Case Study: Michael, a Truck Driver with Type 2 Diabetes and Treatment

This report presents a case study of Michael, a 58-year-old truck driver diagnosed with type 2 diabetes. The analysis begins with Michael's initial treatment with Metformin, which he couldn't tolerate, and his subsequent management with a sulfonylurea and DPP-4 inhibitor, along with an ACE inhibitor for hypertension. The report explores alternative oral medical options, including SLG2 inhibitors and sulfonylureas, considering their efficacy and potential side effects. A significant portion of the report addresses Michael's reluctance to commence insulin treatment, highlighting the potential health risks, such as increased blood sugar levels and diabetic ketoacidosis. The report concludes by summarizing the available medical options and the implications of Michael's decisions on his health outcomes.

a truck driver living
with type diabetes

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
Medical Options Available to Michael........................................................................................3
Issues Related to Michael’s Reluctance Towards Commencing Insulin.....................................4
CONCLUSION................................................................................................................................4
REFERENCES................................................................................................................................5

INTRODUCTION
Type 2 diabetes is a lifelong disease or chronic condition which negatively affects the
manner in which a healthy body is able to process blood sugar levels also known as glucose. This
report analyses the case of Michael, who is a patient suffering from Type 2 Diabetes. Michael
cannot tolerate Metformin due to experiencing diarrhoea and nausea.
MAIN BODY
Medical Options Available to Michael
As Michael is unable to tolerate Metformin, he has access to various different oral
medical options through which he would be able to effectively treat his type 2 diabetes. The oral
medical options available to Michael are as follows:
SLG2 Inhibitors: These types of drugs can be used orally by Michael in order to effectively
address and treat his type 2 diabetes. Such SLG2 inhibitors are able to prevent the patient’s
kidneys from reabsorbing the excess sugar into their blood of the patient, allowing for the sugar
in the patient’s body to be excreted through the urine (Chatterjee, Khunti and Davies, 2017).
Examples of such drugs include dapagliflozin (Farxiga), canagliflozin (Invokana), and
empagliflozin (Jardiance). Such SLG2 inhibitors though mght be useful to Michael, also reduce
the risk of stroke and heart attack for Michael, but also carries higher risks of low blood pressure,
diabetic ketoacidosis etc., Michael being 87kgs already possess risks of heart attack and stroke,
so this medical option is recommended for Michael.
Sulfonylureas: These are also oral medication that can be used by Michael to treat his type 2
diabetes orally. These types of medicines help the patient’s body, who is suffering from type 2
diabetes, to secrete increased amounts of insulin in order to be able to effectively process sugar
in the blood (Yakaryılmaz and Öztürk, 2017). Example of such types of medicines include
glipizide (Glucotrol), glyburide (DiaBeta, Glynase) and glimepiride (Amaryl). Though an
effective medical solution for Michael, such sulfonylureas also can have significant side effects
on Michael, with the most significant of these being weight gain and low blood sugar. As
Michael is already 87kgs, this oral treatment is not recommended.

Issues Related to Michael’s Reluctance Towards Commencing Insulin
Should Michael remain reluctant towards being able to commence insulin treatment,
Michael can be sure to face some issues and challenges to his health on account of refusing to
treat his type 2 diabetes through the use of insulin. Without insulin in Michael’s body, his blood
sugar levels will increase which can make him feel dizzy, uncoordinated and nauseous
(Bloomgarden, 2020). This can also lead to medical emergencies such as diabetic ketoacidosis
(DKA), which is a serious condition in which the body starts to produce harmful levels of
ketones which are natural substances which are created in the body when fat is used instead of
sugar for energy in Michael’s body.
CONCLUSION
Through this report’s findings it can effectively be concluded that Michael has various
medical options available to him towards treating his type 2 diabetes. This report assesses the
oral medical options available to Michael and explores possible issues of Michael’s reluctance
towards commencing insulin.

REFERENCES
Books and Journals
Chatterjee, S., Khunti, K. and Davies, M.J., 2017. Type 2 diabetes. The Lancet, 389(10085),
pp.2239-2251.
Yakaryılmaz, F.D. and Öztürk, Z.A., 2017. Treatment of type 2 diabetes mellitus in the elderly.
World journal of diabetes. 8(6). p.278.
Bloomgarden, Z., 2020. Is the type of diabetes treatment relevant to outcome of COVID‐19?.
Journal of diabetes. 12(7). pp.486-487.