Diagnosis And Treatment Of Diabetes Care Essay Paper

Diagnosis And Treatment Of Diabetes Care Essay Paper

In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.

QUESTION 1
1. Scenario 1: Syndrome of Antidiuretic Hormone (SIADH)
A 77-year-old female was brought to the clinic by her daughter who stated that her mother had become slightly confused over the past several days. She had been stumbling at home and had fallen twice but was able to walk with some difficulty. She had no other obvious problems and had been eating and drinking. The daughter became concerned when she forgot her daughter’s name, so she thought she better bring her to the clinic.
HPI: Type II diabetes mellitus (DM) with peripheral neuropathy x 30 years. Emphysema. Situational depression after death of spouse 6-months ago

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SHFH: – non contributary except for 40 pack/year history tobacco use. Diagnosis And Treatment Of Diabetes Care Essay Paper
Meds: Metformin 1000 mg po BID, ASA 81 mg po qam, escitalopram (Lexapro) 5 mg po q am started 2 months ago
Labs-CBC WNL; Chem 7- Glucose-102 mg/dl, BUN 16 mg/dl, Creatinine 1.1 mg/dl, Na+116 mmol/L,
K+4.2 mmol/L, CO237 m mol/L, Cl-97 mmol/L.
The APRN refers the patient to the ED and called endocrinology for a consult for diagnosis and management of syndrome of inappropriate antidiuretic hormone (SIADH).
Question:
1. Define SIADH and identify any patient characteristics that may have contributed to the development of SIADH

QUESTION 2
1. Scenario 2: Type 1 Diabetes
A 14-year-old girl is brought to the pediatrician’s office by his parents who are concerned about their daughter’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with her school activities. She had been seemingly healthy until about 4 months ago when her parents started noticing these symptoms. She admits to sleeping more and gets tired very easily. Diagnosis And Treatment Of Diabetes Care Essay Paper
PMH: noncontributory.
Allergies-NKDA
FH:- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process
SH: denies alcohol, tobacco or illicit drug use. Not sexually active.
Labs: random glucose 244 mg/dl.
DIAGNOSIS: Diabetes Mellitus type 1 and refers to an endocrinologist for further work up and management plan.
Question
1. Explain the pathophysiology of the three P’s for (polyuria, polydipsia, polyphagia)” with the given diagnosis of Type I DM.

QUESTION 3
1. Scenario 2: Type 1 Diabetes
A 14-year-old girl is brought to the pediatrician’s office by his parents who are concerned about their daughter’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with her school activities. She had been seemingly healthy until about 4 months ago when her parents started noticing these symptoms. She admits to sleeping more and gets tired very easily. Diagnosis And Treatment Of Diabetes Care Essay Paper
PMH: noncontributory.
Allergies-NKDA
FH:- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process
SH: denies alcohol, tobacco or illicit drug use. Not sexually active.
Labs: random glucose 244 mg/dl.
DIAGNOSIS: Diabetes Mellitus type 1 and refers to an endocrinologist for further work up and management plan.
Question
1. Explain the genetics relationship and how this and the environment can contribute to Type I DM.

QUESTION 4
1. Scenario 3: Type II DM
A 55-year-old male presents with complaints of polyuria, polydipsia, polyphagia, and weight loss. He also noted that his feet on the bottom are feeling “strange” “like ants crawling on them” and noted his vision is blurry sometimes. He has increased an increased appetite, but still losing weight. He also complains of “swelling” and enlargement of his abdomen.
PMH: HTN – well controlled with medications. He has mixed hyperlipidemia, and central abdominal obesity. Physical exam unremarkable except for decreased filament test both feet. Random glucose in office 333 mg/dl.
Diagnosis: Type II DM and prescribes oral medication to control the glucose level and also referred the patient to a dietician for dietary teaching.
Question:
1. How would you describe the pathophysiology of Type II DM?

QUESTION 5
1. Scenario 4: Hypothyroidism
A patient walked into your clinic today with the following complaints: Weight gain (15 pounds), however has a decreased appetite with extreme fatigue, cold intolerance, dry skin, hair loss, and falls asleep watching television. The patient also tearfulness with depression, and with an unknown cause and has noted she is more forgetful. She does have blurry vision.
PMH: Non-contributory.
Vitals: Temp 96.4ËšF, pulse 58 and regular, BP 106/92, 12 respirations. Dull facial expression with coarse facial features. Periorbital puffiness noted.
Diagnosis: hypothyroidism. Diagnosis And Treatment Of Diabetes Care Essay Paper

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Question:
What causes hypothyroidism?

