M. G's Body Mass Index (BMI)

Bckground While modern lifestyles and medical care have certainly improved the longevity of humans in the developed world, and contributed to a greater quality of life scenario, those same lifestyles have engendered a number of issues that contribute to disease. Lack of proper diet, fast food, high fat and carbohydrate diets without adequate fruits and vegetables, lack of exercise, smoking and alcohol contribute to an epidemic of obesity which, in turn, contributes to a serious metabolic disorder called Diabetes Mellitus Type 2. While not managed by insulin injections, it is nevertheless quite serious and has a number of progressing symptoms that, if not treated properly, can result in cardiovascular, renal and neurological problems, as well as amputation, ocular issues, and even cognitive dysfunction.

9. Which of the symptoms that Y.L. reported today led you to believe she has some form of neuropathy?

Type 2 Diabetes is a disease that is found in a variety of age groups around the world. This disease is growing at a rapid rate and it is impacting the health of this generation and future generations to come. Diabetes is a disease that impairs the body’s ability to produce or respond to the insulin hormone produced by the pancreas. The insulin allows for the glucose to be effectively used as energy throughout the body. Diabetes causes carbohydrates to be abnormally digested, which can raise blood glucose levels. This means that the glucose is not being taken up by the cells that need it. The cells cannot take up the excess glucose that has accumulated in the blood, so it is excreted through the urine. This can lead to problems with the kidneys, central nervous system, heart, and eyes because high blood glucose can damage the blood vessels of these organs. This diseased is managed by adopting a diet low in fat and high in fiber, increasing physical activity, losing excess weight, and not smoking. If this

Over this last week, I have received a patient named Sherman “Red” Yoder. He is an 80-year-old male farmer, who lives alone in the farmhouse that he had grown up in. Red was married for 50 years and has been a widow now for 10 years. Red has one son, Jon, who takes care of the farmhouse and the land. He has one daughter-in-law, Judy, who is in involved with his care. Red was diagnosed with diabetes six months ago. Diabetes mellitus is a chronic condition that affects your body 's ability to use the energy found in food. As of only a few weeks ago, Red has been managing his diabetes with insulin. Insulin is a hormone that controls blood sugar. Before he began using insulin, he managed his diabetes with oral medication. After carefully assessing Red’s chronic illness, diabetes, many red flags were presented that could interfere with his management. In turn, this would cause further complications.

Uncontrolled diabetes can affect nearly every organ of the body; of which, heart disease and kidney failure are most commonly impacted. Known as diabetes mellitus, a collective term for various blood abnormalities, the term diabetes refers to either a scarcity of insulin in the body or the body’s inability to accept insulin. Though the symptoms of diabetes are manageable, many are unaware as to having it. According to the CDC report “2011 Diabetes Fact Sheet,” approximately 6 million people in the United States have undiagnosed diabetes. Undetected, diabetes can become deadly. In a recent World Health Organization report “Diabetes Action Now: An Initiative of the World Health Organization and the International Diabetes Federation,” it

Mrs. J. is an African American 69years old retired teacher who was diagnosed with advanced type2 diabetes one year ago. She has been responding well to the interventions, including medications, dietary measures, and physical exercises, until recently. She was admitted into the emergency with muscle weakness, vomiting, fatigue, headache, and confusion. Physical examination revealed that her skin was dry and had lost its turgor, while an osmolality blood test revealed an elevated level of sodium in her blood. She confirmed that in the past week, she had breached the diet as was indicated by a dietician, and had been consuming less water. She further confirmed that she felt unfulfilled due to the disease, and the recognition that she was getting older ‘made’ her seek fulfillment by ‘living her life’. Mrs. J. saw diabetes as a limitation to the full enjoyment of her last days on earth, and said she has left it all to God.

Mrs. Jameson is an African American 69-year-old retired teacher who was diagnosed with advanced type 2 diabetes one year ago. She has been responding well to the interventions, including medications, dietary measures, and physical exercise, until recently. She was admitted into the emergency room with muscle weakness, vomiting, fatigue, headache, and confusion. Physical examination revealed that her skin was dry and had lost its turgor, while an osmolality blood test revealed an elevated level of sodium in her blood. She confirmed that in the past week, she had breached the diet as was indicated by a dietician, and had been consuming less water. She further confirmed that she felt unfulfilled due to the disease, and the recognition that she was getting older ‘made’ her seek fulfillment by ‘living her life’. Mrs. Jameson saw diabetes as a limitation to the full enjoyment of her last days on earth, and said she has left it all to God.

