Case Study: Angela is a 35 year old woman diagnosed 2 years ago with type 2 Diab

Question

Case Study: Angela is a 35 year old woman diagnosed 2 years ago with type 2 Diabetes Mellitus. She has 3 children whose birth weights were in the range of 4.5 to 5 kgms. The children now teenagers, show no signs of diabetes, and their weights are reported to be within normal limits despite their mother's fondness for cooking. Her husband, an underpaid construction worker is slightly overweight. Approximately 6 months ago, Angela was seen with a complaint of a series of infections that lasted longer than usual during the past 2 months. At the time she was measured as a 165 cm ( 5 feet 5 inches) and 71 kg (156 lb.) Her glocose tolerance test was positive. She was seen for follow up twice during the next month, each time showing hyperglycemia and glycosuria. At the second follow up, antidiabetic medication was prescribed, and she was referred for mediacartl nutrition therapy (MNT). Angela did not keep this appointment or her subsequent medical appointment. She was not seeing again until 1 month ago, when she arrived to the emergency department with ketoacidosis. She responded well to treatment and was placed on a 1200 kcal diet and a mixture of intermediate and rapid acting insulin given in two injections a day. Her discharge plan included a referral for a MNT consultation session and diabetes education classes.        5. Identify any personal factors that my affect Angela's adherence to her treatment plan. Do you anticipate any problems? If so, then how would you attempt to help her solve them?

Explanation / Answer

Las Angeles husband is underpaid employees Angela might be working for her children maybe she is coping up with a lot of stress in hera day to day life which ideas are the factors for her not able to keep her medical appointments. Or due to the medical expenses she might be away from her checkups.

Mnt consultation involved in-depth individualised nutrition assessment and care using the nutrition care process to manage diseases

Insulin deficiency is the main underlying problem which is triggering hepatic glucose production and reduced glucose uptake resulting in hyperglycemia and it also stimulates ketogenesis and life for lices resulting in ketoacidosis both type of hyperglycemia and hyper ketonemia induce osmotic diuresis leading to dehydration.

Psychological problems eating disorders and drug abuse can be the other factors these patients are usually obese with impaired insulin secretions.

Glycosuria is caused due to the high blood glucose levels and insufficient insulin levels resulting in exvess glucose in urine.

Ketoacidosis can be a life threatening problem if left untreated.

Treatment when ketoacidosis is Severa it must be created in an Intensive Care Unit the treatment involved during insulin and the fluid through the vein and closely observing the electrolytes in the blood it may take several days for the blood sugar level to return to normal range.

2 character hyperglycemia insulin should be continuously given intravenously 1 to 2 hours after flu its all started potassium levels must be monitored every 2 hours is hydration will cause potassium to drop because of dution.

Non adherence to medical regiments is the cause of recurrent diabetic ketoacidosis so the patient must be continuously monitors and provided with such as financial social psychological under the support diabetes education should be provided with certified educator other prevention techniques includes telecommunication web based learning taking medications always do that can effectively treat the disease.

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