Endocrine Function Case Study Questions

Endocrine Function Case Study Questions

In which race and ethnic groups is DM more prevalent? Based on C.B.’s clinical manifestations, please compile the signs and symptoms that she is exhibiting that are compatible with the Diabetes Mellitus Type 2 diagnosis.

According to the Centre for Disease Control and Prevention (CDC), the prevalence of diabetes mellitus was highest among the American Indians/Alaska Natives (14.7%) between 2017 to 2018, followed by Hispanic origin (12.5%), and non-Hispanic blacks (11.7%) in the United States (Glovaci, Fan, & Wong, 2019). Non-Hispanic Asians and non-Hispanic whites recorded a percentage of 9.2% and 7.5% respectively.

The diagnosis of Diabetes Mellitus Type 2 is normally based on the results of the glycated hemoglobin (A1C) test in addition to presenting symptoms provided in the patient history. Glycated hemoglobin (A1C) test results of less than 5.7% are normal, whereas between 5.7% and 6.4% represented prediabetes and 6.5% or higher represent diabetes diagnosis. A fasting blood glucose level of 126 mg/dL (7 mmol/L) or higher is also used to confirm a diabetes diagnosis(Glovaci, Fan, & Wong, 2019). The patient in the provided case study presented witha fasting blood sugar level of 141 mg/dL. His cholesterol levels were also 225mg/dL, higher than 40mg/dl, which also indicates complications of DM. Other diagnostic signs and symptoms displayed by the patient confirming a diabetes type 2 diagnosis include left foot weakness and numbness for about three weeks, in addition to reduced range of movement, increased thirst, increased urine frequency especially at night, and significant weight gain over the past few months.

If C.B. develop bacterial pneumonia in her right lower lobe, how would you expect her Glycemia values to be? Explain and support your answer.

Studies have confirmed the association between hyperglycemia among diabetic patients with community-acquired pneumonia. As such, when the patient in the provided case study develops bacteria pneumonia, then it means that his diabetes is not properly managed. Diabetes type 2 is associated with low immunity as it leads to a reduction in the response of T cells, disorders of humoral immunity, and decreased neutrophil function (Webber et al., 2020). As such, patients with worsening DM will exhibit increased susceptibility to infections such as bacterial pneumonia. Consequently, such infections in addition to repercussions associated with its infectivity can result in complications of DM such as ketoacidosis and hypoglycemia. The bacteria on her right lobe will consume glucose from the patient’s blood for their growth and sustaining their survival leading to decreased glycemia values.
What would be the best initial therapy non-pharmacologic and pharmacologic to be recommended to C.B?

C.B presents with symptoms confirming a diagnosis of Diabetes Mellitus Type 2. The management of DM involves the incorporation of both pharmacological and non-pharmacological interventions. The pharmacological intervention will involve the initiation of Metformin which is FDA approved as the first-line medication for the management of type 2 diabetes. The drug does not cause weight gain. The patient can also be initiated on HMG-CoA reductase inhibitors, or statins, such as atorvastatin to lower her high cholesterol levels (Serbis et al., 2021). Non-pharmacological interventions will involve nutritional therapy, physical activity programs like yoga or walking, psychological interventions to promote patients’ compliance, social network interventions to promote supportive care, and diabetes self-management education and support for the patient to be able to appropriately monitor her blood sugar levels regularly to enhance treatment outcome.