Type II Diabetes Mellitus: A Patient's Presentation and Analysis

This presentation is a case study focusing on a 65-year-old patient named Jack Anderson, who is diagnosed with Type II Diabetes Mellitus. The presentation starts with Jack's patient summary including his lifestyle, medical history, and current medications, specifically Metformin. It explains the process of insulin synthesis, release, and binding to target tissues, and how this process is affected in Jack's condition. The consequences of long-term poorly controlled hyperglycemia, such as myocardial infarction and neuropathy, are discussed in relation to Jack's case. The presentation further analyzes Metformin's mechanism of action and its effectiveness in managing Jack's blood sugar levels, including its impact on insulin resistance and abdominal adiposity. The role and significance of HbA1c in monitoring and managing the patient's condition are also explained. The presentation concludes with a list of cited works used for the research.

TYPE II DIABETES
MELLITUS
-a brief presentation

PATIENT’S SUMMARY
Name: Jack Anderson
Age: 65 years old
Issue: Type II diabetes mellitus
Weight: Overweight with a BMI of 37
Job: Works a senior manager of a local supermarket
Family: Lives with his wife and two college-going children
Drinking habit: Alcoholic in nature, drinks 4-5 glasses of alcohol per day
Medicines used: Takes Metformin on a regular basis but blood sugar level is not being managed.
Family History: His father and Uncle had diabetes and died due to the complications of it.
Hello! I am Jack
Anderson, 65 years old
and my concern is
regarding type II
diabetes mellitus!

INSULIN SYNTHESIS, RELEASE AND
BINDING TO TARGET TISSUE FOR JACK
Beta
cells of
pancrea
s
produc
es
Insulin
After
getting
released
into the
blood
stream,
it is
transport
ed into
the
target
cells
Insulin
gets bind
to the
receptor of
the target
cell
membrane
and then it
sends
signal to
the glucose
channels
Glucose
channels
open into
the cell
reducing
the levels
of blood
sugar
Insulin binding in case of JackI
n
d
ia
betic
p
atie
n
ts
i
n
s
u
li
n
rece
p
t
o
rs
b
ec
o
m
e
resista
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li
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o
se
tra
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rte
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t
o
t
h
ecells
g
et
re
d
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ce
d
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g
l
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c
o
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e
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r
e
a
s
e
s

CONSEQUENCES OF LONG-TERM POORLY
CONTROLLED HYPERGLYCAEMIA
 Neuropathy is common complication of
diabetes that causes nerve damage.
 Jack consumes alcohol and it increases
the risk of developing neuropathy.
 Since his blood glucose level is poorly
managed, osmotic stress can cause
atrophy in his nerve cell that leads to
neuropathy (Yabe, Seino, Fukushima &
Seino, 2015).
Myocardial infarction for Jack
•This occur when coronary arteries are narrowed
by atherosclerosis.
•It can lead to the death of heart muscle.
•According to literatures, diabetes increase the
risk of myocardial infarction due to higher
incidence of cardiovascular disease.
•Jack’s poorly managed blood sugar level causes
hyperglycaemia and it leads to myocardial
infarction.
•Also, BMI is another reason of Myocardial
infarction according to literature and high BMI of
Jack increases the risk of it.

METFORMIN MANAGEMENT
FOR JACK
 Jack is consuming Metformin as a part of
his treatment.
 This is effective because it increases the
sensitivity of muscles and thus blood sugar
level is reduced from the blood easily.
 Jack intakes Metformin after meal and as a
result it reduces spike in blood sugar level
(Weir, Abrahamowicz, Beauchamp &
Eurich, 2018).
Metformin : Mechanism of action
It enables muscle cell to remove
glucose by increasing its sensitivity.
Liver produces glucose, breaking
down the glycogen and metformin
reduces the amount of glucose.
Metformin delays the sugar
absorption from the intestine after
taking meals and results in reduced
blood sugar level.

INSULIN RESISTANCE
AND ABDOMINAL
ADIPOSITY
 Excess body fat enhances the
availability of free fatty acids.
 It increases glucose production,
inhibits glucose utilization, and insulin
secretion.
 Adeponectin is a peptide increases the
sensitivity of peripheral cells to insulin
and for type II diabetes patients, level
of peptide is low (Marcadenti, Fuchs,
Moreira, Gus & Fuchs, 2017).
HBA1C AND ITS
USE ON JACK
HbA1c or Haemoglobin A1c is found in
red blood cells and it is formed when
glucose is attached to haemoglobin.
The concentration of HbA1c depends
on the blood glucose levels.
It provides an average blood sugar level
over 8-12 weeks.
For patients like Jack it is a better
indicator long term management than one
off blood sugar measurements.
Measure of regular exercise and healthy
diet is important for Jack.

WORKS CITED
Czech, M. P. (2017). Insulin action and resistance in obesity and type 2 diabetes. Nature medicine, 23(7), 804.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC648953/
Marcadenti, A., Fuchs, F. D., Moreira, L. B., Gus, M., & Fuchs, S. C. (2017). Adiposity phenotypes are associated
with type-2 diabetes: LAP index, body adiposity index, and neck circumference. Atherosclerosis, 266, 145-150.
Retrieved from https://www.sciencedirect.com/science/article/pii/S0021915017312935
Weir, D. L., Abrahamowicz, M., Beauchamp, M. E., & Eurich, D. T. (2018). Acute vs cumulative benefits of
metformin use in patients with type 2 diabetes and heart failure. Diabetes, Obesity and Metabolism, 20(11),
2653-2660. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1111/dom.13448
Yabe, D., Seino, Y., Fukushima, M., & Seino, S. (2015). β cell dysfunction versus insulin resistance in the
pathogenesis of type 2 diabetes in East Asians. Current diabetes reports, 15(6), 36. Retrieved from https://
link.springer.com/article/10.1007/s11892-015-0602-9