Question

Mrs. Follex is a 51-year-old African American female who works as a bookkeeper for an insurance company. Her father and brother have type 2 diabetes mellitus, and have had severe complications because of poor control of blood glucose. She is 5' 4" tall and weighs 174 pounds with a medium frame. She has a history of obesity, hypertension, hypothyroidism, and frequent urinary tract infections, and is currently taking propranolol and levothyroxine. Mrs. Follex complains of constant fatigue over the past two months and has lost 8 pounds, although she is thirsty and hungry and eats all the time. She is concerned that she may have another urinary tract infection because she has frequent urination and pain in her lower abdomen. Her physician orders some fasting blood tests and the results show the following: glucose 380 mg/dL (normal 70-110 mg/dl), HbA 76% (normal < 6%), serum LDL cholesterol 270 mg/dL (normal <200 mg/dL), triglycerides 290 mg/d, (normal <200 mg/dl). She is diagnosed with type 2 diabetes, and started on a 1200-kcal diet and glyburide. She is also scheduled to see the nurse, who is a Certified Diabetes Educator (CDE), at the end of the week for further counseling 1. What symptoms of type 2 diabetes does Mrs. Folley manifest? Explain the pathophysiology of these symptoms 2. What is the relationship between being overweight or obese and diabetes? 3. What is the HbAie and how is it used to monitor diabetes? 4. In view of her other laboratory results, what other dietary counseling will Mrs. Eolley need? List some specific diet changes needed due to these labs 5. Mrs. Eolley's family members suffer from some of the complications of uncontrolled diabetes. What are some of the chronic complications that she is at risk for developing?

Answer 1

1. What symptoms of type 2 diabetes does Mrs. Folley manifest? Explain the pathophysiology of these symptoms.  

• Increased hunger (polyphasia)
• Lower guts torment
• Weakness
• Loss of weight
• Frequent urination (polyuria)
• Increased thirst (polydipsia)

Due to impaired glucose uptake in body excess glucose reaches the kidney. At the point when kidney achieves its limit glucose is discharged in pee (glucosuria). This expands the osmotic weight of the pee and represses reabsorption of water by the kidney, bringing about expanded pee generation (polyuria) and expanded liquid misfortune.

The lost body liquids are supplanted from water in cells and otger liquid compartments prompting lack of hydration. This prompts expanded thirst.

Body cells are not able to utilize the glucose and produce energy. This leads to easy fatigue.

2. What is the relationship between being overweight or obese and diabetes?  

A high prevalence of diabetes is seen inpatients with obesity. In overweight individuals, nonesterified unsaturated fats, glycerol, hormones, cytokines, proinflammatory markers, and different substances engaged with the improvement of insulin opposition increments. In diabetes the ?- islet cells of the pancreas are disabled, causing an absence of control of blood glucose. The development of diabetes becomes more inevitable if the failure of ?-islet cells of the pancreas is accompanied by insulin resistance.

3. What is the HbA1c and how is it used to monitor diabetes?  

HbA1c is known smas glycaled haemoglobin. It is estimated to give multi month normal of plasma glucose focus. More elevated amount HbA1c demonstrates poor control of blood glucose. Larger amounts of HbA1c are found in individuals with diligently hoisted glucose. A diabetic with great glucose control includes a HbA1clevel inside the reference go.

4. In view of her other laboratory results, what other dietary counseling will Mrs. Folley need?  

Mrs Folley have high LDL and triglyceride which proposes hyperlipidemia. Her eating routine modificatiins ought to incorporate low fat sustenance, low admission of greasy and slick nourishment and sodium. She likewise needs to join a few activities in her daily schedule.

5. Mrs. Folley's family members suffer from some of the complications of uncontrolled diabetes. What are some of the chronic complications that she is at risk for developing?  

Complications include blood vessel disease, cardiovascular disease, diabetic retinopathy, nephropathy, chronic kidney disease, diabetic neuropathy.

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