Diabetes Management: A Case Study of Patient Care & Pharmacotherapy

This case study presents the case of Karen, a 57-year-old woman with type 2 diabetes, hypertension, and asthma, focusing on her pharmacotherapy assessment and diabetes management. The case details her medical history, including emergency admissions and a knee replacement, and her...Read More

Radiological/pulmonary diagnostic
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Introduction
As an advanced practical pharmacist in type2 diabetes, I work closely with patient issues. In the
field of medicine, I also work collaboratively in the existing primary care setting to offer
proximity to the patient's wellbeing. As a nurse, I help in the integration of pharmaceutical,
medical and education service provision. Direct care operations are also appropriate to meet the
person's self-evaluation, management and intervention that type 2 diabetes requires.
The existing patient education, information, awareness and self-evaluation skills in the conduct
change are significant underpinnings of the pharmaceutical care (Docherty et al,2013). This is
because they directly relate to the entire problem and relate closely to the intervention methods
needed. As a health care provider, it is important to offer continuous medication to diabetic
people. This means that nurses are important in the evaluation of complications prevention, goal
setting in the clinical settings and help in the management of cost issues.
In this case, the work of the health care professional involves conducting clinical assessments
and other physical examinations to acknowledge the purpose for additional care if need be
(Feldkamp, Carey, Byrne, Krikov, & Botto, 2017). In the clinical intervention of diabetes, it is
vital to consider carrying out special laboratory tests and interpretation of the results. This will
help in the dissemination and analysis of key information need for correct intervention of the
disease.
There is a need to design a medical care plan for medical providers such as charts and graphs.It
is also important to conduct effective and open communication with diabetes patients. This will
help the caregiver to detect any changes, problems with the patients and if the intervention

affects the patients cultural or ethnic domain (Gentile, Strollo, Della Corte, Marino, &
Guarino,2018).
Depending on every countries' laws and the hospital setting protocol follow-up, it is key to
prescribe medication after proper consultation with other clinicians who have had past
experiences regarding the problem. This helps in increased ideas that are diverse in the treatment
of diabetes.
The following case presentation indicates the pharmacological problems of diabetes, the process
and health risks which are specific to the individual patient, overall ethnicity or the cultural
values in the contemporary society. There also exists the close guideline needed in the
intervention of the disease such as home follow-up of the patient in the provision of health care.
There is some home issue relating to this type of diabetes which affect the patient either
negatively or positively.
Case presentation
CPT 99203-History
Karen is a 57-year-old white woman who has been referred to the health care professional for
pharmacotherapy assessment and also the management of the diabetes disease. She has various
medical conditions such as type 2 diabetes, hypertension and asthma.
However, the most prevalent medical condition is type 2 diabetes. Her existing medical history
also includes various emergency admissions as a result of the disease (Merger, Leslie, & Boehm,
2013). She also had various admissions for asthmatic conditions and suffered a knee
replacement. These medical challenges have made her type 2 diabetes to be quite prevalent in all

the times. It is evident that her historical condition regarding the disease has made her immune
system to weaken and be vulnerable to multiple challenges.
In the current era, Karen's diabetes is being offered treatment with the use of 74% insulin lispro
protamine suspension. She normally tales in 32 units and 22 units before the meal. However,
after follow-up, the patients indicates that in some cases she acquires a little more than the
prescribed one. This is in instances where she notices increased high blood glucose (Meyer,
Gabb, & Jesudason,2018). This is quite wrong since she had not been initially instructed by the
medical health caregiver. She has also not been given instructions on the utilization of an insulin
adjustment algorithm.
The patients other regular medical use includes the utilization of fluticasone dose inhaler. She
often inhales twice daily. Other medication prescribed also includes nitroglycerin that helps in
the healing of chest pains, furosemide and albuterol that are important in swelling and helps in
shortness of breath.
The patients do not use nicotine or other drugs such as alcohol consumptions. She does not have
any known drug-related allergies and her immunization have been updated regularly. She does
not miss any immunization prescribed on her as part of long term medical intervention (Miyoshi,
Ogawa, & Oyama,2016). The patient could not exercise daily for close to two weeks due to bad
climatic conditions and her asthma.Her diet includes carbohydrates in the form of snacks.
Physical examination
The patient blood pressure is at 130/78 mmHg
Her pulse rate is 88bpm indicating 22 respiration per minute

The lab reports of my patient indicate that her swelling occurs throughout the entire day time.
After further probing, she indicates that she takes an extra furosemide tablet in case there is
excessive swelling. She states that the swelling ate extremely painful especially during the lunch
hours.
CPT 99213-Home visit
After follow-up to her home, the patient indicates that she has several children who need her
care. This negatively impacts her life and recovery as it brings about distress, anxiety, anger and
depression feelings. She also indicates that her husband is abusive and quite violent at times.
This tress her hence increases her diabetic level. This home setting this negatively affects her.
In her culture, the patient indicates that her husband dictates that she carries out all her duties in
the house such as caring for the children. However, her medication condition does not allow her.
This indicates that cultural barriers negatively affect the condition of the patient. Besides, in her
husband's ethnic society most people perceive diabetic to be a curse (Prater & Chaiban, 2015).
This makes it difficult for her to acquire support from other family members as she is
discriminated because of her condition. She is afraid that they will object followup visits by the
heth careacee givers king it a problem for her recovery.
This normally puts her at risk as her blood glucose level increases each time she faces her family
and cultural challenges in her home.
Diabetes billing codes
Q040-Diabetes management incentive-$74

Billed once in a month to meet the following medical record needs.
HbA1c
Blood pressure
Weight
The health promotion existing and the patient self-evaluation help
K030-DMA-$37
Billed maximum of 3 per patient. Done after 1 year. Involves assessment
This billing code is payable to all the health care who ensure management of support for patients.
This includes counseling and management of diabetic patients
Diabetic monthly management-Insulin injection (2 therapy injections on a daily basis
G500-$31-Insulin injections to maximum of 2 months per patient in the entire life
G514-$11 Billed for each additional moth, 1-3 contracts
G520-$20-done on each additional month for 4 contacts.
The billing codes, G514 and G520 are claimed by health care professionals after continued home
follow-up for assessment and treatment.
E/M & HCFA-1500
Therapeutic care and treatment

The therapeutic endpoints of the patients ought to be highly specific, measurable and achievable.
As per of the care system, long term observations and retrospective analysis should be carried
out n order to ensure that the results are achievable (von Geijer,& Ekelund, 2015).
The outcomes and endpoints of the patient must be determined collaboratively. There is also the
need to use both pharmacotherapy and non-pharmacotherapy interventions.
There is a need to properly follow the patient to enhance continuous strategies that are important
for the medication in an appropriate manner (Wang et al,2018). It also enables the creation of a
common vision that optimizes the capability for diabetes control and overall patient satisfaction.
As per the intervention program, the patient needs to do a lot of physical exercises and eat
healthy food.
Conclusion
Therefore, glycemic control and screening should be carried out to manage the diabetes
condition. Karen also needs to undergo structural behavioural weight loss therapy. There should
also be key randomized controlled trials as a diabetes prevention program in the hospital setting.
Karen should be given clear guidelines on nutrition-based treatment to control her eating habits,
physical exercise is also important as interventions for diabetes.

References
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