Case Study of Type 1 Diabetes

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Diabetes mellitus (DM) is a multisystem disease with both biochemical and anatomical/structural consequences. (Wolfsdorf et al: 2009) It is a chronic disease of carbohydrate, fat, and protein metabolism caused by the lack of insulin, which results from the marked and progressive inability of the pancreas to secrete insulin because of autoimmune destruction of the beta cells. Type 1 DM can occur at any age. It occurs most commonly in juveniles but can also occur in adults, especially in those in their late 30s and early 40s. Unlike people with Type 2 DM, those with Type 1 DM are generally not obese and may present initially with diabetic ketoacidosis (DKA). The distinguishing characteristic of a patient with Type 1 DM is that if his or her…show more content…
Due to distance, as well as parental knowledge, the doctor advised that he thought it would be more practical for V to receive home based treatment and management, and arranged for the specialist diabetic nurse (SDN) within the practice to schedule home visits. Medical tests for V were also organised to be held at the clinic, initially on a monthly basis, so that a professional monitoring of V’s condition could take place, as well as providing a forum for oversight and support, in respect of any family concerns that might arise as a result of V’s disease.

Clinical/ homecare of V by specialist diabetic nurse.

Outside of her responsibility for scheduling home visits, the SDN organised for the clinics dietician to accompany her on V’s home visits for a three month period, to assess V’s progress and to formulate a dietary plan that provides V and her parents with all the necessary dietary information, to sustain and manage V’s disease, whilst providing a best outcomes scenario for V. Diet is an exceptionally important factor when managing Type 1 DM because the NICE target for long-term glycaemic control is an HbA1c level of less than 7.5% without frequent disabling hypoglycaemia, therefore, V’s care package should be designed to attempt to achieve this. V will have a greater chance of keeping within desired levels if her diet is coordinated with her insulin management; consequently it is essential that a specialist diet is created that will
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