Question

Patient: S.J.

HPI: pt African American 86 yr old , Not feeling 100 percent, tired hungry and thirsty often from last month. Blurry vision, , I take multivitamin statin and aspirin, also has pain in the feet, has cut hand and not heeling; both parents have DM type II; last bloodwork showed high cholesterol and ai was started on statin.

History: Has a life expectancy of < 5 years, hypertension, chronic kidney disease, and history of CVA and MI.

Results from the blood test: Fasting glucose is 204 mg/dL and his A1C is 8.4%.

Dx: type II DM

After looking at all of the labs and reviewing his medical history, what treatment plan would you recommend for patient care? Why? Give rationales/resources for your plan.

Answer 1

The goals of diabetes management are to reduce symptoms, promote well- being, prevent acute complications of hyperglycemia and prevent or delay the onset and progression of long-term complications. These goals are most likely to be met when the patient is able to maintain blood glucose levels as near to normal as possible. Diabetes is a chronic disease that requires daily decisions about food intake, blood glucose tsting, medication and exercise. Patient teaching, which enables the patient to become the most active participant in his or her own care, is essential for a successful treatment plan. Nutritional therapy, drug therapy, excecise and self-monitoring of blood glucose are the tools used in the management of diabetes. The two major types of glucose lowering agents used in the treatment of diabetes are insulin and oral agents. Drug therapy include

• Insulin
• Oral and other agents
• Enteric-coated aspirin
• ACE inhibitors
• Antihyperlipidemic drugs