Diabetes Mellitus Q 60 - Gyan Darpan : Learning Portal
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Thursday, 7 April 2022

Diabetes Mellitus Q 60

A client diagnosed with type 1 diabetes receives insulin. He asks the nurse why he can’t just take pills instead. What is the best response by the nurse?
    A. "Insulin must be injected because it needs to work quickly."
    B. "Insulin can't be in a pill because it is destroyed in stomach acid."
    C. "Have you talked to your doctor about taking pills instead?"
    D. "I know it is tough, but you will get used to the shots soon."

Correct Answer: B. “Insulin can’t be in a pill because it is destroyed in stomach acid.”

Insulin must be injected because it is destroyed in the stomach acid if taken orally. Insulin is a particularly difficult drug to ingest orally. It is a protein that degrades in the stomach and small intestine, making it almost impossible to design oral delivery which works.

Option A: The onset of insulin action is not the issue here. Insulin delivery via the stomach would transport the much-needed hormone directly to the liver, where it could mimic the action of endogenous insulin.
Option C: The nurse should answer the client’s question, not refer him back to the physician. At this stage, insulin remains too complex a protein to survive within the environment of the body. Leading pharmaceutical companies are thought to be using protein engineering to bring the insulin pull one step closer.
Option D: Telling he will get used to shots does not answer his question and is condescending. Giving diabetes patients the chance to avoid the pain of needles has been the goal of many pharmaceutical companies for many years.

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