A Case Study on Mary, a 35 Old Obese Woman's Diabetes Manifestation

Published: 2021-09-24 02:35:10
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The present case scenario describes Mary, who is a 35 years old obese patient. Mary complains that she has been experiencing persistent thirst, frequent urination, discoloration of the armpit, and blister with a smelly discharge on her toe. She also has vision impairment and consistently feeling dizzy. Her vital signs indicate that she has elevated systolic blood pressure 138/72mmHg, temperature of 98.2 and a pulse rate of 88 which is slightly elevated. Her urinalysis results indicates presence of ketones and the finger stick exam indicates 452 which is higher than normal. From the above history Mary could be suffering from Diabetes Mellitus type 2.
Diabetes Mellitus type 2 is a health condition that develops when the body is unable to produce adequate insulin leading to increased blood glucose levels. An increase in blood glucose level is referred to as hyperglycemia. Hypoglycemia, on the other hand occurs when the blood glucose level is low. The disease can also occur due to a low response of the body cells to insulin. Consequently, the body cells are unable to generate energy through glycolysis. The disease is characterized by a gradual onset and commonly occurs in individuals who are above 30 years of age. The health condition is persistent in obese individuals as a result of unhealthy eating habits. Individuals who have a family history of Diabetes are also at a high risk of developing the condition (Vijan, 2010).Currently, Mary is obese and the health condition has taken a relatively long time to show the symptoms as indicated by Mary’s frequent complains. Additionally, individuals who suffer from type 2 diabetes present with complains of polyuria, polydipsia, polyphagia, fatigue, sudden vision change, slow healing sores and frequent infections. The patients are also prone to the presence of ketones in their urine which indicates that he body is metabolizing proteins instead of glucose. Presently, Mary experiences frequent urination (polyuria), she also experiences thirst (polydipsia). Mary has also been diagnosed with the presence of ketone in her urine. Mary presents with blurred vision which indicates vision impairment Mary’s dizziness could be indicative of low hemoglobin levels .Mary’s symptoms confirm that she has type 2 diabetes. The diagnosing health care provider should also investigate Mary’s family history to assess if she has genetic predisposition to diabetes.
The onset of type diabetes is not easily diagnosed since the patient displays very few symptoms. However, diabetes 2 has a high preference in individuals older than 30 years. It can also be inherited and therefore individuals whose family backgrounds indicate diabetes conditions should conduct regular screening. The disease is sometimes described as a lifestyle problem since it can be caused by excessive drinking and unhealthy eating habits. The disease is also prevalent in obese individuals.
Mary’s doctor has prescribed metformin 500mg twice daily, Lantus insulin 25 units at bedtime and glipizide 2.5mg daily. Metformin is an oral hypoglycemic drug prescribed to patients with type 2 diabetes that cannot be managed through nutrition. Metformin is used as a first line drug for the management of obesity. Lantus insulin is a long acting insulin drug given once in 24 hours to help in lowering the blood sugar level. Glipizide is an oral drug given to lower blood glucose levels. A treatment for the pungent blister on the right toe has not been prescribed. Mary’s present medication is meant to control her obesity and maintain the proper blood glucose levels.
A healthcare provider should advise Mary to avoid wearing closed shoes which would increase blistering in her feet. Additionally she should avoid cuts and other forms of skin injuries since patients with type 2 diabetes take long to heal. Obesity is a contributing factor to the occurrence of type 2 diabetes and thus, Mary should adopt a weight management plan. Taking regular exercise would help in alleviating her obesity. Type 2 diabetes patients should lead a healthy lifestyle and avoid excessive alcohol intake. Mary should also be advised to regularly monitor her blood glucose levels because it fluctuates in patients with her condition. Mary should also maintain cleanliness especially when using the injection equipment.
Patients suffering from type 2 diabetes require proper nutrition to control the total calorie intake and to maintain reasonable blood glucose levels. Excess glucose levels cause problems in patients with Mary’s condition. Mary should be advised to avoid skipping meals. She should take regular little meal portions and avoid eating excessively. Her diet should constitute 50% carbohydrates, with low levels of simple sugars. Such food are made up of whole grains and their derivatives. Her protein intake should be 20% and majorly constituted of low fat plant proteins. Patients with type 2 diabetes should avoid animal proteins since they cause health complications. Additionally, her diet should contain 30% unsaturated fats which can be obtained from vegetable oils. A healthy meal should also contain both soluble and insoluble fibers as well as low levels of sodium salts. Healthy foods will include brown rice, cauliflower, sweet potatoes, and whole grain pasta meals. The patient should take whole grain bread and rolled oats, bran flakes and raisin bran for breakfast. Similarly, peas and leafy greens e.g. broccoli are perfect for stews.

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