Challenges and Complexity of Type 2 Diabetes: A Holistic Approach - Desklib

This study discusses the challenges and complexity of type 2 diabetes and its impact on the health of a 60-year-old man named John. It covers his medical history, presenting complaints, drug history, and family history. The study aims to identify the reasons for the problem and provide effective healthcare services to the patient.

Component A
This study will discuss some challenges and complexity that client may face with type 2 d
issues (Jirakulsomchok, 2020). This component A comprises with both objectives and sub
For discussing holistic approach and past medical history, evidence-based approach will
from secondary research and data that type 2 diabetes led to complexity around d
different diagnosis process. Number of things have been discussed in this study that can h
health of John, 60 years old man who is suffering from type 2 diabetes. Some other
discussed in component A and part A include family history of client, drug history, review
examinations, demographics, and others. Aim of discussing all these things is to iden
reasons of the problem that client is suffering from. It can help care providers in ta
regarding providing healthcare services to service user or John. Managing type 2 diabete
as if it is not treated in a timely manner then it can lead complexion.Based on family h
history, drug history and social and personal history, service provider can improve over
user. By discussing causing factors of this situation and current medical treatment, health
be improved.
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Part A
Findings Literature support
SUBJECTI
VE
Identifying
informatio
n
John (Male),
Born in 1961
John was
diagnosed
with type 2
diabetes
with
mobility
issues
He was
diagnosed
at the age of
40
Regarding diabetes, it can be said that it is a group of non-commu
body finds difficulties in producing enough insulin. When human’s bo
produced glucose in an effective and appropriate manner then th
diabetes (Cheng, 2021). Type 2 diabetes is the one in which human’s
sugar in the bloodstream. High blood sugar level or this condition
nervous system.
Some common causes of this condition include lack of exercise, overw
with these, some other social and environmental factors may also
2021).
Some common symptoms by which it becomes easier to ident
excessive hunger, thirst, dry, itchy skin, blurry vision, frequent u
wounds. (Halim, 2019)
Some other problems that this condition cause to John and people
dark patches in the fold of skin, injuries, blisters. It takes longer to
feel symptoms at the time of diagnose such as pain and numbness. (C
Type 2 diabetes often occur in the people over the age of 45 and p
be diagnosed because of sedentary lifestyle and overweight. Regardi
is overweight, and it can be one of the main reasons of this condition
From secondary data, it is found that around 30.3 million people
among which 90-95% have type 2 diabetes. retinopathy, skin proble
damage and amputations are serious condition that people face
increases to the great extent and when they are not being treated
Wang and Zhang, 2021).
Presenting
Complaint
John is 60-
year-old
Specialized multidisciplinary community care providers play a vital ro
per the Canadian diabetes association guidelines, it is found that
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Findings Literature support
male
patient.
He has
presented
with high
glucose
level of
435mg/dl
and foot
injury or
wound in his
right leg for
25 days. The
wound was
due to
heavy object
fell on the
leg. There
was no
discharge or
redness, but
swelling was
present. He
cited the
pain as dull
and was
lasting for
past 2
weeks. Pain
aggravates
while
walking and
relieved in
resting.
should be inter and multidisciplinary as they find easier in providing
care as per the current requirements of clients (Taylor, 2020).
Allied healthcare professionals also play a vital role in diabetes
collaboration with healthcare providers and physicians also makes
situation in a cost-effective manner. people who make multidisc
management include primary care, specialist, registered dietitian, an
on this, it can be said that John can take effective treatment and care
him out from infectious foot injuries, gangrene and other critical pr
sugar level. By developing multidisciplinary care programs and inten
care providers can improve overall health of people with type 2 diab
2021).
It makes multidisciplinary community care providers able in educat
awareness regarding different types of diabetes and ways by
themselves.
But along with this, it can be said that John should take proper m
treatment to protect against complex challenges and problems, le
2020).
History of
Presenting
Complaint
He was not
able to
articulate
continuous
clinical
history
which was
obtained
from his
family.
