professionals can successfully understand the overall picture of the blood sugar levels that have been present over a period (Balselles et al., 2015). It is evident from the case study, that the patient has high levels of HbA1c that in turn indicates poorly maintained diabetic condition in the patient. The increase of the serum cholesterol level and the increase of the triglycerides are well associated with the improper maintenance of diabetes. Researchers are of the opinion that when the patients do not effectively control the diabetes, there will be high level of glucose as well as insulin in the blood. When insulin is present, it results in the conversion of glucose into the glycogen that thereby helps in the storage of glycogen in the liver. When the liver is seen to become too much saturated with glycogen, glucose is seen to be utilized for the creation of the fatty acids that are realized in the blood stream (Cafes et al., 2015). In course of time, it is seen that these fatty acids are seen to make more number of glycerides that result in building up of fat in the cells. This is in turn seen to result in development of body fat that creates a situation of obesity. Researchers are of the opinion that high levels of glucose caused by the occurrence of diabetes over time affect the nerves resulting in neuropathy and thereby they can lead to poor circulation of blood. Therefore, blood required for skin repairment for reaching the areas of the body affected by sores and wounds cannot be obtained (Stokum et al., 2017). These mainly result in the wounds remaining open as well as unhealed for months resulting in gangrene, fungal infections as well as bacterial infections.
Medication options for controlling cholesterol levels
Therefore, effective medications need to be taken by the patient so that she can effectively control the symptoms of diabetes and thereby get free from the disorders that are resulting from the source of poor management of diabetes. Therefore, in such situation, metformin can be used. The nursing professionals should help the patient develop education and knowledge about the use of medication so that the patient becomes careful about her approach towards medication and aligns with the medication regime to keep her fit (Farmer et al., 2016). The professionals should provide metformin with proper diet and exercise along with other medications for controlling the high blood sugar. She should be taught that controlling the high blood sugar level may result in prevention of the kidney damage, blindness, loss of limbs, nerve problems as well as sexual function problems. Proper controlling of the diabetes would also help the patient to be safe from heart attack and stroke. All these education would help het to become more serious about her health and take medications diligently. Metformin mainly acts by two ways. It helps in restoring the proper response of the body to the insulin that is naturally produced by type 2 diabetes patients. It also helps in the decreasing of the amount of sugar that the liver makes and the amount of sugar that the intestine absorbs (Harshman et al., 2017). This would prevent in the formation of triglycerides in the body. In most of the cases, the sugar level, which increases in the blood, becomes very difficult for the patients to maintain. Although many of the patients can maintain them through proper diet with absence of glucose but in other cases, patients need the help of gibenclamide. Gibenclamide is mainly seen to be a fast acting oral-antidiabetic medication that helps in controlling the blood sugar level in type 2 diabetic patients (forslund et al., 2015). Researchers are of the opinion that for betterment of the affectivity of the medication, healthcare professionals should influence the patients to have that drug along with controlled diet and exercises regularly so that better results can be obtained. Atorvastatin is one of the drug that when taken with proper diet mainly helps in the lowering the bad cholesterol or fats such as the LDL and triglycerides. It helps in raising the good cholesterol or the HDL in the blood (Moss et al., 2017). This drug is mainly seen to work by the reduction of the amount of cholesterol made by the liver. This drug mainly helps in decreasing the risk of the heart diseases and thereby helps in prevention of strokes as well as heart attacks. The nursing professionals should educate the patient that all these medications will only show benefit when they are combined with low cholesterol and low fat food. Lifestyle changes that will result in helping these medications to work mainly include exercising, losing weight when overweight and stopping smoking (Adams et al., 2015) . The nursing professionals should also educate the patients about the various kinds of side effects that each of the medication may result. They should also provide the patient with effective coping strategies so that the patient do not suffer and rather live a better quality life.
Lifestyle changes to control diabetes
The culture of the indigenous people makes them highly vulnerable for alcohol consumption as well as tobacco smoking throughout the entire period of their life. Therefore, the professional should warn the patient about the interaction of alcohol with atorvastatin that might result in harmful liver disorders (Rosenquist et al., 2015). Researchers have stated that alcohol consumption in large quantities with gidenclamide should be stopped as that might have adverse effects on the individuals by the improper control of the blood sugar levels after drinking alcohol. Researchers have also stated that drinking of alcohol with that of metformin should be limited as it may result in lactic acidosis and development management of low blood sugar level (Horta et al., 2015).
