Introduction
The purpose of this paper is to examine the subjective and objective information using
the national diabetes guidelines to diagnose and formulate a management plan for a case study
patient.Week 5 Case Stu
...
Introduction
The purpose of this paper is to examine the subjective and objective information using
the national diabetes guidelines to diagnose and formulate a management plan for a case study
patient.Week 5 Case Study 2
Assessment
Primary Diagnosis:
Type 2 Diabetes Mellitus (ICD- 10 E11). I chose DM type 2 as my primary diagnosis
based on the American Diabetes Association’s Guidelines (ADA). DM2 is a decline in insulin
secretion because of impaired B-cell function (ADA, 2018) a diagnosis of diabetes can be made
contingent on s criterion of the fasting glucose, the 2-h plasma glucose value in a glucose
tolerance test or an A1C criteria (ADA, 2018). My patient’s fasting blood glucose of 126 (H) and
her Hgb A1C of 6.9 (H), confirmed the diagnosis because they are two definitive values that are
over the threshold (ADA, 2018).
My reason for selecting DM2 also included the patient’s signs and symptoms, risk factors
such as her age (56), ethnic background (Hispanic) and she previously delivered a nine-pound
two-ounce baby which is indicative of gestational diabetes.
Diabetes signs and symptoms include fatigue, frequent urination, blurred vision, feeling
hungry, pain and tinging in hands and feet as well wounds and cuts that heal slowly (ADA,
2018).
Those living a sedentary lifestyle, older age, obesity women previously diagnosed with
gestational diabetes, Hispanics and blacks and those with high cholesterol and hypertension are
all at a higher risk for type 2 diabetes (ADA, 2018). Mrs. R has been experiencing fatigue,
weight gain, hung and thirst and frequent urination, she is overweight with a BMI of 29.7 which
places her in the overweight category.
Many individuals with non-insulin dependent diabetes are overweight and extra weight
effects insulin resistance (ADA,2018). This patients abnormal lab values are as follows a blood
glucose of 126(H), Hgb A1C 6.9 (H), LDL 144 (H), HDL 38 (L), Triglycerides 232(H) , and aWeek 5 Case Study 3
small amount of protein in her urine with 1+ glucose , warrants further investigation into her
health need.
Plan
Diagnostics
I am going to order a Hgb A1C for the DM2 diagnoses. Hgb A1C is a test that measures
an individual’s blood glucose level for 3 months it is a measure of glycemia average (ADA,
2018). This test is also a prediction of value and detects glycemic targets (A1C is most effective
when used along with CGM), (ADA, 2018). My patient’s A1C is 6.9 (H), individuals not
previously diagnosed with DM with an A1C greater than 5.7, an abnormal glucose tolerance and
an abnormal fasting glucose are ideal for diabetes prevention (ADA, 2018). This test should be
obtained on the first visit and should continue throughout treatment (ADA, 2018). American
Diabetes Association (ADA) Guidelines recommend that A1C levels be obtain every three
Months until optimal levels have been reached or sustained (ADA, 2018). Results of the Hgb
A1C will provide me with the opportunity to treat as indicated. Glycemic targets vary depending
on patient’s specific needs (ADA, 2018). I am also going to order a Fasting Glucose because it is
a predicting factor of DM2 (ADA, 2018).
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