Case Study of a Patient with Diabetes Type 2

“Case study of a patient suffering from Diabetes Type2”
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Contents
Introduction.................................................................................................................................................3
New Medication..........................................................................................................................................4
Standards of practice for nurse....................................................................................................................4
References...................................................................................................................................................5
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Introduction
Diabetic kidney disease has been found to be very prevalent among adults who are suffering
from diabetes type 2. It has been recommended that assessment of albumin excreted through
urine and estimated glomerular filtration rate that is eGFR should be done annually in order to
detect any kind of damage in the individuals suffering from diabetes type 2 (Sun et al., 2017).
A case study
Sharon is a 58 year old female, who is 170cm tall, weighs 120kg, and has a waist circumference
of 110cm. She was diagnosed with type 2 diabetes three years ago, and takes metformin
(Metformin Sandoz 1000mg, twice per day). She states that her usual blood glucose levels
(BGLs) are 8 to 11mmol/L throughout the day, and 7 to 8mmol/L when she wakens in the
morning. Her BP is 140/95mmHg. She now has consistent evidence of chronic kidney disease,
with an eGFR of 85ml/minute and some proteinuria. The patient is a 52 year old female who is
suffering from Diabetes Type 2. Medicine prescribed to her is metformin which does not leads to
hypoglycemic condition in the patient (Kulvinder Kaur, 2017). But as she is suffering from a
chronic kidney disease this would lead to the excess usage of glucose trough gluconeogenesis
and glycogenolysis resulting in hypoglycemia. If glucovance would also be given along with the
metmorfin then it could lead to the decrement of glucose in the bloodstream. The patient is also
having chronic kidney disease and metformin is excreted out of the body through renal pathway
only, which adds on to the risk of getting adverse effects on kidneys of the patient. It can only be
used with those patients who have their kidneys functioning normally. Also the dosage
Glucovance which is mentioned is too high for a patient aged 52 as the renal functions get much
more deteriorated by age. Considering the age of the patient the dosage should be titrated first
and then given in an amount that does not cause any harm. Using both the drugs in combination
can lead to various serious complications or a condition called lactic acidosis. It is a condition in
which pH of blood goes extremely down due to the depositions of lactate in the body which is
due to the malfunctioning caused with the body’s oxidative metabolism which results in the
excess of acid in the blood stream (Connelly et al., 2017). Lactic acidosis can cause the
following symptoms in the patient like low levels of sugar in the blood including chills,
headache, nausea, dizziness, having problem in breathing, tingling sensations on feet as well as
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