Managing Diabetes in Patients with Dementia, Euglycemic Diabetic Ketoacidosis, and Beliefs about Com

Scenario 1 – Managing diabetes in a patient with dementia

Scenario 1 – Managing diabetes in a patient with dementia.

Mr Samuel Jackson is 72 and has lived alone since his wife died two years ago. He has a son and a daughter and four grandchildren who live close by and with whom he is very close. He has no significant medical history apart from mild dementia and diabetes. He is on the following antidiabetic medication:

Metformin 500mg od

Gliclazide 80mg od

A week ago, he started acting ‘funny’. He told his family that the government is watching him, therefore, he is going to be very careful with his diabetes management.

Scenario 2 – Euglycemic diabetic ketoacidosis

A 21-year old female with TIDM diagnosed 5 years ago and on insulin pump for the past 2 years was admitted to the hospital due to weakness and inability to eat since yesterday. No history of fever, nausea, vomiting, diarrhoea or other symptomssuggestive of any infective pathology. Patient’s insulin pump had stopped working 2 days before the admission. . On admission, the patient had moderate dehydration with loss of skin turgor and was diagnosed with Euglycemic diabetic ketoacidosis (EDKA).

Scenario 3 – Personal belief and the use of complementary therapy in diabetes

Mr Shah is a 50-year old man who was admitted to the ward with a worsening medical condition. He has a past medical history of T1D and his current insulin dose is 2.5 units isophane with 10 units of soluble insulin in the morning and evening. He has a poorly controlled diabetes and lives alone following the death of his wife. During a routine assessment, the patient told you that he has a trust in herbal remedy, and he is convinced that chewing the leaf that his mother gave him when he went to India recently is going to take away his diabetes.