Question

4-10. Ms Lee is a 35-year-old Asian woman comes to the clinic with complaints of chronic fatigue, increased thirst, constant hunger, and frequent urination. She denies any pain, burning, or low back pain on urination. She tells you she has a vaginal yeast infection that she has treated numerous times with over the counter medication. She works full time as a clerk in a loan company and states she has difficulty reading numbers and reports, resulting in her making frequent mistakes. She reports her feet hurt, they often bum or feeling like there are pins in them. She has a history of gestational diabetes and reports that after her delivery she went back to her traditional eating pattern, which is high carbohydrates. In reviewing her chart her weight is 183 lbs., her BP is 154/98mm Hg and random plasma glucose is 390mg/dl. The primary care provider suspects she has developed type 2 diabetes mellitus and the following lab test return: Fasting glucose-198 HLAIC.89 Cholesterol-278 LDL-C 190 HDL-32 UA-+glucose, -ketones 4. Identify 3 methods used to diagnose Diabetes? 5. Identify three functions of insulin? 6. Describe the major pathophysiologie difference between type 1 and type 2 Diabetes? 7. What are the risk factors for the development of type 2 Diabetes? Ms Lee is diagnosed with type 2 Diabetes. The PCP starts her on Metformin 500mg and Glipizide 5mg orally each day at breakfast and Atorvastin 20mg orally at bedtime. She is referred to the dietian for instruction on starting a 1200-calorie diet using an exchange system. You are providing education regarding pharmacotherapy and exercise. 8. What is the rational for starting her on Metformin, Glucotrol, and Atorvastatin? 9. What teaching do you need to provide regarding Diabetes? 10. What are some changes that Ms Lee can make to reduce to risk of slowing the progression of both microvascular and macrovascular disease?

Answer 1

4. Here doctor suspects that Ms. Lee may have diabetes from the sign and symptoms.

So the doctor uses three methods to diagnose diabetes.

a. The doctor send fasting blood glucose investigation to identify the present glucose level in the blood.

b. The doctor sends HbA1C to identify the average blood glucose level of the previous 3 months.

c. The doctor also sends urine analysis to identify the presence of glucose in the urine because in diabetes the excess blood glucose is excreted by the kidney through the urine.

Answer:- Fasting glucose test, HbA1C, urine analysis.

5.

Functions of insulin include

a. It controls the blood glucose level.

b. Insulin acts as a key for glucose to enter into the cell.

c. Insulin regulates storage of fats (Carbohydrate used as energy in our body, which is regulated by insulin but excess carbs are converted to triglycerides for future use which is regulated by insulin)

6.

Type 1 Diabetes Mellitus is known as insulin-dependent diabetes Mellitus because there is no insulin production due to the destruction of the beta-cell of the pancreas. the patient needs insulin to live.

Type 2 Diabetes Mellitus is known as Non-Insulin dependant diabetes Mellitus because there is insulin in the body but body is resistant to insulin or there is a lack of insulin production. In this case, a person does not require insulin in every case.

7.

Risk factors for Type 2 Diabetes Mellitus Includes.

- Older age(> 45)

- Family History

- Obesity

- High triglycerides or High LDL

- Inactivity

- Pancreatitis