COURSE RESOURCES INCLUDE THE FOLLOWING:
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
• Chapter 21: Mechanisms of Hormonal Regulation, including Summary Review
• Chapter 22: Alterations of Hormonal Regulation, including Summary Review
• Chapter 23: Obesity and Disorders of Nutrition, including Summary Review

American Diabetes Association (2020). Standards of medical care of patients with diabetes mellitus. Diabetes Care, 26(suppl 1), pp. s33-s50. https://care.diabetesjournals.org/content/26/suppl_1/s33

Orlander, P. R. (2018). Hypothyroidism. Retrieved from https://emedicine.medscape.com/article/122393-overview

Hoorn, E. J., & Zietse, R. (2017). Diagnosis and treatment of hyponatremia: Compilation of the guidelines. Journal of the American Society of Nephrology, 28(5), 1340–1349 Diagnosis And Treatment Of Diabetes Care Essay Paper

Question 1

SIADH is a condition that results owing to the body retaining too much water. The body produces an antidiuretic hormone (ADH) in response to increased levels of blood osmolality, which stimulate the release of water from the kidneys back into circulation. However, in individuals with SIADH, the release of ADH is not adequately matched by the reabsorption of water from the kidneys, resulting in a build-up of water in the body. The hallmark features of SIADH are low serum osmolality with concomitant elevated urine osmolality/sodium level (Hoorn & Zietse, 2017)Diagnosis And Treatment Of Diabetes Care Essay Paper. In addition, individuals with SIADH may experience weight gain due to relative water retention.

There is no specific cause for SIADH. However, it is thought to result from an underlying disorder that causes the body to produce too much ADH. There are several patient characteristics that may have contributed to the development of this condition. The patient has type II diabetes mellitus, which can cause damage to the nerves and vessels. Mentrasti et al. (2020) posit that this can lead to diabetic neuropathy, which can cause the body to produce less ADH. Besides, the patient has been experiencing situational depression following the death of her spouse. This can lead to bereavement syndrome, which is characterized by feelings of sadness and grief. All of these conditions can lead to a decline in ADH production.

Question 2

Type 1 diabetes mellitus (T1DM) is a common chronic condition caused by the pancreas’s destruction of insulin-producing beta cells. This results in the inability or inadequate production of insulin and leads to high blood sugar levels. The three Ps are common symptoms of T1DM and are caused by the individual’s inability to regulate their blood sugar levels. Polyuria is the most common symptom of T1DM and is characterized by excessive urination (Hoorn & Zietse, 2017)Diagnosis And Treatment Of Diabetes Care Essay Paper. This can be due to several reasons, including an increase in the amount of water consumed, a decrease in the amount of food eaten, or a combination of both. Increased water intake concurrently increases the glomerular filtrate rate, hence increasing the urge to urinate.

Polydipsia is the next most common symptom of T1DM. The heightened urge to quench thirst in Type 1 DM is attributed to high blood glucose and insulin deficiency. Polyphagia is the last of the Ps and is characterized by increased appetite. This can be due to a number of factors, including a decrease in insulin production, hence an increase in hunger sensations (Hoorn & Zietse, 2017)Diagnosis And Treatment Of Diabetes Care Essay Paper. This insulin inadequacy culminates in less glucose conversion to energy for cellular activity.

Question 3

The exact cause of T1DM is idiopathic but is more of an autoimmune origin. T1DM’s etiologies are unknown but may include genetics and environmental factors. The risk of developing T1DM is heightened in certain gene variants, including the HLA-DRB1*15, HLA-DQB, and HLA-DQA1 alleles (McCance & Huether, 2019). T1DM is more common in children and young adults than in adults 50 or older. It tends to develop slowly over many years, with no initial symptoms. However, as the disease progresses, it can cause serious health problems.

Question 4

Type II diabetes (TIIDM) is highly-linked with extensive insulin resistance and beta-cell dysfunction. Its underlying pathophysiology is not fully comprehended. According to American Diabetes Association (2020), insulin resistance is considered the primary defect in this disorder. Insulin resistance occurs when the body’s cells become incompliant to the insulin’s physiologic effects. This resistance results in decreased insulin uptake, which leads to elevated blood sugar levels. Beta-cell dysfunction is also thought to play a role in the pathophysiology of TIIDM. Beta-cell dysfunction occurs when the cells that produce insulin cannot function properly (American Diabetes Association, 2020)Diagnosis And Treatment Of Diabetes Care Essay Paper. This dysfunction can lead to decreased insulin production and secretion, leading to elevated blood sugar levels.

Question 5

Hypothyroidism occurs when there is insufficient thyroid hormone production. This can happen for various reasons, including autoimmune disease, surgical thyroid removal, radiation therapy, or certain medications (Orlander, 2018)Diagnosis And Treatment Of Diabetes Care Essay Paper. For instance, radiation therapy and some antidepressants can cause the body to develop an autoimmune response that attacks the thyroid gland. Individuals with hypothyroidism often have a decreased sensitivity to cold, a lowered immune system response, and an increased risk of developing heart disease.

References

American Diabetes Association (2020). Standards of medical care of patients with diabetes mellitus. Diabetes Care, 26(suppl 1), pp. s33-s50. https://care.diabetesjournals.org/content/26/suppl_1/s33

Hoorn, E. J., & Zietse, R. (2017). Diagnosis and treatment of hyponatremia: Compilation of the guidelines. Journal of the American Society of Nephrology, 28(5), 1340–1349

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th Ed.). St. Louis, MO: Mosby/Elsevier.

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Mentrasti, G., Scortichini, L., Torniai, M., Giampieri, R., Morgese, F., Rinaldi, S., & Berardi, R. (2020). Syndrome of inappropriate antidiuretic hormone secretion (SIADH): optimal management. Therapeutics and Clinical Risk Management, 16, 663. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386802/

Orlander, P. R. (2018). Hypothyroidism. Retrieved from https://emedicine.medscape.com/article/122393 Diagnosis And Treatment Of Diabetes Care Essay Paper