Case Study: Diabetes Mellitus of a 61-Year-Old Woman Analysis

This case study presents a detailed analysis of diabetes mellitus, focusing on a 61-year-old woman, Pauline, living in supported tenancy. The assignment explores the pathophysiology of type 2 diabetes, highlighting the role of insulin, glucose metabolism, and risk factors like obesity and sedentary lifestyle. It examines Pauline's symptoms, including increased thirst, hunger, blurred vision, and frequent urination. The paper discusses diagnostic methods, such as glycated hemoglobin tests and random blood sugar tests, and outlines pharmacological interventions like metformin and GLP-1 receptor agonists, alongside non-pharmacological approaches like dietary modifications and activities of daily living. The case study emphasizes the importance of support workers in providing emotional and physical support, adhering to ethical codes, and empowering patients. National guidelines and strategies are also considered to improve patient outcomes. The conclusion emphasizes the global burden of diabetes and the role of social workers in ensuring patient well-being through comprehensive care plans.

Running head: DIABETES MELLITUS
Name of the student
Name of the university
Author note:

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Introduction:
Over the decade, the prevalence of diabetes mellitus contributed to global mortality and
morbidity rate. Brinck et al. (2016), highlighted that diabetes mellitus is a group of metabolic
disorder characterized by hyperglycemia which resulted from a defected secretion of insulin
from the body. The chronic effect of this defect is that it is associated with long term damage,
dysfunction of organs. Hornby et al. (2015), highlighted that in united states, approximate 27
million people in united states are suffering from the diabetes mellitus. There are several
pathogenic processes are involved in diabetes ranges from autoimmune disease to the
Abnormalities due to the presence of insulin action (Li et al. 2016). The case study represents
diabetes mellitus of 61 years woman, Pauline who lived in support tenancy. She suggested that
she was experiencing increased thrust and hunger especially after eating. She also stated that her
vision was blurred and frequently urinates, feeling nauseous. Due to blurred vision, she was not
able to do her daily activities and remain unhygienic majority of the time. She had a higher
blood glucose level and usually lived a sedentary lifestyle. She was obese and had a frequent
habit of smoking. Consequently, she was feeling low, demoralized and has no one to talk about.
This paper will illustrate pathophysiology of the diabetes mellitus, how it is manifested in client,
diagnosis and interventions, policies and guidelines in the following paragraphs:
Discussion:
Pathophysiology of Diabetes Mellitus:
The case study represents diabetes mellitus type II of a 61 year women who are suffering
from different diabetes syndromes and seeking the assistance of social workers to resolve her

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health issues (Holman, Young and Gadsby 2015). From the perspective endocrinology, insulin
is a peptide hormone excreted from the beta cells of the pancreas. The pancreases secrete insulin
in the bloodstream where it circulates in the blood to lower the blood sugar level through
inducing glucose metabolism. Glucose plays a major role in the development of diabetes mellitus
II. When glucose level is low for several conditions, insulin breaks down stored glycogen to keep
the glucose within the threshold level (Evans et al. 2018). In patient with diabetes type 2 as
observed in case of Pauline, as glucose level increased in the blood due to glycogen metabolism
the insulin-producing beta cells in the pancreases started secreting more insulin’s and eventually,
these cells become impaired to meet the demand of the body (Holman, Young and Gadsby
2015). Therefore, deficient insulin action results from inadequate insulin action or diminished
tissue responses to insulin due to the complex action of the hormone pathway. Accumulated
evidence highlighted that overweight, family history, having a sedentary lifestyle, pre-diabetic
syndromes are highlighted as the risk factors of the developing diabetes mellitus type II
( Holman, Young and Gadsby 2015). In the case study, the patient had was overweight and
usually has a sedentary lifestyle without exercise. Hornby et al. (2015), suggested that physical
activity helps to control the weight and uses glucose as energy which consequently makes cells
more sensitive to insulin. Moreover, the blood glucose level of Pauline is higher which further
indicated pre-diabetic syndrome and she also had the habit of smoking which gave rise to
diabetes II. Therefore, extreme symptoms such as increased thrust, hunger, blurry vision and
frequent urination are observed in patient. . Brinck et al. (2016), suggested that when the glucose
level is high in blood, the excessive glucose excreted in the urine, the water follows the
concentration of the glucose resulted in high output as an observed inpatient. This further leads
to the increased thirst as observed in the case of Pauline. Hornby et al. (2015), reported that