References:
Adams, I. (2015). Diabetes and Cholesterol [2015].
Aroda, V. R., Christophi, C. A., Edelstein, S. L., Zhang, P., Herman, W. H., Barrett-Connor, E., … & Knowler, W. C. (2015). The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the Diabetes Prevention Program outcomes study 10-year follow-up. The Journal of Clinical Endocrinology & Metabolism, 100(4), 1646-1653.
Balsells, M., García-Patterson, A., Solà, I., Roqué, M., Gich, I., & Corcoy, R. (2015). Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: a systematic review and meta-analysis. Bmj, 350, h102.
Caffes, N., Kurland, D. B., Gerzanich, V., & Simard, J. M. (2015). Glibenclamide for the treatment of ischemic and hemorrhagic stroke. International journal of molecular sciences, 16(3), 4973-4984.
Dalli, J., Chiang, N., & Serhan, C. N. (2015). Elucidation of novel 13-series resolvins that increase with atorvastatin and clear infections. Nature medicine, 21(9), 1071.
Farmer, A. J., Oke, J., Hardeman, W., Tucker, L., Sutton, S., Kinmonth, A. L., … & Holman, R. R. (2016). The effect of a brief action planning intervention on adherence to double-blind study medication, compared to a standard trial protocol, in the Atorvastatin in Factorial with Omega EE90 Risk Reduction in Diabetes (AFORRD) clinical trial: a cluster randomised sub-study. Diabetes research and clinical practice, 120, 56-64.
Forslund, K., Hildebrand, F., Nielsen, T., Falony, G., Le Chatelier, E., Sunagawa, S., … & Arumugam, M. (2015). Disentangling type 2 diabetes and metformin treatment signatures in the human gut microbiota. Nature, 528(7581), 262.
Harshman, S. G., Shea, M. K., Fu, X., Smith, D., Grusak, M. A., Lamon-Fava, S., … & Booth, S. L. (2017). Atorvastatin Decreases Menaquinone-4 Formation in C57Bl6 Male Mice. The FASEB Journal, 31(1 Supplement), 646-11.
Horta, B. L., Loret de Mola, C., & Victora, C. G. (2015). Long?term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta?analysis. Acta Paediatrica, 104(S467), 30-37.
Madiraju, A. K., Erion, D. M., Rahimi, Y., Zhang, X. M., Braddock, D. T., Albright, R. A., … & Jurczak, M. J. (2014). Metformin suppresses gluconeogenesis by inhibiting mitochondrial glycerophosphate dehydrogenase. Nature, 510(7506), 542.
Moss, J., Stylianou, M., Levine, S. J., Barochia, A. V., Weir, N., Parrish, S., … & Browning, R. (2017). Atorvastatin Treatment For Pulmonary Sarcoidosis, A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Am J Respir Crit Care Med, 195, A4755.
Moss, J., Stylianou, M., Levine, S. J., Barochia, A. V., Weir, N., Parrish, S., … & Browning, R. (2017). Atorvastatin Treatment For Pulmonary Sarcoidosis, A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Am J Respir Crit Care Med, 195, A4755.
Rosenquist, K. J., Massaro, J. M., Pedley, A., Long, M. T., Kreger, B. E., Vasan, R. S., … & Fox, C. S. (2015). Fat quality and incident cardiovascular disease, all-cause mortality, and cancer mortality. The Journal of Clinical Endocrinology & Metabolism, 100(1), 227-234.
Stokum, J. A., Keledjian, K., Hayman, E., Karimy, J. K., Pampori, A., Imran, Z., … & Simard, J. M. (2017). Glibenclamide pretreatment protects against chronic memory dysfunction and glial activation in rat cranial blast traumatic brain injury. Behavioural brain research, 333, 43-53.
Tsujita, K., Sugiyama, S., Sumida, H., Shimomura, H., Yamashita, T., Yamanaga, K., … & Nakamura, S. (2015). Impact of dual lipid-lowering strategy with ezetimibe and atorvastatin on coronary plaque regression in patients with percutaneous coronary intervention: the multicenter randomized controlled PRECISE-IVUS trial. Journal of the American College of Cardiology, 66(5), 495-507.
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