Discussion: Diabetes and Memory
NOW FOR AN ORIGINAL PAPER ASSIGNMENT:Discussion: Diabetes and Memory
I would ask how often she checks her glucose levels at home and if she has an appropriate meter or test strips. I would also ask about any new or existing issues or problems she has noticed. I would discuss why she takes Ginseng and Aricept and the dosages of both.
What would be your position on the Ms. GMs use of alternative supplements for her diabetes and memory? Explain and include contraindications, if any.
I would advise Ms. GM to discontinue the use of Ginseng and Cassia Cinnamon because of the interactions with Coumadin and glucose levels. The Ginseng interacts with Coumadin causing increase or decrease on coagulations and interacts with insulin causing hypoglycemia in people with diabetes (Ginseng, 2018). There have also been reported potential interactions between cinnamon and warfarin and are labeled as significant, which means there is an increased risk of an interaction occurring and are not recommended for use together. Cassia cinnamon contains high levels of coumarins which are likely toxic in high doses (Kawatra & Rajagopalan, 2015).
Are there any additional test/assessments you would complete for this patient given this list of medications? Explain.
Yes. The additional test/assessments I would complete for this patient include clotting times (PT & INR and PTT), and blood glucose levels including an A1C, because these should be closely monitored. I would explain to the patient that, according to NIH (2018), her current use of the supplement’s cinnamon and ginseng with Aricept and Coumadin is not safe. Medications, like Coumadin, require a certain therapeutic range, which may be compromised by the supplements. The use of the supplement can cause the levels to be too high or too low which would cause the medication to either become toxic or sub-therapeutic. Cassia Cinnamon has been reported to worsen liver disease, so I would perform a metabolic panel to check liver function (NCCIH, 2017). A complete blood cell count (CBC) would also be obtained to check for infection, anemia, and assess platelet count.
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