Please respond to at least 2 of your peer’s posts.
Does your plan align with your peers’ plan of care?
Share your thoughts if your plan of care differed from one of your peers and provide a rationale for why your plan differed from your peer.
Share your thoughts in support of a peers’ plan that aligned with your plan of care. Provide support for those plan elements that were aligned with your peer.
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
PLEASE USE UPDATED REFERENCES FOR EACH PEERS POST WHICH I WILL PROVIDE FOR THIS ASSIGNMENT.
MondayDec 13 at 10:07am
To diagnose this 16-year-old patient as being diabetic it would be best to perform a hemoglobin A1c. According to Eyth & Naik (2020), a HgbA1c test can be used to confirm diabetes as it looks at the average blood sugar levels over the past 3 months (a level of 6.5% or higher is used to confirm the presence of diabetes. The strength of this evidence from the article provided is strong. It is scholarly article from a government source, there are no ads, no overt biases, and the article is very recently updated.
Depending on the patient’s HgbA1c level, cardiovascular and stroke risk factors, a variety of therapeutic agents are available. However, since this patient is a newly diagnosed type 2 diabetic, metformin would be the first line of treatment (Quattrochi et al., 2020). It is important that treatments are effective and safe (especially in children and young adults), a starting dose of Metformin 500mg PO taken twice daily with breakfast and dinner meals would be prescribed. The source of this scholarly article is the government, there are no ads, and it is from 2020, so I would classify this as a strong source.
The first bit of education I would provide centers around decreasing the patient’s BMI through diet and lifestyle changes. It seems she is active (being on the soccer team), so teaching would emphasize limited fat, salts, and carbohydrate intake. It is important to eat a variety of foods in balanced proportions, stressing vegetables, fiber, and whole grains.
The second part of teaching would center around taking the medication and what to watch out for. Diabetes increase the risk for cardiovascular and stroke complications, so it is important to get to the goal HgbA1c level of less than 6.5%. Take this medication as ordered and with meals, and if you miss a dose, take as soon as possible, however, if it is close to your next dose, just skip it (Mayo, 2021). The source here is reliable as it is from the Mayo Clinic, it is recent, but there are ads included in the website (so that detracts a bit from the strength).
If we are unable to get the patient to their goal HgbA1c, I would recommend a consultation with an endocrinologist and dietician. According to Siopsis et al. (2020), it is recommended that diabetics seek consul with a dietician to mitigate the effects and progression of diabetes. This source is strong as it from the government, it is recent, there are no ads, and it is a scholarly article.
Eyth, E., & Naik, R. (2021, April 5) Hemoglobin A1C. In: StatPearls https://www.ncbi.nlm.nih.gov/books/NBK549816/ (Links to an external site.)
Mayo Clinic. (2021). Metformin. https://www.mayoclinic.org/drugs-supplements/metformin-oral-route/proper-use/drg-20067074 (Links to an external site.)
Quattrocchi, E., Goldberg, T., & Marzella, N. (2020). Management of type 2 diabetes: consensus of diabetes organizations. Drugs in context, 9, 212607. https://doi.org/10.7573/dic.212607 (Links to an external site.)
Siopis, G., Colagiuri, S., & Allman-Farinelli, M. (2020). Dietitians’ experiences and perspectives regarding access to and delivery of dietetic services for people with type 2 diabetes mellitus. Heliyon, 6(2), e03344. https://doi.org/10.1016/j.heliyon.2020.e03344 (Links to an external site.)
Edited by Scott Krueger on Dec 13 at 10:08am
MondayDec 13 at 12:41pm
Case Study: 16-Year-Old Female with DM II
Based on the patient’s HbA1c greater than or equal ≥6.5% and her two-hour fasting plasma glucose greater than 130, she meets the criteria for Diabetes Mellitus type II (McCance & Huether, 2019).
The therapeutic goal is to have near-euglycemia and control other metabolic disorders (McCance & Huether, 2019). Interventions will primarily focus on healthy dieting and weight loss. The patient is involved with soccer but may need more physical intervention or specific exercise regimens. Pharmacological interventions include Metformin PO 500mg once a day. If her blood glucose is not controlled after three months, the dose may need to increase or a second agent may be added (McCance & Huether, 2019; Metformin Dosage, n.d.)
The patient needs education on how type II diabetes works in her body. Unlike type I, her body is insulin resistant. Interventions such as losing weight help with insulin sensitivity and glucose tolerance. Additionally, the patient will learn good self-management techniques which include healthy diets, physical activity, blood glucose monitoring, foot inspections, and medication adherence (Pamungkas, Chamroonsawasdi, & Vatanasomboon, 2017). Her diet should include complex carbohydrates, foods with low-fat content, protein, and fiber. However, she should also prepare for adequate carbohydrates when about to play a game or exercise. The patient should reach out to the clinic if she has any feet sores or if she has signs and symptoms of HHNKS. She should also be made aware of the signs and symptoms of hypoglycemia.
Follow-up consultations will include an endocrinologist, physical therapy, nutritionist or dietician, and a personal trainer. Therapy may be included based on the patient’s ability to adapt to health changes.
McCance, K., & Huether, S. (2019). Pathophysiology : the biologic basis for disease in adults and children. St. Louis :Mosby
Metformin Dosage Guide + max dose, adjustments. Drugs.com. (n.d.). Retrieved December 13, 2021, from https://www.drugs.com/dosage/metformin.html.
Pamungkas, R. A., Chamroonsawasdi, K., & Vatanasomboon, P. (2017). A systematic review: Family support integrated with diabetes self-management among uncontrolled type II diabetes mellitus patients. Behavioral Sciences, 7(3), 62. https://doi.org/10.3390/bs7030062