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diabetes mellitus not only affected the pancreases also affected other body parts. Diabetes
increases the risk of serious optical disease because high glucose level causes the lenses of the
eyes to swell which further causes blurred vision as observed in the case study. Moreover, as
discussed by Brinck et al. (2016), diabetes dramatically increases the risk of heart disease,
celebrated, high blood pressure and narrowing the blood vessels. Excess glucose also causes
tingling, numbness and burning pain in limbs due to neural abnormalities’. The high glucose
level causes the damage of the nerves which causes control the digestive system leading to
nausea as observed in this case study. These symptoms not only affected Pauline mentally but
also affected her wellbeing (Federici et al. 2018). It was observed that she was feeling low
frequently due to her physical issues and frequently feeling low. There it has become difficult
for her to live a life of loneliness where she had no one to communicate about the problem which
further affected her mental and physical wellbeing.
Diagnosis and treatment:
In the current context of the patient, the diagnosis of the patient is required to suggest
accurate pharmacological and non- pharmacological intervention of the patient. The type 2
diabetes usually diagnosed using glycalated hemoglobin test where the blood tests indicate the
large blood level for 2 months month. The blood level over 6.5 % or higher indicates diabetes.
Moreover, random blood sugar tests are done where the blood sugar level higher than 200 mg/dl
suggested diabetes with the combination of symptoms of frequent urination and extreme thirst as
observed in this case study. Therefore, in the current context, pharmacological interventions
such as metformin, Thiazolidinediones, GLP-1 receptor agonists such as Exenatide, semaglutide
can be administrated to control the blood glucose level of Pauline. Her diet can be amend
according to her body need which involves low-fat dairy products, whole grains, leafy vegetables

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like broccoli, lettuce, fiber-enriched foods such as fruits and vegetables should be included to
control the blood glucose level (Federici et al. 2018). The monitoring of the dietary
consumptions and blood glucose level is required to monitor for at least two or three months for
reducing the severity of the symptoms. The non- pharmacological management can be done by
using the care plan of activities of daily living.
The activity of daily living:
The activities of daily living face a series of basic performed by individuals on the daily
basis necessary in living at home. In the current context, it was observed that because of blurred
vision she was not able to perform daily activities and remain unhygienic for most of the time.
Therefore, in this case, first care would be to assist her in bathing, showering, nail care, and oral
care to maintain her personal hygiene (Li et al. 2016). Assist her in dressing such as developing
appropriate clothing decisions. The Residential care also includes assist Pauline in the feeding
herself and include appropriate diet (Federici et al. 2018). In the current context, since she was
having a frequent urge of urination, maintaining continence is an important aspect of the activity
of daily living. Due to the blurred vision, she also had mobility issues, managing her to move,
getting in and out of the body, ability to walk independently .The policies and national diabetic
management strategy UK 2017 guidelines can be followed to implement these interventions for
the patient (Brinck et al. 2016). Affordable care can be implemented for management if health
issues and guideline can be followed for the wellbeing of the patient. According to the guiding
of diabetic management strategy UK 2017, assisting patient in conducting daily activities such
as bathing, eating healthy diets, assist patient to reduce the smoking habits , involving her in
light physical activities for 30 minutes every day, monitoring her blood glucose level for three

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months , involving her in social activities such as motivational therapy, motivational talk, music
therapies , different community program are required to reduce the health issues .
Role of support workers:
In the current context, the support workers play a huge role in assisting a patient to live
her independently since the work of social workers is to support the patients emotionally and
physically through evidence-based practice The British Association of Social Workers release
codes of ethics release codes of ethics to support the patient for their emotional and physical
wellbeing. The first code is the ethics in social work where social workers which comprise the
statement of values and principles related to human rights, social justice and professional
integrity for providing support to the patient (Bowles et al. 2016). Under the first code, the
second division is to establish the definition of social work through evidence practice. In the
current context, bringing social changes, engaging patients in the different social activities
mentioned above, empowering patients are part of the first code and standard of the social
worker. The second code is following ethical principles such as valuing the human dignity;
uphold each person’s physical, psychological, emotional and spiritual integrity, respecting the
decision of patient, promoting full involvement of the patient in the social services (Boetto
2018). The third code of ethics is ethical practice principles such as social workers would build
and sustain a relationship with the patient based on their rights and decision of controlling their
own life. In the current context, the patient’s choice should be prioritizing and care should be
given through extra initiatives for the patient within the professional role. Building a therapeutic
relationship is recognized as a crucial practice of social worker to gain an understanding of the
mental and physical condition of supporting their wellbeing (Bowles et al. 2018). Moreover,
providing detailed information to the patient before implementing any care plan or implementing

