Question

SC, a 53-year-old African-American male, presents to the Adora clinic. He complains of always being hungry (“I feel like I want to eat all the food in my refrigerator!!”) and thirsty, along with waking up, most nights of the week, to urinate. During your assessment, you see that SC keeps yawning and you inquire about this; he states that for the past 3 months, he has been feeling run down and tired all the time. He complains that he has no health insurance because he works two part time jobs and that he does not have much extra money at the end of each pay period.

PMH significant for: hypertension, dyslipidemia, depression, gout

FH: Type I diabetes (father), mother (hypertension), brother (prostate cancer)

SH: recently divorced, lives alone, works on a dry-erase marker assembly line, has smoked for 30 years (2 packs/day), drinks 4-5 Coronas/day, no history of illicit drugs

Height: 5’4”; Weight: 230 lb; BP: 150/90; HR: 86; RR: 18; POC glucose: 180 mg/dL

QUESTIONS

1)         Calculate SC’s BMI (show calculation) and interpret the results.

2)         What patient characteristics put SC at risk for diabetes?

3)         How would you explain the disease state with respect to insulin resistance vs. normal metabolic function?

4)         List several lifestyle changes that could improve SC’s overall health and provide a justification for each recommendation.

Answer 1

Answer: The Body Mass Index ranges are:

• BMI is less than 18.5. Underweight
• BMI is 18.5 to 24.9: Normal weight
• BMI is 25 to 29.9: Overweight
• BMI is 30 or more: Obese

SC should include Physical activities as well as adopt a healthy lifestyle. At least a daily exercise for 35 minutes can also help to reduce the weight as well as decrease the risk of diseases. He should include green vegetables, proteins in diet and try to avoid junk food and fast food.

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