A diabetes registered nurse educator is preparing an in-service presentation for student nurses on agents to control blood glucose levels for diabetes mellitus. The in-service will include a brief review of the pathophysiology of diabetes mellitus. Drugs to be included in the presentation will include insulin, chlorpropamide (Diabinese), glyburide (Micronase), and metformin (Glucophage). (Learning Objectives 1, 4, and 5)

a. What alterations in metabolic pathways and changes to basement membranes occur with diabetes mellitus?
b. What are the key nursing implementation considerations for patients taking insulin?