The challenge regarding managing Type 2 Diabetes among the pat
amount of stress are more likely to have such kind of disease in easy
certain family issues with their kids as both his sons live far away fro
with his wife thus suffering from mental trauma and high amount
which is the major reason for Type 2 Diabetes. It has been identified
high level of stress hormones might stop insulin producing cells in t
properly and reduce the amount of insulin they prepare. Hence, th
development of Type 2 Diabetes among individual as thus in John as
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Findings Literature support
He is
currently
presented
with 2-3
main issues
such as:
 He
does
not
have
impro
ved
relatio
ns
with
his
family
as his
2 son
lives
far
away
from
him.
He
lives
with
his
wife
and
sufferi
ng
from
menta
l
traum
a and
tensio
n.
 Other
main
Although, studies have been evaluated that Type 2 Diabetes develop
that slows down the flow of blood among the body parts of the patie
well. This is the major reason that he is suffering from foot injury fro
Type 2 Diabetes makes it difficult for his body to deliver nutrients
injury heals slowly or may not heal at all from long time frame. Hig
John tend to stiff his arteries and cause narrowing of the blood vessel
healing (Sharp, 2021).
From various previous studies, it has been evaluated that Type 2 Dia
older adults, but it also increased even in younger ones because of
also suffering from obesity or overweight issues. Apart from this, it
that almost 90% of patients with Type 2 Diabetes are overweight and
John as well. He is also facing overweight issues due to which
inflammation enhances that lead to insulin resistant which in turn le
2020).
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Findings Literature support
proble
m is
painful
foot
injury
and
blister
s. He
said
that
he is
unable
to
walk,
and he
is now
depen
dent
on his
wife,
and it
makes
him
more
depres
sive.
His
wife
stated
that
painful
blister
s and
foot
injury
is
affecti
ng
him
physic
ally to
the
great
extent
.
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 As
John is
overw
eight
so, it
becom
es
difficul
t for
his
wife to
handle
him
and
make
him
walk.
Manag
ing
high
sugar
level
is
becom
ing
difficul
t for
his
wife
and
John
as
well.
Past
Medical
History
The detailed
history
about the
John was
gained by
speaking to
John with
the
assistance
of his wife
as she is the
one who
assists him
at every
Various studies evaluated that early symptom are the major things th
at utmost priority basis as this should be treated at very initial level.
diseases as well if not treated at the right moment such as heart and
blood pressure, Low HDL cholesterol, being overweight, depressio
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Findings Literature support
point of
situation.
However,
certain gaps
are evident
within the
history. The
discussion
includes
certain
aspects that
are
discussed
with the
John
involves:
 He
was
diagno
sed
with
classic
sympt
oms of
blurre
d
vision,
lower
extre
mity,
overw
eight,
by
checki
ng
blood
glucos
e
record
s and
hyper
glyce
mia.
 1996-
Vitami
n D
deficie
ncy.
emerging picture become one of the major issues for the patient a
period, the patient losses lots of his abilities and functionality of th
Sometimes it leads towards serious conditions of the patient a
medication or insulin injections on urgent basis to keep their sugar
Hence, if it has been diagnosed at the appropriate point of time
prevented and treated at an early stage. (Hunt, 2021).
Diabetes management is a lifelong procedure and hence act as
glucose control. It directly affects the glucose level which releases a
blood stream and this respiratory rate enhanced. Constant stress
release the hormones that affects the body in complete manner a
insulin. reference
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 1999-
Hearin
g
impair
ment
and
mobilit
y
issues.
 2002-
Blurre
d
vision
and
enhan
ced
hunge
r
issues
that
create
s
obesit
y.
 2003-
Stress
issues
Drug
History /
Allergies
Allergy
John
diagnosed
with skin
allergy
previous
year when
he was
diagnosed
for Type 2
diabetes.
Current
medication
 Sulfon
ylurea
s
It has been specified from various studies that diabetes can cause c
vessels, and these can cause skin issues and problems called diabeti
context of dark colored patches PR scaly patches (Haynes, 2021).
This group of medicine used to treat Type 2 diabetes as with this, the
properly and leading to elevated levels of blood sugar. This includes
glyburide (Kattupalli, Vesta et.al., 2019).
