Sharon’s Case Study: Diabetes, Obesity, and Kidney Failure

Sharon’s case study
Introduction.
The essay assignment is a response to Sharon’s case study. Sharon is a 58-year-old female
patient with a height of 1.7 m and she weighs 120 kg. she also has a waist circumference of 110
cm. she has a past, medical history of type II diabetes mellitus which was diagnosed three years
ago. She is currently under metformin to manage her diabetic condition. Sharon states that her
usual blood glucose levels range from 8 mmol/L to 11 mmol/L throughout the whole day. When
she wakes up in the morning her blood glucose levels read 7mmol/L to 8mmol/L. She is
hypertensive with a systolic pressure of 140 mmHg and diastolic blood pressure 95 mmHg. For
now, her consistent chronic kidney disease is evident with an eGFR of 85ml/minute and some
proteinuria. The essay assignment will, therefore, be divided into five parts both of them
responding to the case study described.
Question 1
Sharon was diagnosed with diabetes type II. This type of diabetes is normally associated
with lifestyle risk factors. Or it can be hereditarily inherited from one generation to the next
generation. The risk factors related to the lifestyle include poor diet, physical activities which are
not sufficient for the daily body requirement. Other risk factors are being obese or overweight.
Sharon is obese with a Body Mass Index of 40.6 kg/m2. Her obesity is indicated by a BMI of
above 30 kg/m2 and above (Bae et al 2016, pp 212-220). Her waist circumference of 110 cm
also confirms her obesity since her waist circumference is more than 88 cm for her gender. Her
age being above 40 years is an increased risk factor for her developing the type II diabetes
mellitus (American Diabetes Association, 2017 pp. S11-S24). The diabetes mellitus a condition

characterized by high circulating blood sugar can lead to kidney failure. The kidney failure
caused by diabetes mellitus takes some time for its signs and symptoms to manifest. With time
the high blood glucose levels damage the kidney nephrons leading to kidney nephropathy which
can progress to kidney failure (Reidy et al 2014, pp.2333-2340). The kidneys affected by diabetic
nephropathy cease to work efficiently resulting in water and salt retention that raises the blood
pressure rendering the client hypertensive. The renin-angiotensin system which regulate the
blood pressure is thought to be involved in the development of diabetic nephropathy. People with
diabetes have a high risk of developing hypertension (Hall et al 2014, p 75). In return, the
hypertension is a risk factor for kidney disease development.
Many arteries supply the blood containing the waste products and the fluid to be filtered by
the kidney at the glomerular filtration site. Over time, if the high blood pressure is not managed
it causes narrowing of the arteries supplying the blood to the kidney for filtration. The arteries
become weak too and the excess glucose deposited harden the arteries with time too. They,
therefore, become unable to deliver enough blood to the kidney and that is the onset of the
kidney failure.
Question 2
Sharon reports usual blood glucose levels of 8 to 10 mmol/L throughout the whole day.
These blood glucose levels are higher. The normal glucose levels in a day should be between
3.2mmol/L to 6.5 mmol/L (Nankervis et al 2014). Sharon also states her morning blood glucose
levels ranging from 7 mmol/L to 8 mmol/L. her glucose level should, therefore, be managed to
be maintained at the normal ranges.