Management Approaches for Type 2 Diabetes: A Case Study of Bill McDonald

This article discusses the potential management approaches for Type 2 Diabetes and develops an education plan for Bill McDonald. It covers patient education, dietary advice, glucose control, drug treatment, control of blood pressure, and support resources available for diabetic people in Australia.

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Type 2 Diabetes
Name
Institution

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Type 2 Diabetes
Introduction
Type 2 diabetes can be described as a progressive condition that forces the body to
develop a form of resistance to the normal effects of insulin. As a result, the pancreas may lose
the capacity to produce sufficient insulin (Chatterjee, Khunti & Davies, 2017). This condition is
more common among adults above the age of 45 and represents around 85% - 90% of all cases
of diabetes. Type 2 diabetes is said to run in a family such that if your family member suffers
from it then you have a genetic disposition for this condition. It can also result from other
variable lifestyle risk factors (Chatterjee et al., 2017). We are presented with a scenario where
Bill McDonald is diagnosed with diabetes. In this essay, we will analyze the potential
management approaches for Mr. McDonald. Additionally, we will develop an education plan for
Bill.
Management Approaches for Mr. McDonald
The aim of caring for type 2 diabetic patients is to get rid of the symptoms and prevent or
reduce any potential complications that may arise from this condition. Best control of glucose
and the potential cardiovascular risk factors such as hypertension, smoking, and obesity among
others is crucial for the management of type 2diabetes (Kahn, Cooper & Del Prato, 2014). This
management should be designed in such a way to suit the needs of a particular patient. Below are
some of the approaches management of type 2 diabetes.
Patient Education

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Mr. McDonald should have an access to a structured patient education at the time of
diagnosis and then on subsequent assessments. Patient education improves an individual’s
perspective regarding their condition. During this program, it is important to advise the patient
on dietary issues while giving consideration to conditions like hypertension and obesity (Ley,
Hamdy, Mohan & Hu, 2014). From the provided case, we are informed that Bill has been
smoking since he was 35. This education program can, therefore, be used to advise him to cease
smoking.
Dietary Advice
Mr. McDonald should be encouraged to take practice a diet that is rich in high-fiber
carbohydrates like vegetables and fruits. Additionally, he can be advised to include dairy
products that are low in fats while at the same time limiting the intake of food rich in saturated
fats (Ajala, English & Pinkney, 2013). He could also be advised to substitute foods containing
sucrose for other carbohydrates in his meal plans.
Glucose Control
His level of HbA1c should be measured at intervals of three to six months until the level
of HbA1c becomes stable. After stability has been gained the measurement should be taken at an
interval of six months. The aim of this measurement should be to ensure that the level of HbA1c
is around 6.5% instead of the 7.2% that he is currently on (Powers et al., 2015). Once the target
level has been attained, Mr. McDonald should be advised to maintain HbA1c at that level.
Drug Treatment

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The initial treatment that Bill should receive is a standard release metformin that helps to
control the levels of glycated hemoglobin. A dual therapy that involves a combination of
metformin and dipeptidyl peptidase-4 or sulfonylurea may be considered if the initial treatment
does not help to lower the level of HbA1c (Kahn et al., 2014). Furthermore, a triple therapy
involving metformin, dipeptidyl peptidase-4 and sulfonylurea may be recommended if the dual
therapy fails.
Control of Blood Pressure
Bill’s blood pressure is measured to be 170/100 mmHg, and this value is extremely high.
His blood pressure should, therefore, be checked at a monthly interval management purposes.
The doctor can additionally provide lifestyle advice concerning diets and exercise to help in
reducing the blood pressure (Cushman et al., 2010). An antihypertensive drug treatment can be
recommended in addition to other therapy until a consistent blood pressure of 140/80 mmHg or
lower is attained.
Support Resources Available for Diabetic People in Australia
Australia has numerous organizations that support diabetic people, raise awareness for
diabetes and search for the cure. Some of these organizations include the Australian Diabetes
Educators Association that is tasked with promoting best practice and ensure the well-being of
all diabetic individuals and those at the risk of getting diabetes. Another organization is the
Australian diabetes society that is responsible for providing the ultimate care for diabetic people
in addition to researching on the prevention and cure of diabetes ("Key diabetes organisations",
2018). These organizations have support programs that educate people the importance of

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monitoring their blood sugar levels, healthy diets, the importance of physical exercise, and
management of the complications that may arise due to diabetes.
An Education Plan for Bill McDonald
The main purpose of this education plan is to help the patient in making informed
lifestyle choices that are aimed at promoting health. Mr. Bill’s program should be made up of a
treatment approach that includes education about nutrition therapy and diabetes, an appropriate
plan of meals that is suited to his lifestyle and long-term goals regarding lifestyle changes
("nursesaregreat.com - Homepage", 2018). An appropriate education plan should be made up of
6-day classes with each class having a session of 2-3 hours. The following topics might be
incorporated into the education plan. On day one, he will have a 2-hour session to learn about the
general overview of diabetes. This session ensures that the patient gains an informed
understanding about diabetes and the complications associated with the condition. On the second
day, the discussion should be about monitoring the level of blood glucose and setting the goals
for blood glucose level. The third day is about medication and insulin, which is a 3-hour session.
On the fourth day, the discussion will be about the complications of diabetes and physical
exercises. The fifth and sixth days will be about healthy diet and coping with diabetes.
Conclusion
Type 2 diabetes is a progressive disease that that results in an insulin resistance by the
body which eventually leads to insufficient production of insulin. It results from an individual’s
lifestyle choices and sometimes may be due to hereditary genetics among family members. There
are several management approaches that can be used to care for diabetic patients like Bill
McDonald. These management approaches may include dietary advice, drug treatment, blood

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sugar control, control of blood pressure and patient education. An appropriate education plan
may be developed to help the patient further in preventing and managing diabetes. All these
approaches in addition to the developed education can help Bill McDonald in managing his
diabetic condition.

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Key diabetes organisations. (2018). Diabetesaustralia.com.au. Retrieved 24 April 2018, from
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nursesaregreat.com - Homepage. (2018). Nursesaregreat.com. Retrieved 24 April 2018, from
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