It is type of oral diabetic medications approved by the food and drug
disease mellitus in adults. This blocks the action of DPP-4 an en
hormone incretion. Incretions helps the body to produce more insul
and reduce the amount of glucose being produced by the liver whe
2019).
This specific drug improves glycemic parameters and helps to re
agents work by activating GLP 1 receptors in the pancreas which
release and reduce glucagon release (Febriani, 2021).
This drug is approved for use with diet and exercise to lower down
type 2 diabetes. It improves cardiovascular outcomes in high car
(Fegan‐Bohm, 2020).
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 DPP-4
inhibit
ors
 GLP-1
recept
or
agonis
ts
 SGLT2
inhibit
ors
 Insulin
Drug history
 Metfor
min-
(Com
mence
d
initiall
y in
Augus
t 2001
when
John
was
diagno
sed
from
Type 2
With this medication, pancreas responds which allows the glucose
provide energy. When insulin levels are high, excess glucose is st
2018).
This specific type of medication is utilized at very initial stage to lowe
by improving the ways the body handles' insulin. This is the primar
diabetes when diet and exercise alone have not been enough to
(Moroianu, 2020).
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Diabet
es).
Family
History
 The
family
history
of the
patien
t has
shown
that
john is
not
living
with
his
son.
 The
patien
t has
two
sons,
and
both
do not
care
about
john.
 John
has no
one to
take
care
of him
during
his
tough
times.
 It has
been
found
out
that,
there
was
no one
with
the
patien
As it has been found out, that the patient has no family support. T
emotional aspect of the patient. As the john is going through the ha
humans have a desire in relation of having morale support from their
and Nwabuo, 2021). But he has no support from his sons. It has
research that when the patients have no morale support. Then, it aff
the patient (Nissen-Lie, 2020). Same has happened with the john.
affected the physical ability of the john. And no support from his fam
has highly affected the mental health of the patient as well.
From various research it has been evaluated that, the mental heal
aspects is getting the physical recovery. No medicine can affect i
patients are mentally not stable. The mental health determines
patients. In john's case, the patient is highly affected in term of hav
mental health. No morale support from the family of patient is c
getting recover in the service user. It is important to understand the
patients while they are on a treatment (Harder, Lemoine and Harw
the big change in getting recovered.
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Findings Literature support
t,
when
he
came
for
check-
up.
 John
must
maint
ain all
his
respon
sibiliti
es by
own
withou
t
gettin
g
depen
dent
on
family
memb
ers.
Social and
Personal
History
John is
suffering
from issues
such as
stress
because
they live
alone with
his wife and
their both
sons stay
away from
him. Hence,
he is socially
not very
much
engaged
kind of
personality.
 Hobbi
es
were
From various research, it has been identified that high amount of
communicating with others within the society and to build relationsh
Juraschek, 2020). It also affects persons personal relationships as wel
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Findings Literature support
watchi
ng
Televi
sion
and
readin
g.
 Non -
smoke
r
 Doesn
’t
drink
alcoho
l
 No
history
of
drug
abuse
 Unem
ployed
 Reduc
ed
mobilit
y
Review of
Systems
Cardiovascul
ar System
John is
suffering
from high
blood
pressure as
well.
No chest
pains
No
shortness of
breath
 Inspec
tion
It has been identified from certain research that high blood sugar dam
as the nerves that controls the heart of the individual (Seferović, 20
are also more likely to have other conditions that raise the risk
increases the risk of high blood pressure with the enhancement
through arteries and can damage artery wall. This increases th
sometimes stroke. (Ma, Chen, Meng, Yang, and et.al., 2018).
Type 2 Diabetes affects many major organs which includes hea
kidney, and eyes. From varied studies, it has been evaluated that
likely to have asthma, 25% candidates are more likely to have chro
disease, 55% are more likely to have pulmonary fibrosis, a disease in
lungs interferes with the ability of the individual to breathe (Kaur, Kau
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Findings Literature support
- No
palpita
tion.
Pulse
rate
was
regula
r with
good
volum
e
(82be
ats
/min).
