Diabetes Management and Education

Running Head: DIABETES MANAGEMENT 0
Diabetes Management and Education

DIABETES MANAGEMENT 1
Mr. Smith is a 58 years old male with type-2 diabetes. In 2010 Mr. Smith was diagnosed with
type 2 diabetes mellitus, after when his general physician did his blood glucose test during one of
his routine visits. His blood sugar level was 10mmol/L. T2DM exists in other family members of
Smiths too like his mother and his sister. Mr. Smith’s physical exams also revealed the high
levels of blood pressure and also has gained enormous amount of weight. Along with obesity
(weight 113 kg. BMI 32) he is also a smoker. He has noted a marked decrement in the levels of
his energy and strength. Current medications that Mr. Smith is on are, Atenolol, 50mg for
hypertension and Metformin 500mg BD for blood glucose level (Sheehan, 2017).
Most recent blood results of Mr. Smith are HbA1c - 9% (75mmol/mol), Total cholesterol -
5.0mmol/L, Triglycerides - 2.5mmol/L, LDL - 2.5mmol/L, HDL - 1mmol/L, Albumin/keratinize
micro albuminuria - 5mg/mmol. His most recent blood pressure was 140/90mmHg Mr. Smith’s
all conditions like hyperglycemia, hypertension and the obesity has affected him in several ways.
All these issues along with all the factors related to these issues like, medical, nursing health,
allied health etcetera are discussed below.
Generally diabetes has been divided into different type of categories. In order to recognize the
type of diabetes depends on the symptoms and the circumstances significant to the time of
diagnosis. Sometimes, it becomes hard to decipher the type of diabetes in the patient. It is
because they do not fit into any type of category completely. In this case during one of the
routine check-ups, the patient complained of uncontrollable weight gain, excessive urination,
numbness in hands and feet’s and increase in blood pressure (Diabetes Australia, 2015). He
also complained about shortness of breath and getting fatigued easily. On the basis of all these
symptoms, his general physician did some test. The test results showed elevated level of glucose,
cholesterol and mainly indicated the presence of type2 diabetes. Few tests were done for instance

DIABETES MANAGEMENT 2
blood test and blood glucose tests were done which measured the level of glucose in the blood of
the patient. All these test results were shocking since they stated a very high level of blood
glucose compared to normal level. Other tests were for measuring the level of blood pressure
level and those results also showed a very increased level of blood pressure in patient American
(Diabetes Association, 2015). Mr. Smith has gained a lot of weight in the past few years due to
lack of exercise and healthy living. The hyperglycemia led to severe deficiency of insulin in the
patient and due to this condition blood glucose level increased tremendously. Another medical
risks that rose were, tingling in the feet while walking, blurred visions, numbness and fatigueless
etcetera.
On the basis of these results, Mr. Smith was prescribed little medicine in order to stabilize the
condition and lower down the hyperglycemic condition for instance metformin 500mg,
metformin is the only biguanide available right now in the market. To improve the glucose
tolerance in Mr. Smith, metformin was suggested as the ant hyperglycemic agent for type 2
diabetes. It helps the patient by lowering the glucose absorption in the intestine and also
decreasing the hepatic glucose production (Ley, Hamdy, Mohan and Hu, 2014). Metformin also
helps with the obesity condition and to prevent cardiovascular complications. Other tests were to
measure the level of cholestrol and triglycerides in the body fluid and those were also on the
borderline. All these tests confirmed the presence of diabetes. Because of presence of diabetes in
other members of the family, the doctor took it seriously and did the blood glucose test.
In context to the given topic, after reviewing a literature which is titled as “5 Important Tests for
Type 2 Diabetes” many other tests that can be done to measure the level of glucose effectively,
A1C which indicates the average blood glucose in past 2-3 months (Health, 2016). Fasting
plasma glucose test was also done which indicated the blood sugar on empty stomach. For this

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test the patients are advised to not eat or drink anything but water for around 8 hours before the
test. Another test was Oral glucose tolerance test to measure the blood glucose level before and
after 2 hours of drinking a sweet drink. These tests are done to know the level of glucose inside
the body accurately. These tests are so helpful in reducing the risk of diabetes by bewaring the
individual (Bell, et al 2015). Other tests were for measuring the level of blood pressure level to
confirm the hypertension in the patient. Mr. Smith has type 2 diabetes, in which body fails to
meet the adequate amount of insulin. The insulin resistance gets developed in the body. It can be
because of lack of production of the insulin hormone or when insulin fails to respond to the
different cells of the body (Norris, Engelgau and Narayan, 2013). Insulin resistance can lead to
lack of response by fat cells, muscles or liver cells towards the insulin even when there is a high
amount of insulin present. Due to this condition free fatty acids are produced which a complete
failure because of triglycerides is not getting converted into smaller components. Another failure
can be seen in producing glycogen store in the liver and lack of energy in muscles. Eventually
this scenario leads to rise in glucose level in the blood and since the glycogen levels are reduced
it fails to fulfill the glucose requirement of the body. It is a heterogeneous condition and affects
the function of beta cells. An incretion effect can be observed along with the deposition of islet
associated amyloid peptide (IAPP) inside the islets and also around the islets. In the earlier stages
of this type of diabetes, the secretion of insulin increases but as the time passes, the beta cells
fails to do their specified function and therefore the amount of insulin secreted decreases (Norris,
et al 2013). In type 2 diabetes, amount of circulating glucagon increases and lipid metabolism
also starts to function abnormally. This disturbance in production and break down of fat might
lead to cardiovascular diseases and risks along with the obesity issues.
For the treatment of type 2 diabetes, the patient was prescribed the metformin 500mg drug. It