For this assignment, I interviewed a thirty-two year old African American male with type-one diabetes. I learned having this particular disease is difficult to manage; nutritious eating, exercise, watching their disorder, taking medication and reducing their risk for problems are usually part of your their day-to-day routine. It seems that all of this is pretty overwhelming and there are two main types of diabetes (type-one and type-two). This particular illness distresses your body’s capability to generate or use insulin. Insulin is a hormone. When your body turns the food you eat into energy, it’s usually referred to as glucose or sugar. If you produce little or no insulin, or are insulin resistant, too much sugar rests in your blood. Blood glucose levels are greater than standard for individuals with diabetes. The cause of diabetes is unknown. Genetics, diet, obesity and lack of exercise may play a role in developing diabetes, specifically in cases of type-two diabetes.

The following is a case study of a 41 year-old Mexican American woman who was recently diagnosed with type 2 diabetes.

Patient G.M. is a four-year-old female from a middle class family living in San Diego. She originally presented with her mother and father to her general practitioner with lethargy and several vomiting episodes in the past few days. Her father stated concern after realizing her frequent urination in the past week. Her vital signs upon initial assessment were HR 140 RR 22 Temperature 102.7 degrees Fahrenheit, BP 70/62, O2 saturation 97%, 32 pounds, and 40 inches tall. Her General practitioner was concerned about type I diabetes and performed a blood sugar check. Upon assessment the monitor read HI, indicating that the level was above 500 and too high for the monitor to read. The doctor informed them she needed immediate treated in the closest pediatric ER due to the potential for diabetic ketoacidosis.

The main concern that JB as well as this author identified as needing to be addressed to ensure JB’s health and well being for her and her children was the prevention of diabetes mellitus. JB’s genogram revealed that she had numerous family members on her mother’s side that suffered from the consequences of developing type 2 diabetes mellitus. Her maternal grandmother and four out of five of her grandmother’s children, including JB’s mother, acquired type 2 diabetes mellitus.

The patient, CB, presents with signs and symptoms of diabetes mellitus type II. McCance and Huether describe the "well known risk factors" to include age, obesity, and physical inactivity (2014), all of which the patient currently exhibits. The patient has a history of high blood glucose as well high cholesterol, neither of which were further evaluated. Not only does CB present with a fasting glucose of 141 and cholesterol of 225, but CB discusses her "weight problem". CB falls into the category of obesity based on a body mass index of 35.7. In addition, CB also has reported an increase in urine production and frequency; vaginal discharge; and blurred vision at times. These manifestations are consistent with diabetes type II (McCance &

BMI is the body mass index of your body. This is a way you can estimate your body weight in relation to your height. However, this is only an estimate because this does not take muscle or weight distribution into consideration. The formula to calculate your body mass index is BMI (kg/m2) = weight (kg) / height (m)2. Currently I am 5'1 and 180 pounds. To achieve my weight in kilograms we divide 180 by 2.2. This equals to 81.82. To convert my height to meters I divide my height in inches by 39.37. This equals to 1.55. Therefore, 81.82/(1.55 x 1.55) is 34.0. My body mass index is 34.0. I am considered obese. To be at a healthy weight I would have to be about 150 pounds or less. I need to lose at least 30 pounds. I will do this by exercising, eating healthier, and living a better lifestyle.

Obesity in the United States has more than doubled over the past four decades. Prevalence of obesity cause many other disease such as diabetes and heart issues. Obesity can be described as a health condition of a person or people of a population that have excess body fat. Diabetes is a disease related to high level of blood sugar in the blood. Obesity and diabetes are among disease that have direct relationship with each other. As obesity increase in a population, diabetes increases too. Jennifer B.Marks, Professor of Medicine at the University of Miami Miller researches in “Obesity in America: it’s getting worse”, Roger Z. Joanne a public health provider in the Obesity Action Coalition group researches in “Obesity and type 2 Diabetes”, Eckel H. Robert, Professor of Medicine in Colorado University researches in “Obesity and Type 2 Diabetes: What can be Unified and What needs to Be Individualized”, and Obesity Society group researches in “Your weight and diabetes”, mention that while obesity and diabetes have different definition in medical process, the reason why people become obese and diabetic as well as how to prevent them is same. Eating larger portion size than what the body needs , lack of physical activity, and putting foods without good quality in diet are the major reasons that people become obese.

Furthermore, before one can begin to change any lifestyle behavior, one must understand the “reasons” and the “why” it is necessary to make the changes. I have identified heredity, lifestyle, and actions/interactions factors that I need to improve upon towards my quest for optimal wellness. The heredity factor is a little more difficult considering I do not know much about my mother and her side of the family with regards to health problems or inherited risks. Despite, heredity being a factor we have no control over, as we cannot decide to not come from this family, “adopting healthy lifestyles may significantly reduce inherited risks for certain diseases” (Corbin, et al, 2016, p. 501). Thus, simply a commitment to healthy living can diminish risks, whether known or unknown.