Case Study : Diabetes Mellitus Type 2

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Case Study #1: Diabetes Mellitus Type 2
Monay Link
The University of Tampa

Case Study #1: Diabetes Mellitus Type 2 Diabetes Mellitus (DM) is an endocrine disorder that has the potential to affect various major organs throughout its progression. Diabetes Mellitus is divided into three common categories: type 1 diabetes mellitus, type 2 diabetes mellitus (non-insulin dependent), and gestational diabetes. Ninety percent of over 24 million people suffer from type 2 diabetes in the United States (Arcangelo & Peterson, 2013). The pathophysiology of type 2 diabetes can be any combination of resistance to insulin, elevation in hepatic glucose production, or a pancreas that secretes less insulin than needed to control glucose levels
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The gold standard for diagnosing type 2 diabetes is testing the hemoglobin A1c (HbA1c), or the average of the body’s blood sugar over three months’ time (Arcangelo & Peterson, 2013). Other diagnostic testing include the fasting plasma glucose or the oral glucose tolerance test. The fasting glucose is a lab draw taken when the patient has fasted (nothing by mouth) for eight hours or more (Arcangelo & Peterson, 2013). Oral glucose tolerance testing is typically only used in diagnosing gestational diabetes. Normal glucose values are variable to each diagnostic test. The fasting plasma glucose is defined as a normal reading of < 100. Postload glucose, or the reading two hours after a meal, is normally <140. The American Diabetes Association recommends a blood glucose log that tests before meals and two hours after each meal (ADA, 2015). Arcangelo and Peterson (2013) define an impaired fasting glucose as a reading above 100 but below 126, or a two hour postload glucose of 140-200. These values indicate a pre-diabetic state. Repeat diagnostic testing at a different time is warranted in the diagnosing of diabetes (Arcangelo & Peterson, 2013). Recognition of drugs such as corticosteroids, thiazide diuretics, estrogen, beta blockers, and furosemide can explain a sudden increase in glucose levels (Arcangelo & Peterson, 2013).
Case Presentation A 49 year old Caucasian female presents to the practice for her quarterly lab review. G.C. has been a patient for
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