Mr. Bagwell's Diabetic Case Study

Mrs Frances Jones is and eighty-two year old retiree who has been admitted the hospital, with compromised circulation to her right lower leg and a necrotic right foot. She is a known diabetic and is prescribed insulin to control her diabetes. Mrs Jones has been scheduled for a below-the-knee amputation of her right leg later today. She has been fasting from last eight o’clock last night; unfortunately she is scheduled to be last on the list.

Researcher James Levin’s “Poverty and Obesity in the U.S” from American Diabetes Association, research about the Obesity and Diabetes in Poverty counties/reigns of the United States. Levin believes poverty and obesity are linked to each other. According to Levin’s research “ People in America who live in the most poverty-dense counties are those most prone to obesity. ” . There are many reason that link poverty to obesity, but Levin believes lack of fresh food and inactivity has a huge role in chronic metabolic disease (obesity and diabetes), and cardiovascular death. People who

According to the United States Library of Medicine, diabetes is a disease that occurs when the body does not make or use insulin correctly, therefore causing fluctuating amounts of glucose in the blood. Diabetes is a disease that affects millions of adults and children from various cultures. According to the American Diabetes Association (2014), someone is diagnosed with diabetes every 19 seconds. The Center of Disease Control and Prevention most recent statistical report indicated there were 29.1 million adults and children affected by diabetes. Those numbers are astounding. Unfortunately, the American Diabetes Association (2014) estimates by year of 2050, one out of three adults will have diabetes. Therefore, it is imperative that adults take aggressive measures to prevent this disease. By the same token, diabetes diagnosed in children and adolescent is becoming more prevalent every day. The American Diabetes Association (2014) reported there were about 216, 00 children in the United States with diabetes. It is predicted that one out three children will be diagnosed with diabetes in their life. The statistics for both adults and children with diabetes are frightening; however, early detection can help lower the risk of developing the debilitating effects of diabetes.

I could feel the acid in my throat; I desperately needed water and couldn’t keep any food down. I had felt like this for the last three months but no one believed me. I started to doubt it myself, my mom said I was fine so why wouldn’t I be?

The most significant difference between the regular insulin and the rapid acting insulin is the onset. The onset for rapid-acting or lispro is 10-15 minutes, and for the regular it is ½-1 hour.

HISTORY OF PRESENT ILLNESS: This is a 53-year-old black individual a patient of Dr. Shelton, who has had diabetes for at least six months, but he thinks it has been longer than that. He says his last known blood sugar was in the 300’s. He presents in the ER today with a foot ulcer since January of this year. He

1. Annotated Bibliography Entry: Diabetes Education: Art, Science and Evidence (1). (2012). Hoboken, GB: Wiley-Blackwell.

Diabetes remains the 7th leading cause of death in the United States. The cost of care for diabetics and new cases of diagnosed diabetes patient’s rise more and more each year. In 2010 234’051 death certificates were issued with the mention of diabetes as a contributing factor to the death. About 60% of lower limb amputations were performed. The cost of care for diabetics is now at an astronomical high of $176 billion dollars. A change a most be made to prevent all of this loss. (American Diabetes Association, 2014)

For my key informant interview I chose to contact the Outpatient Diabetic Education Department at Texas Health Presbyterian Hospital in Dallas, Texas. The reason I chose Texas Health Presbyterian is that it belongs to the most extensive hospital network in North Texas. Texas Health Resources has over 25 acute care, transitional, rehabilitation and short-stay hospitals and employs over 23,000 people. The largest hospital in the network is Texas Health Presbyterian. Texas Health Presbyterian is an 888 bed acute care hospital in Dallas County and is one of many hospitals that serve approximately 1.25 million people.

On Tuesday November 1, 2016 Anthony Rizzotti asked Wellness Coach Teresa Cain if he can received assistance in food shopping. Wellness Coach walked with Mr. Rizzotti to Power Supermarket Corporation around the corner from his residence. Mr. Rizzotti had a hard time with rolling his wheel chair and stated that his shoulder was hurting. Mr. Rizzotti also stated that he was tired and did not like going shopping by himself because he cannot pick up a lot of grocery’s due to limited space on his wheel chair. Wellness Coach informed Mr. Rizzotti that staff can look into a motorized wheel chair but he might have to pay the difference of what the health insurance will not pay. He said he tried that and the price for the wheel chair is expensive. As we are heading to the grocery store he explaining to Wellness Coach that it is hard to move

Cardiovascular disease- Diabetes drastically increases the risk of different cardiovascular manifestations, such as coronary artery disease and affiliated chest pain (angina), stroke, tightening of arteries (atherosclerosis), and heart attack. Having diabetes mellitus, raises the likely hood of having heart disease or stroke.

I appreciate your ability to cover such a broad area of diabetes mellitus (DM) and diabetes insipidus (DI). However, I agree that type 1 DM needs a lifelong insulin treatment as the cause of type 1 DM is autoimmune which could be due to genetic or environmental with histocompatibility leukocyte antigen HLA class II alleles HLA-DQ and HLA-DR. Environmental factors such as drug exposure, food, and viruses contributes to the disease. In addition, the autoantigens formed from the gene environment reaction damage the beta cells of the Islet of Langerhans (pancreas) thereby prevents insulin secretion causing increased blood glucose (hyperglycemia) (Huether & McCance, 2012). Great information.

Ms. Brown is dehydrated due to decreased oral intake. Her sodium is elevated at 156 mEq/L, potassium is elevated at 5.6 mEq/L, chloride is elevated at 115 mEq/L and her blood sugar is also elevated at 412 mg/dl all due to her dehydration and diabetes. Due to her sodium and chloride being elevated, she would have an increase in her ADH secretion which would lead to a decrease in blood circulation, decrease in blood pressure, retention of water and increase of thirst. Because her potassium is so high it has caused her to have an insulin deficit and has lead to diabetic ketoacidosis. She would be experiencing vomiting, dehydration and confusion. She needs insulin to correct her hyperglycemia and IV fluids for her fluid loss. Her anion gap is 21

This is it. Today will be the day to end the mystery of all the fainting I have been doing lately. I had my blood tested a couple of weeks ago, because my mom thinks I am diabetic. I don't think I am, but it's always better to be safe then sorry. I can't keep still, I really want to know what has been causing me to faint.

American Diabetes Association websites provides information regarding events and available resources. Centers for Disease Control partnership with YMCA and United Health Group deliver National Diabetes Prevention Program. Moreover, community outreach, home care agencies, county clinics, school clinics, primary care physicians, health fair, and many offer physical assessment, diabetes education and support in every county in every states in United States. The National Institute of Diabetes and Digestive and Kidney Diseases currently has been working on the campaign “Small Step, Big Rewards, Prevent type 2 Diabetes” all across United States to promote and support community to be aware about this chronic illness. Nonetheless, family and friends