- No
chest
swellin
g
- No
scar
marks
and
defor
mities
 Palpati
on
- Norma
l apex
beat
palpat
ed in
the
precor
dium
left 5th
interc
ostal
space,
half
inch
medial
to the
left
midcla
vicular
line
and 3-
There is an inverse relationship between the rate of gastric empty
concentration, so that emptying is slower during hyperglyce
hypoglycemia (Richter, 2018). The motor dysfunction responsible for
in patients with diabetes are heterogeneous. (Luvanda, Kumar, Mishr
Various Musculoskeletal conditions are associated with the diabetes
disorders affecting the hands such as limited joint mobility steno
dupuytren's contractures and diabetic sclerodactyly, the shoulders
(Maleszewski, Young, and et.al., 2021)
Type 2 diabetes medication affects the other organs as well becaus
own personal, side effects that greatly affects the patient in some
2020).
Stress is not at all good for such kind of diseases as stress secrete ce
that enhances the risk for diabetes people and more of the heart
2020).
Feeling of stress, worry, depression and anxiety in individuals w
among the diabetes patients. There are considerably less evidence
anger in persons with diabetes are compared to anxiety and dep
2020).
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4
inches
left of
left
border
of
sternu
m.
- No
palpab
le
murm
ur or
thrill
- Heart
sound
of S1
+ S2
audibl
e
 Percus
sion
- Area
of
superfi
cial
cardia
c
dullne
ss –
norma
l
- No
added
sound
like
murm
ur,
perica
rdial
rub
- No
cyano
sis
- No
jaundi
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ce
- Not
anemi
c
- No
dehyd
ration
- Blood
pressu
re was
170/1
00mm
Hg.
- Palpat
ed and
record
ed the
periph
eral
pulses
of the
feet
which
was
80/mi
n.
Respiratory
System
John was
having
certain sort
of asthma
symptoms
as well
after
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Findings Literature support
diagnosing
the Type 2
Diabetes as
he feels
shortness
of breath.
Normal
adult chest
Equal chest
movement
No
intercostal
and
subcoastal
recession
No swelling,
scar mark,
pigmentatio
n, or
engorged
vein.
GI
No
abdominal
pain
No
constipation
No diarrhea
No skin
pigmentatio
n or scar
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mark
Hair
distribution
on the
abdomen
Bowel sound
present
Musculoskel
etal
Nothing
abnormal
detected.
Head, Ears,
Eyes, Nose
and Throat
From
discussion,
it has been
revealed
that John
maintained
his diet and
his wife
also
focused on
nutritional
diet or
requiremen
ts that has
evoked
challenge.
Although
he was
suffering
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Findings Literature support
for skin
allergies
because of
the
medication
s that have
been taken.
There was
no
neck/head
pain
No issue in
hearing
Neurological
In context
of
neurologica
l condition,
John is
facing
depression
and stress
issues
because of
few of his
personal
life issues.
Psychologic
al
Feeling of
stress,
anxiety and
depression
has been
faced by
John.
OBJECTIV
E
General  On As it has been found out that, patients those are taking the metf
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Findings Literature support
statement,
including
vital signs
assess
ment
Vital
signs
were
stable.
 Was
orient
ed,
alert
and
co-
operat
ive.
 Was
obese
(weigh
t
90kg).
Blood
pressure
was
170/100mm
Hg on right
arm
Pulse rate
was 82/min
on right
radial
Respiration
was 16
breaths/min.
Temperatur
e – 36.7C
Oxygen
saturation –
94% on
room air
Body weight
90kg
Blood
glucose
consumption of the tablet leads to create large number of issues
various research it has been found that, the patients who are facin
take the metformin in order to get recover). But, at the same time, t
is contributing towards the various problems. As stated, the patien
related to vomiting and nausea. The patient is not able to eat some
As, the heavy doses creates the hesitation in the service user. It ha
patients who are facing Type 2 diabetes experience high amount of
the consumption of the medicines). For instance, John is facing the s
the patient has got affected.
