Case Study: Type 2 diabetes
Case Study: Type 2 diabetes
Case Study’s
Case Study: Type 2 diabetes
Fatimah Aswad is a 55-year-old married woman of Middle Easter origin. She lives with her husband. Her two daughters are married and live nearby. Her mother (deceased) had type 2 diabetes. Her father is well. She has a body mass index of 32. She seldom smokes and does not drink alcohol. She denies taking any recreational drugs. She buys St John’s Wort over the counter, as she feels anxious and depressed at times. She has no allergies. Her past medical history reveals that she has had two caesarean sections. She presents with oral thrush, a second occurrence in three weeks. On questioning she reports thirst, lethargy and that her vision has deteriorated. Her blood pressure is 150/90.
1. List Mrs. Aswad’s risk factors for a possible diagnosis of type 2 diabetes.
2. What tests would you order for Mrs. Aswad in order to confirm a diagnosis of type 2 diabetes.
3. Draw on your knowledge of the complications of type 2 diabetes and consider what mutually agreed goals you could set to minimize progression of any diabetes-related complications.
Caste Study: Diabetic drug adherence
Mr. Edmund Wilson is a 77-year-old retired post office worker. He has never been married and lives alone with a social support from neighbors and family. He is a past smoker and likes a beer each evening. He denies taking any recreational drugs and does not use any over-the-counter (OTC) remedies. He reports no allergies. He is not overweight. His father died of a heart attack aged 65. Past medical history includes hypertension diagnosed over twenty years ago and a myocardial infarction two years ago. He was diagnosed with type 2 diabetes ten years ago. Current medication includes metformin, glipizide, simvastatin and captopril. At the most recent review, HbA1C was 6%.
On closer questioning, it would seem that Mr. Wilson stopped taking his anti-diabetic drugs several weeks ago, as he reported feeling generally unwell.
1. Based on his current medications what do you see as problematic?
2. In view of the low HbA1c test-revise his treatment plan -using your guidelines and knowledge of anti-diabetic drugs. State rationale for each medication you prescribe.
3. What would your goal be for Mr. Wilson’s HBA1c?
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