A 38 years old female from Nepal , married with 1 child. Diagnosed with type 2 diabetes in June 2010 . No family history of diabetes.
Past medical history
Myopia diagnosed at the age of 10.
Hypo and hyperglycaemic episodes
Exercise: daily 45 min walk.
Well controlled diet but only when not on night shift (missed meals)
Non-smoker and no alcohol consumption
Diagnostic test 2010
Random BGL: above 15mmol
Postprandial BGL: 28mmol
Fasting BGL: 14mmol
HBA1C above 10%
Commenced on metformin and gliclazide , two months later she was commenced on insulin( Novo mix 30/70 and gliclazide ceased due to uncontrolled BGL.
She migrated from Nepal to Australia in 2014. Works as a personal care worker and does shift work.
She is on temporary visa, therefore cannot get government medical benefit
She is covered under private insurance (only for basic cover)
Insulin Novo mix 30u mane and 26u nocte
Metformin 850mg BD
Acarbose lunch time
Medical review January 2017
HBA1C below 7%
Random BGL x a week fasting 7mmol, post prandial 12mmol
Renal function test normal
Thyroid function test normal
Digital retinal check: NAD
Multidisciplinary team involved in her care
(Cannot afford other diabetes services and other multidisciplinary team)
Construction of the essay
The following headings may be used as a guide to structure the essay.
Who and what are you going to discuss?
- Include in the introduction, a summary of the person with diabetes biographical and medical details..
- Outline briefly, a list of issues you are going to discuss in the essay, for example, the medical, nursing, allied health and health worker management of the person.
- In the course of the essay outline how the medical diagnosis of diabetes was made for the person. For example, what tests were done and what were their results. To show that you know what tests should be done and why, you will need to include a discussion from a suitable literature.
- The discussion will also need to include the type of diabetes the person has and the pathophysiology of the type of diabetes, the use of glucose lowering medications and/or insulin therapy and other pharmaceutical agents, healthy eating, exercise/physical activity, diabetes complication management and relevant psychosocial problems that the person/family might need to have considered. Again refer to suitable evidence to support your discussion.
- In the discussion also include the rationale for and critique of the management of the person with diabetes Refer to the relevant literature/evidence to support the discussion.
- When discussing the management of the person with diabetes, include your own assessment of persons needs/problems and the actions which are required to achieve desired outcomes.
- Locate any useful resources which may assist your chosen person with diabetes to increase their knowledge and potentially improve their health e.g Diabetes Australia Living with Diabetes - Work