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435mg/dl
Height
170cm
Physical
Examinati
on
Centra
l
Nervo
us
Syste
m
Crania
l
nerve
exami
nation
- No
neck
or
facial
pain
- Sense
of
smell
was
good
- Both
pupils
were
equal
and
reacti
ng to
light
- Visual
was
good
- No
restric
tion of
eye
move
ment
- Sensat
ion of
face
fine
touch
By clinical examination, there are two types of assessments such as
assessment. In the patients who are facing diabetes must be che
pulse, blood pressure, respiration, and state of hydration. In the non
to the described parameters' measurement of BMI and waist to hip ra
Orthostatic BP should also be measured (Singh, 2018).
John did not have any cardiovascular disease like heart strokes. Joh
asthma which is determining the nose part of the body (Bird, Sánch
et.al., 2018).
In loco regional examination diabetes can affect almost every system
suspected of having diabetes should be examined thoroughly from
Examination of head and neck, eyes, biccal cavity, skin, nail, hands
abdomen, legs, feet, etc have also been diagnosed to determine the e
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Findings Literature support
sensat
ion
with
cotton
wool –
felt
the
sensat
ion
Assess
ed
with
neuro
tip –
he felt
the
prick
sensat
ion
- No
deviati
on of
mouth
/ no
weakn
ess
- No
chang
e in
taste /
hearin
g
- Able
to
smile,
frown,
and
raise
eyebr
ows:
bilater
al
equal
move
ments
- Was
able
to
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Findings Literature support
clench
teeth
- Weber
’s test
using
tuning
fork
was
positiv
e
- Glosso
phary
ngeal /
vagus
nerve
Swallo
wing
good
- Soft
palate
and
uvula
–
Symm
etry
and
uvula
move
ment
presen
t
- No
delaye
d in
swallo
wing
Access
ory
nerve
- Able
to
raise
should
ers
- Sterno
cleido
mastoi
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Findings Literature support
d
muscl
e – no
weakn
ess
- No
signs
of
fascic
ulation
or
tongu
e
atroph
y
Upper limb
neurological
examination
Gener
al
inspec
tion
- Norma
l body
postur
e
- No
scars,
wastin
g of
muscl
es,
involu
ntary
move
ment,
fascic
ulation
, and
tremor
- Tone
of
arms
were
good
(no
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Findings Literature support
rigidit
y and
cog-
wheeli
ng)
Power
- Should
er
adduc
tion-
good
- Elbow
flexion
and
extens
ion –
good
- Wrist
extens
ion
and
flexion
– good
- Finger
extens
ion
and
abduc
tion –
good
Reflex
es
- Biceps
and
triceps
reflex
es
were
good
- Supina
tor
reflex
– good
Sensat
ion of
arms
- Was
able
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Findings Literature support
to
identif
y light
touch
with
cotton
wool
on
both
arms
- Felt
the
pin
prick
sensat
ion on
both
arms
- Patien
t was
able
to
sense
vibrati
on on
proxi
mal
bony
points
Co-
ordina
tion
- Finger
to
nose
test
on
both
hands
– No
intensi
on
tremor
and
past
pointi
ng
- Rapid
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Findings Literature support
altern
ating
move
ment
test –
was
able
to
perfor
m the
test
Lower
limb
exami
nation
Gener
al
inspec
tion
- Pain
on
right
leg
- Woun
d on
right
foot
- No
wastin
g of
muscl
es,
involu
ntary
move
ment,
fascic
ulation
, and
tremor
- No
proxi
mal
muscl
e
weakn
ess
- Tip
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Findings Literature support
toes
walkin
g and
heel
walkin
g was
quite
difficul
t
- Romb
erg’s
test –
Did
not
feel
unstea
dy
Tone
- Hip
flexion
and
extens
ion –
good
- Abduc
tion
and
adduc
tion –
good
- Knee
flexion
and
extens
ion –
good
Reflex
es
- Both
knee
jerk
move
ment –
good
- Plante
r
reflex
– good
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Findings Literature support
Sensat
ion
- Sensor
y
exami
nation
showe
d
decrea
sed
sensat
ion to
touch
and
neuro
tip on
right
leg
- Was
unable
to
sense
vibrati
on
sensat
ion on
right
leg
Coordi
nation
- Heel
shin
test –
norma
l
- Toe
finger
test –
norma
l
- Foot
tappin
g test
-
norma
l
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Differentia
l diagnosis
1. Type 2
diabet
es
Basically,
it is
considere
d difficult
to
diagnose
the type
2
diabetes
with just
single
test. It
consists
of huge
number
of tests
and
clinical
assessme
nts to
identify
the
disease
in
effectual
manner.
