Critically analyse the suitability of insulin pump therapy for Brendan based on National guidelines and current evidence base.
Insulin Pump Assessment lf you are sitting the PGA or Masters degree you are required to complete two pieces of course work for this module. These are: 1. A written assignment – you will be given one question (2,500 words) 2. A case study – you will be given a case study and questions to complete (1,500 words) Both components must reach a pass standard for the module to be successfully completed. Adult Assessment Written assignment (2,500 words): Critically analyse and evaluate the current evidence base with regard to the benefits and drawbacks of insulin pump therapy with particular reference to avoiding hypoglycaemia and improving quality of life in adults with diabetes. Case study (1,500 words) Brendan is 36 year old married man, who has two pre-school children. Currently Brendan works as a maintenance manager in a localfactory. Brendan enjoys his work despite the fact that he is contracted to work shifts, which does include nights. When he had time Brendan likes to play five a side football. Brendan was devastated, when age 24 he was diagnosed with Type 1 diabetes and he found it very difficult accepting his diagnosis. As a result Brendan intermittently attended clinic, rarely tested his blood glucose levels at home, glycaemic control was sub-optimal and he was admitted to hospital on several occasions as a result of ketoacidosis as he often missed insulin injections. Over time Brendan has developed retinopathy which required laser treatment to both eyes and at his last review it was noted that he was now had microalbuminurea which required treatment. Over the last 12 months Brendan has tried to turn his diabetes around and improve glycaemic control and stability. Brendan’s knowledge base in relation to diabetes has vastly improved since he attended the in house training programme which included carbohydrate management. Currently Brendan uses a multidose injection (MDl) regimen which incorporates an average daily insulin dose of 36 units of Aspart just before meals and 24 units of glargine at 10pm. Brendan however is very worried; although his HbAlc has improved he explains that he now has only intermittent warning signs and symptoms of hypoglycaemia. This situation has resulted in Brendan falling down the stairs and breaking his arm whilst alone and in charge of his children. Brendan has also experienced fits in the night which were hypoglycaemia related and required his wife to administer glucagon. Brendan is also very worried about his job as colleagues have started to notice that he is experiencing frequent episodes of hypoglycaemic episodes as work. Brendan has decided to run his blood glucose levels high as he explains that he is too frightened to try to obtain target values. Critically analyse the suitability of insulin pump therapy for Brendan based on National guidelines and current evidence base. Drawing on specific aspects from the case outlined above and utilizing current literature, how would you address the educational implications for the initiation of this new treatment regimen.
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