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
Blood glucose –see if glucose was elevated at a current moment. Fasting blood glucose may indicate diabetes or if normal numbers could rule out diabetes.
The problem with this long-term condition is that usually it is diagnosed at a very late stage, due to which it becomes impossible to cure the patient. Fasting Plasma Glucose Test (FGT) and the Oral Glucose Tolerance Test (OGTT) are the two common tests used for testing the diabetes and pre-diabetes. These tests are time consuming, tough for the subjects and neither easy to perform nor give accurate results; therefore many of the patients are not diagnosed at the early stage.
Diabetes is a growing concern and health challenge for the American people (b). Diabetes is a condition in which the body cannot react to insulin appropriately or either cannot produce insulin efficiently (w). “Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications” (w). There are numerous forms of diabetes amongst the nation, however, there are three main forms of diabetes. Most people have heard of type one diabetes, type two diabetes, and gestational diabetes because they are common. Type two diabetes deals with a resistance to insulin, while
If you are eligible for Medicare, then you have the right to know, upon request and prior to receiving treatment, the health care facility accepts the Medicare assignment rate as payment in full. The Diabetes Education Program at Broward Health Medical Center can teach you how to live a healthier and more productive life. In order to determine whether or not you have pre-diabetes or diabetes, a physician conducts a Fasting Plasma Glucose (FPG) Test or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster and less expensive to perform. With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has
This test indicates to the doctor whether or not the body is processing glucose correctly. Diabetes is diagnosed with this test if after two hours the blood glucose level is greater than or equal to 200 mg. There is also a Random Plasma Glucose Test, which is a blood test that can be done at any point in the day when experiencing diabetic symptoms (American Diabetes Association, 2013).
There are three types of diabetes: type 1diabetes and type 2 diabetes, and gestational diabetes. All three are chronic conditions that "affect how the body uses blood glucose" or blood sugar. The body needs glucose because it is "an important source of energy for the cells that make up an individual 's muscles and tissues" Individuals with diabetes have too much glucose in their blood, which will inevitably lead to serious problems with a person 's health. Since every cell, tissue, and muscle needs glucose to function properly, it is important for a person who shows signs and symptoms of diabetes to see a doctor
Diagnosis of diabetes mellitus involves; patient history and physical examination. Blood tests including; FBG level exceeding 7.0mmol/l, OGTT level exceeding 11.0mmol/l using a 75g glucose load, postprandial blood glucose, HbA1c over a 2-3 month period >8%, lipid profile, serum urea and serum creatinine, electrolytes. Complete urinalysis. (Brown & Edwards, 2012)
The authors thoroughly discussion the reason for each laboratory test. In additional to the threaded discussion there are many signs and symptoms, many of which go unnoticed until the disease is in the late stages. Mr. Bobo is a diabetic which seems uncontrolled so focusing on education is of importance. Education has been identified as a significant factor in the effective control of blood glucose levels. Education is import to emphasize to the patient the importance of close monitoring and management as diabetes can become a chronic disease with multiple health issues and a poor quality of life. Mr. Bobo will need to know the importance of making changes to their lifestyle in regards to nutrition, diet, and weight control. Casto, Cherry, Ellerbee, Gatlin, and Young thoroughly discussion long term complications such as eye complications, nephropathy, neuropathy, and cardiovascular disease. Complications from diabetes can be quite serious to life threatening, including kidney damage, nerve damage, which cause numbness, pain or tingling sensations, amputation due to lack of circulation or secondary infection, and retina damage, an incurable condition that can lead to a total loss of
Question 1: Are college students who are diagnosed with type 1 diabetes mellitus during freshman and sophomore years more likely to have difficulties coping than individuals diagnosed prior to college attendance?
Diabetes is one of the major health issues with which the America is battling today. Increasing incidents of diabetes have are reported in the United States in the past decade. Type 2 diabetes is the most common form of diabetes. In type 2 diabetes, the body does not use insulin properly. At first, the pancreas makes extra insulin to make up for it. However, over time the pancreas is not able to keep up and cannot make enough insulin to keep the blood glucose levels normal.
Blood glucose needs to be tested to ensure the blood glucose is not too high or too low to determine how much insulin is needed.
Since doctors have not figured out a cure for this disease yet, the only way to treat it is to manage it (Joslin Diabetes Center). Some ways to do that is by eating healthy, exercising, losing extra weight, and medications. Common medications include metformin, glucophage, and glumetza (Mayo Clinic). In addition, some patients use insulin therapy to manage their diabetes. This is a once or twice a day injection of insulin (American Diabetes Association etal.). Given these points, diabetes can achieve the common goal of an A1C less than 7% and overall keeping their blood glucose levels between 80 to 130 mg/dl. before a meal and less than 180 mg/dl. after a meal. The way patients with diabetes know their blood glucose levels when not at the doctor’s office is by using a meter. The way this machine works is by the patient pricking their finger in order to get a drop of blood, putting the blood on a test strip. They then stick the test strip with the blood in the meter and the meter gives them their current blood glucose level (American Diabetes
The World Health Organization (2016) defines Type 2 diabetes as ‘a chronic disease that occurs when the body cannot effectively use the insulin that is produced by the pancreas’. Type 2 diabetes is the most prevalent form of diabetes mellitus. A number of individuals with Type 2 diabetes initially produce standard amounts of insulin, however, their tissues over time do not respond appropriately to insulin (Martini, Nath, & Bartholomew, 2012). Insulin resistance occurs in individuals with Type 2 diabetes, as a result of the human body’s cells reacting ineffectively to insulin. As a result of the cells resisting the effects of insulin,
The tests for type 1 and type 2 are glycated hemoglobin (A1C) test, fasting blood sugar test, and oral glucose tolerance test (Mayo Clinic, n.d). Tests for gestational diabetes are initial glucose challenge test and follow-up glucose tolerance testing (Mayo Clinic, n.d).
A simple blood test to check blood glucose levels can show if you have any type of diabetes.