It has
been
diagnose
The patient must adopt healthy lifestyle such as commit to manage
healthy eating habits and physical activity as a part of their day-to-d
to build relationship with the doctor that helps to reduce stress
examination plan in order to check over the diagnosis regarding
Basically type 2 diabetes is a serious kind of disease and following th
that takes round the clock commitment to meet the demand of diabe
the patient requires good support network. (Hashem, Esmael, and
depression are highly common in people living with diabetes hence s
good source of diabetes education, emotional support as well as help
ways through which the health care person is able to direct the patien
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Findings Literature support
d
specially
using the
glycated
hemoglo
bin test.
This
blood
test helps
to
indicate
the
average
blood
sugar
level for
the past
two or
three
months.
If the A1C
test is
not
available
or the
patient
have
certain
condition
s that
interfere
with an
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Findings Literature support
A1C test,
the
doctor
may
utilize
other
tests
such as
random
blood
sugar
test,
fasting
blood
sugar
test, oral
glucose
tolerance
test,
screening
, etc.
If the
patient is
diagnosed
with
diabetes
issues, the
health care
provider
may do
other tests
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Findings Literature support
as well to
differentiate
the type of
the disease.
Since the
two
conditions
requires
individual
treatments.
The health
care
provider
must repeat
the test A1C
at least two
times a year
and when
there are
any changes
within the
treatment. It
is highly
dependent
upon the
age factor
as well as
other
factors. The
primary
treatment
involves
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Findings Literature support
healthy
eating
habits,
regular
exercise,
weight loss,
possibly,
diabetes
medication
or insulin
therapy and
blood sugar
monitoring.
Regular
monitoring
of blood
sugar levels
in significant
to avoid
severe
complication
s. The
patient also
must be
aware about
the
symptoms
and signs
that may
suggest
irregular
blood sugar
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Findings Literature support
level and
the
requirement
of
immediate
care.
2 more
differential
diagnosis
should be
written
The diabetic
neuropathy is a
kind of nerves
damage that can
cause an
individual if they
are already
suffering from
diabetes. While
the physical
examination
John has not
founded
suffering from
this disease as
he is not having
problem related
to digestive
system, urinary
infection and
heart related
things.
2. The
diabetic
keto
disease
has been
occur
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Findings Literature support
when
the
human
body
started
to
produce
high
level of
blood
acid into
the
body. It
is a
serious
complica
tion if it
occurs to
a
diabetic
patient.
John has
to deal
with this
high
level of
blood
acid
because
of
increase
of
glucose
from
which
the
other
tissues
enters in
the body
which
harms
the
diabetic
human.
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Findings Literature support
Diagnostic
s
In case of
diabetes,
continues
sugar test,
random
blood sugar
test, glucose
sugar test
and many
more test
essential for
identificatio
n of that
patients
have face
many issues
and define
how long it
faces
various
challenges
from the
specific
issue. As the
John is
suffering
from various
disease,
with the
help of
diagnosis’s
checkup
they
founded
that John is
not suffering
from cancer
and gastral
issues.
By adopting evaluation this factor Johan has responsibility to co
keeping regular check in case of needs and try to reduce weight with
many more activities which provide benefits for health effectiveness
Ryugo, 2021). From the identification of John health problems, i
diagnostics which makes and provide idea about which product es
which medicines practices has to involve into their lifestyle’s effective
Plan John faced
many issues
from the
diabetes so
from the
application
of
To communicate and concern with doctors which has power to p
managing various aspects with continues and regular activity. Ident
of various activities about blood testing before and after lunch beca
which factors mainly affects patient has increasing sugar from eatin
food. Also, various aspects have been providing information abou
essential in solution of any problem or any health related issues (Mo
about all these aspects makes clarity in how to develop contin
Page 36 of 48

Findings Literature support
(non-
pharmacol
ogic,
pharmacol
ogic,
education,
referral,
follow-up,
social
care,
mental
health)
diagnostics
activities its
defiantly
gives
benefits in
life and it
improves
quality of
life with
effective
manner.
