Type 2 diabetes mellitus - Diagnosis

Running Head: T2DM 0
TYPE 2 DIABETES
MELLITUS
JANUARY 24, 2020

T2DM 1
Table of Contents
Case presentation........................................................................................................ 2
Onset.................................................................................................................... 3
Pathophysiology...................................................................................................... 3
Prognosis............................................................................................................... 4
Lifespan consideration.............................................................................................. 5
Impact on the patient and her family............................................................................. 5
Social construction................................................................................................... 6
Nursing care needs................................................................................................... 7
Conclusion................................................................................................................ 9
References.............................................................................................................. 10

T2DM 2
Introduction and case presentation
Type 2 diabetes mellitus (T2DM) is recognised as one of the main causes of death
around the world. It is characterised by the increased levels of sugar in the patient’s blood. It
has been identified that around 241,463 people are diagnosed with this health issue in New
Zealand in 2016 (Casey, 2018). A 62-year-old Maori woman named Luna Brown with no
substantial medical history, with unhealthy eating habits and an inactive lifestyle was
detected with diabetes mellitus type 2 at the local hospital after showing symptoms like
frequent urination and polydipsia for some weeks. Increased analytical levels of the serum
glycosylated hemoglobin (HbA1c) 8.5% (58 mmol/mol) established the diagnosis. She has
three years of LDL hyperlipidemia and hypertriglyceridemia. She has been prescribed with
metformin and insulin. Her vital sign assessments showed that she has BMI 41.4 kg/m2,
blood pressure is 143/84 mmHg, increased respiration rates, and temperature of 101-degree
centigrade. She is also diagnosed with increased glycosylated hemoglobin levels, deprived
glucose controls and increased levels of glycosylated hemoglobin persevered [HbA1c= 9,1%
(76mmol/mol)]. Laboratory assessment discloses trace of protein on urine analysis, blood
urea nitrogen is measured as 14 mg/dl, serum creatinine is 1.2 mg/dl, random serum glucose
levels are 169 mg/dl, normal electrolytes, and usual levels of thyroid-stimulating hormone. A
one-day urine collection discloses a urinary albumin elimination rate of 250 mg/day. She has
been living alone for the last 5 months after the death of her husband due to chronic disease.
She is not very interactive with other people and isolated herself from the community. She
manages her daily life work herself and experiencing financial issues. she has two daughters
and one son living in other cities. Both the daughters visit her once in a month and her son
visits her once in two months. She complained that she frequently forgets to take medicines
on time and she also does not think that the treatment is effective anymore. She frequently
experiences psychological issues like depression, stress, and annuity. T2DM affecting her life

T2DM 3
and she is facing issues in managing thinks like cleaning the house, cooking food and
walking. As diabetes affects the visual ability of a person it can also lead to falls (Zheng, Ley
& Hu, 2018). She also at high risk of fall as she is living in a two-floor building and use
stairs. Diabetes also causes trouble in moving the fingers or hands which might also
contribute to a fall incident. Checking blood sugar is an important task for every diabetic
patient (Chatterjee et al., 2017), which becomes difficult in the case of Luna. Her age is also
contributing to her reduced ability to perform the medical task.
Onset
Being more than 45 years old is a risk aspect for type 2 diabetes. Persons of this age
and older must take active stages to prevent the illness, counting steady, light-to-moderate
workout and controlled nourishment (Cloete et al., 2017). However, the progress of the
condition is contingent on too many other aspects to accurately foresee on an individual
source. A comprehensive mix of well-being and lifestyle aspects can influence the
development of the disorder. Many individuals have diabetes for many years without being
conscious they have the disorder (Zhang et al., 2017). This sources a wide difference between
the age of onset and age of diagnosis. The risk factor associated with the occurrence of these
health issues includes an unhealthy lifestyle, being over 45 old, being Asian, pacific islander,
native American, Latino, or African descent. Having the first-degree family members with
any type of diabetes also increases the chance the developing type 2 diabetes mellitus
(Wilmot & Idris, 2014).
Pathophysiology
Type 2 diabetes mellitus is frequently associated with certain hereditary
predispositions, environmental aspects, lifestyle adoptions, and the lively interactions
between all of these dissimilar aspects (Cersosimo et al., 2018). This T2DM is an illness state
which includes the dysfunction of the insulin- creating pancreatic β cells, the resistance of