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pharmacological interventions for the patient is required to obtain informed consent for avoiding
any social issues. Empowering patient is highlighted, as one of the patients is a crucial part of the
health care activities (Bowles et al. 2018). . Empowering patient by developing health policies,
respecting values and beliefs through implemented it in the care services are required. These
practices by following codes of ethics and standard would empower Patient (in this case
Pauline), boost, self-esteem, and self-confidence; liberate the patient from the burden of feeling
low (Bowles et al. 2018).
Conclusion:
Thus, it can be concluded that the prevalence of diabetes mellitus has become a global
burden which affected the physical and mental wellbeing of a considerate number of individuals.
The case study represents diabetes mellitus of 61 years woman, Pauline who lived in support
tenancy. She suggested that she was experiencing increased thrust and hunger especially after
eating. Considering pathophysiology of diabetes mellitus, when glucose level is low for several
conditions s, the lever breaks down stored glycogen to keep the glucose level within threshold
level and to meet the demand of body, beta cells were impaired to produce insulin. In the
current context, social workers play a crucial role in supporting the patient for ensuring their
mental and physical wellbeing. The activities of daily activities are required to incorporate in this
case by following the codes of practice to manage her daily activities which involve eating a
healthy diet, bathing, maintaining personal hygiene, and communicating.

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References:
Boetto, H., 2018. Advancing transformative eco-social change: Shifting from modernist to
holistic foundations. Australian Social Work, pp.1-13.
Bowles, W., Boetto, H., Jones, P. and McKinnon, J., 2018. Is social work really greening?
Exploring the place of sustainability and environment in social work codes of
ethics. International Social Work, 61(4), pp.503-517.
Bowles, W., Boetto, H., Jones, P. and McKinnon, J., 2018. Is social work really greening?
Exploring the place of sustainability and environment in social work codes of
ethics. International Social Work, 61(4), pp.503-517.
Brinck, J.W., Thomas, A., Lauer, E., Jornayvaz, F.R., Brulhart-Meynet, M.C., Prost, J.C.,
Pataky, Z., Löfgren, P., Hoffstedt, J., Eriksson, M. and Pramfalk, C., 2016. Diabetes mellitus is
associated with reduced high-density lipoprotein sphingosine-1-phosphate content and impaired
high-density lipoprotein cardiac cell protection. Arteriosclerosis, thrombosis, and vascular
biology, 36(5), pp.817-824.
De Ferrari, G.M., Stevens, S.R., Ambrosio, G., Leonardi, S., McGuire, D.K., Armstrong, P.W.,
Green, J.B., Bethel, M.A., Holman, R.R., Peterson, E.D. and TECOS Study Group, 2018. P1877
LDL-C treatment patterns and associated outcomes in patients with type 2 diabetes and CVD:
insights from TECOS. European Heart Journal, 39(suppl_1), pp.ehy565-P1877.
Evans, M., Mehta, R., Gundgaard, J. and Chubb, B., 2018. Cost-effectiveness of insulin degludec
vs. insulin glargine u100 in type 1 and type 2 diabetes mellitus in a UK setting. Diabetes
Therapy, 9(5), pp.1919-1930.

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DIABETES MELLITUS
Federici, M.O., McQuillan, J., Biricolti, G., Losi, S., Lebrec, J., Richards, C., Miglio, C. and
Norrbacka, K., 2018. Utilization Patterns of Glucagon-Like Peptide-1 Receptor Agonists in
Patients with Type 2 Diabetes Mellitus in Italy: A Retrospective Cohort Study. Diabetes
Therapy, 9(2), pp.789-801.
Holman, N., Young, B. and Gadsby, R., 2015. Current prevalence of Type 1 and Type 2 diabetes
in adults and children in the UK. Diabetic Medicine, 32(9), pp.1119-1120.
Hornby, S.T., McDermott, F.D., Coleman, M., Ahmed, Z., Bunni, J., Bunting, D., Elshaer, M.,
Evans, V., Kimble, A., Kostalas, M. and Page, G., 2015. Female gender and diabetes mellitus
increase the risk of recurrence after laparoscopic incisional hernia repair. The Annals of The
Royal College of Surgeons of England, 97(2), pp.115-119.
Knott, C. and Scragg, T. eds., 2016. Reflective practice in social work. Learning Matters.
Li, Y., Wang, C., Huai, Q., Guo, F., Liu, L., Feng, R. and Sun, C., 2016. Effects of tea or tea
extract on metabolic profiles in patients with type 2 diabetes mellitus: a meta‐analysis of ten
randomized controlled trials. Diabetes/metabolism research and reviews, 32(1), pp.2-10.