Application
of continues
practices
from the
consult of
doctors they
clearly
provide
information
about which
activities
essential to
combine
into life for
more
consistency
expansion
into life for
maintain
efficiency.
Based on
above
discussed
current
medical
history and
medication,
some
effective
plan can be
diagnostic of any health issues application and consulting activity dev
In regard to treatment and care plan for type 2 diabetes, it can be
regular exercise, maintaining weight by having spinach, cabbage,
cashew and brown rice can help people in maintaining their sugar l
and et.al., 2021).
By knowing sugar level ranges, people can take actions for mainta
sugar level. Some normal sugar level ranges include:
 Less than 100 mg/dL is normal as fasting blood sugar.
 100 to 125 mg/dL can be diagnosed as pre diabetes.
 126 mg/dL and higher than this can be diagnosed as diabetes.
Some precautions that need to be taken by service users after diagn
include:
Healthy eating
Weight loss
proper blood sugar monitoring
Physical activities including aerobic exercise, limit inactivity and resis
Some effective medications that can be taken after prescribing wit
DPP 4 Inhibitors and insulin therapy.
On the basis of above discussed pharmacological as well as non-phar
can be said that John can improve his health by taking proper su
providers. Along with this, it can be suggested that service users sho
social activities because isolation and loneliness increase stress and
main causing factors of type 2 diabetes.
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Findings Literature support
suggested
as per the
need of
John.
Nonpharm
acological:
fruits,
vegetables,
whole
grains, and
nuts
 Keepin
g the
blood
sugar
contro
lled.
 Mainta
in the
clean
ulcer
and
banda
ged.
 Clean
up the
wound
on
daily
basis
by
utilizin
g the
clean
and
proper
banda
ge.
People are
required to
maintain
and balance
their mental
health
accordingly
and should
focus on the
mental
Page 38 of 48

Findings Literature support
structure
from which
they can be
able to
recover
faster.
Pharmacol
ogical:
Human
insulin
analog
Foot care
 check
your
feed
daily
 wear
clean
and dry
socks
Mental health
 Exercise
often
 Get
enough
sleep
 interact
with
people
and stay
happy
Social care
 Increase
heath
care
Page 39 of 48

Findings Literature support
costs
 Do not
smoke
 Consider
good
environ
ment
Follow up
 Required
to do
self-care
 Take
medicati
on on
time
 Monitor
the
glucose
and
sugar
level.
Demograp
hics
John is 60
years old
man live
with his
wife. He is
overweight
and
currently
suffering
from
mobility
issues.
Based on secondary data, it is known that African Americans and Am
risk for type 2 diabetes. Some factors that can lead this problem to
weight, inactivity, race, age, ethnicity, prediabetes, and unbalanced
and older adults are at the highest risk for developing type 2 diabet
45 have high chance to get affected with this disease and som
overweight, stress and unhealthy lifestyle Sahin and et.al., (2021).
Based on this demographic trend, it can be said that John needs to t
is overweight, have unhealthy lifestyle and is 60 years old. By consu
he can improve his health and can live better life. (Bilsker, Fogarty, a
increase life expectancy and by having proper nutritional value of d
social activities, he can maintain his sugar level.
John get suffer from heath issues and similarly various people get
And in Maldives statistical data multiple people get suffer from simila
life because of their culture. People get highly consider and prefer d
Page 40 of 48

Findings Literature support
health and as well as its generates multiple health issues. So
government and health department develop awareness in audience t
of right food and right exercise for society effectiveness. Its importan
maintain their lifestyles on the basis of health issues identification
manage life effectiveness and control or manage health problems.
