Pathology and Pathophysiology
Type 2 diabetes mellitus is linked to chronic kidney disease as a part of long –term complications. In type 2 diabetes, the pancreas does not make enough insulin and as a result, there is a high blood sugar level in the body. Due to high sugar levels, there is renal insufficiency and as a result, vascular abnormalities occur that accompanies chronic kidney disease with high blood pressure of 150/100 as manifested in Mrs Mallacoota.
In the given case study, Mrs Mallacoota’s high blood sugar levels in the body are affecting the filtration rate of the kidney in the patient. The type 2 diabetes injures the small blood vessels in the body affecting the glomerular filtration rate (McCance and Huether 2015). As a result, the kidneys are not able to filter the blood efficiently and there is retention of water and salt in the body. This retention is causing swelling in the ankles and tiredness in Mrs Mallacoota. This has led to the puffy eyes due to excess retention of sodium and fluid in the body. During the sleep, this fluid gets accumulated in the body due to gravity and as a result, it becomes puffy.
Relationship between type 2 diabetes and chronic kidney disease (CKD)
Due to type 2 diabetes, chronic kidney disease is a co-morbid condition and has increased prevalence. It is prevalent among ethnic groups like Aboriginals, including elderly population than the non-indigenous population (Burrow and Ride 2016). Due to type 2 diabetes or high blood glucose levels, the tiny blood vessels that act as filtering units of the kidney become narrow. As a result, there is insufficiency in the glomerular filtration rate in the patient and fluid retention in the body leads to puffiness in ankles, eyes and tiredness. The high blood pressure is also a complication for CKD as the damaged kidney is unable to regulate blood pressure and as a result, it increases.
Plan of care
The plan of care involves glycemic and blood pressure levels improvement of lifestyle and stress management in Mrs Mallacoota. A diet low in sodium, phosphorus and potassium, meal plan, physical exercise, proper sleep and limiting protein in diet would help Mrs. Mallacoota to control her blood glucose levels and bring positive health outcomes (Inzucchi et al. 2015). The case study also shows that she is stressed about her future and requires a new pair of kidneys. The relaxation therapy would help her to manage stress and prevent the related heart co-morbidities.
Burrow, S. and Ride, K., 2016. Review of diabetes among Aboriginal and Torres Strait Islander people. Mt Lawley (AUST): Edith Cowan University Australian Indigenous Health InfoNet.
Inzucchi, S.E., Bergenstal, R.M., Buse, J.B., Diamant, M., Ferrannini, E., Nauck, M., Peters, A.L., Tsapas, A., Wender, R. and Matthews, D.R., 2015. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 38(1), pp.140-149.
McCance, K.L. and Huether, S.E., 2015. Pathophysiology: The biologic basis for disease in adults and children. Elsevier Health Sciences.