Type 2 diabetes mellitus is often accompanied by a number of dysfunctions resulting from prolonged hyperglycemic circumstances and a combination of insulin action, inadequate insulin production, and excessive glucagon secretion (Goyal & Jialal,2018). Diabetes and chronic hyperglycemia can cause damage to vital organs and macrovascular issues. The American Diabetes Association and Clinical Endocrinologists’ American Association recommend that insulin be used with care for patients suffering from type 2 diabetes with HbA1c levels between 9.0% to 10%. (Bloomgarden, 2017). The Type 2 diabetes patient we have in this case is reluctant to start insulin therapy despite her higher HgbA1c. It could be because of her personal values. Therefore, it is important to respect the patient’s decision about treatment. Therefore, we should investigate alternative treatment strategies that take into consideration her cultural, legal and ethical values.
Based on patient age, life expectancy and other factors, an optimal treatment plan would include education (medical nutritional therapy, diet, exercise, and diet), evaluation of cardiovascular prevalence factors, and the avoidance of medication that may cause insulin abnormalities. The therapies can significantly lower hyperglycemia and prioritize insulin supply by enhancing insulin sensitivity.
Even though these alternative treatment options may be available, there are significant ethical concerns, especially when it comes to self-management. Insufficient preparation by the family or patient will limit the patient’s capacity to manage her own affairs without putting herself at risk. A second problem is when the patient empowerment philosophy does not provide sufficient support for the patient or her family. This could lead to the patient being forced to take on more responsibility than she and her family can handle. These ethical dilemmas must be balanced with the other aspects of life. It is important to manage possible consequences.
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