PART B
Summary of Johns’s case
From the identification overall study, it has been clear that John face major problem
from overweight, from this reason it affects from multiple problems like stress, higher
blood pressure, Metformin issue and many more. As well as they do not properly
communicate with family members, so their 2 children do not stay with him. This
reason also gets badly influence their mental health. Children mainly leave their
house because of their father’s bad behavior and from lots of health issues. One
major factor knowing from this study that overweight influence 2 major disease like
diabetes and second one is mobility (Dubey, Thakur and Chattopadhyay, 2020). Both
issues and disease influence their mental health, physical injuries and many more.
John not properly considers and manage lifestyle. That's the reason they must face
many challenges and issues in life. Also, it evaluated that John has no potential to eat
food because when they eat food their digestive system has no power that do not
properly work. Uses of drug effects on overall health and John provide various
problems to their family members as well and mostly his wife because her
responsibility to provide food medicines on proper time. So, it’s essential that they
have to become responsible towards their family members. it’s very important
because without consideration of all these aspects impacts on mental health and it’s
getting very bad aspect for children mental health. John only considers their
enjoyment but not consider which issues they have to face in the future.
From the issue of overweight its very challenging for family members. John has no
potential to stand up with his own leg so it’s not easier to handle the overweight
individual. Also, from the diabetes they face foot injuries as well continuously after
having mobility and diabetes issues multiple factors affect John and their family
members. From the mobility disease john face many problems like joint pain,
weakness, muscles pain and major problem is walking without support. This specific
Page 41 of 48

reason individual need support from others. It has been also evaluated that when
human involve of wrong things in life, like harmful drinks, drugs, bad food influence
may create problems, so human must consider all these essential aspects. It’s
important that daily maintains health food, healthy drinks and many more which is
useful for health stability (Czech, 2017). Furthermore, john has responsibility towards
family members, so major concern and responsibility is to develop healthy family
environment. Controlling sugar is not easy. His wife faces many challenges in his
treatment and John’s overweight, so they do not have potential and able to move
anywhere, from this reason their children get badly affected because they do not
have stability from house. Mother faces many issues from their father’s unhealthy
lifestyle since they are not responsible towards the family. From the overall study it
has been found out that john is taking Metformin in order to get recover from the
diseases. But this leads to creating certain issues for the service user.
As patient is taking high doses of medicines it resulted in creating allergies to john.
The consumption of Metformin has created issues related to diarrhea, vomiting and
nausea (Oguntibeju, 2019). It has further created large number of lactic acids in
digestion. Within this, it has affected immune power of the patient as well. As a
result, patient has become weak. Physical capacity of the patient has been decreased
over a high note. This medical prescription is often concerned in creating anxiety in
patient.
It has been found that john is not living with his children. And patient has no support
from his children. This is contributing to health issues of patient as well. Family
support at the time of treatment has been considered as one of the main elements in
treating patient. But, in this case, service user has no love and support from family.
No support and love from family has influenced the john to adopt the introvert
personality. Patient no more believes in making interaction with people. This further
leads to create depression to john. It has been analyzed that, john has no family
therefore, patient often faces anxiety and depression (Zhuang, (2020). Service user is
often experiencing mental problems. And this influence john in negative manner.
Patient has no more desire to make interaction with people in society. Service user
even do not make interaction with service provider. Personal history of the patient
has a high impact over social history of the patient. Patient has lost all desire of
Page 42 of 48

getting love. Physically and mentally from both aspects, john is less effective. This
has impacted social and personal aspects of patient in high manner. Type 2 diabetes
impact cardiovascular system and respiratory system of the patient. Major effect of
type 2 diabetes over cardiovascular system is that it leads to high blood pressure.
There are high chances of damaging the blood vessel to john and along with this
there is a high risk of cardiovascular diseases in patient (Bakris, (2020). As Type 2
diabetes increases blood pressure, this leads in affecting arterial walls. Major effect of
type 2 diabetes over respiratory system is that it leads to create problem of asthma
in the patient. The patient must face certain issues while breathing. There is a risk of
having pulmonary diseases and pneumonia as well to john.
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