Understanding Diabetes Mellitus: A Letter to Mateo from Oma

Overview:

You have conducted research and discussed with your classmates concepts surrounding diabetes mellitus. In this assignment you will demonstrate your new knowledge about this disease to help Mateo understand this disease and how it keeps his great-grandmother from visiting him. Alternatively, you may choose to offer support and suggestions to Oma.

Read the attachment then consider how to best explain the complications of diabetes mellitus. Create a letter to Oma or Mateo. The letter should be 300 words. Specifically, in your letter be sure to address the following: Describe how the endocrine and digestive systems (including the liver) function in regulating blood glucose levels.

What causes diabetes mellitus? What new advances in medicine may help people with diabetes mellitus? Explain how the disease causes renal failure, and what can be done to delay the onset of dialysis.

Please use clear language in your letter that could be understood by someone who does not have an extensive medical/science background. You may not always have references to cite, but if you do have sources that you have consulted in order to write your letter, these must be cited on a separate page using APA Style.

Research and APA sources must be based upon American info. Put questions above the answer If you write 299 words or less i will be sending it back.

Dear Mateo,

I have been sitting here going over our last conversation about life, love, family, and my diseases. You asked me specifically about diabetes, and I thought it would be good to write it down so you can read it again later.

I was a teenager before I learned my father’s father died of complications of diabetes and my father had high blood pressure. Dad always said his father died of “bad insulin.” I never met my grandfather. I always thought I would develop diabetes, as I was chubby and not very active. Diabetes is inherited, but can develop from other influences such as bugs or visiting certain places in the world.

I married in Colorado, then moved to New Jersey, had two kids, got divorced 16 years later, and moved back to Colorado. The stress of ending the marriage, having to go to work full time, and life in general caused a great deal of stress, which activated the diabetes. The doctor did blood tests and declared the results, told me to go home, remove stress from my life, and above all, lose weight. There wasn’t any instruction on how to control the diabetes or how to lose weight. “Stay away from sugar and exercise.”

Instructions:

I went to the hospital to have all four wisdom teeth removed in 1980, and they did routine blood tests. My results showed extremely high blood sugar. Again, there was no explanation of how diabetes works, what causes it, or how to control it. “Lose weight.”

I went home tired, forlorn, and frustrated. My sugars remained so high that I lost 80 pounds, but I had no idea what I had done to lose the weight. I loved being thin, but I had no idea how to maintain the loss. After I moved back to Colorado and life settled down, on came the weight. Glucose meters for home use had been developed, and I bought one. I faithfully took readings, but I had no idea what to do with them. What do I do?

One of the new doctors sent me to a nutrition class. I knew everything she taught us, but I dislike vegetables and I eat few fruits. I had diabetes for four years and developed neuropathy in both feet and my lower legs – very painful and out of nowhere! My friend who is a nurse could not explain the pain to me, and all I knew was my feet hurt! My A1C remained in the teens.

The stress of starting a new job in a new town (and my son skipping school all the time) caused severe headaches. These were diagnosed as migraines and I was prescribed some pretty strong medication. My vision had begun to be fuzzy when I was tired, too. I was dizzy walking across the room, particularly when I was tired, which seemed to be all the time. I was also worried that my teenage son would begin using drugs. Instead, when he was 13, he drove from Colorado Springs to Denver in the middle of the night with a neighbor girl. Ugh!

I married again and started a new job. The insurance offered gym memberships. I joined and went to the Y three days a week for a year. I gained 10 pounds.

I finally became the patient of a nurse practitioner named Luis who began to treat me specifically for the diabetes and really knew his stuff. He reorganized the injections and the types of insulin I was taking. The best thing he did was to start me on the long-acting new insulin called Tresibo. One shot a day covers 24 hours. When no insulin is needed, it rests. I no longer have to worry about my blood sugar going to the “sub-zero basement” in the middle of the night. The only super lows I get now come from too much short-acting to cover meals.

Letter:

Luis has also explained how the body works, why my kidneys have started to fail, and how the proper amount of insulin keeps things working well. He has not been able, however, to explain why I can’t lose weight. Old age, a sedentary lifestyle, and poor diet all contribute and apply to me. My last A1C was 6.3 so something is working right. Luis took blood tests that indicated I do not produce any insulin on my own. My beta cells have quit on me! With things better controlled, I have very few headaches, but my feet still hurt. I have developed arthritis in my knees and hands. This is why I had so much trouble trying to play ball with you.

After nearly 40 years of diabetes with no control, I have developed fourth-stage renal failure, and I am finally facing, for sure, the dialysis the doctor told me four years ago to expect “any day.” I was so scared, I had the surgeon insert my peritoneal catheter so it would be ready for the first exchange, and they would not have to go in through the jugular vein.

The doctor told me that when my numbers (from the monthly kidney function blood tests!) reach the right limits, I will start dialysis. In the meantime, I am to eat no frozen food, no restaurant food, and no processed food. The lettuce must be dark green, and veggies are better that meat. Fruit is even better. I should not eat tomatoes, potatoes, onions, corn, or bananas. Limit fats and sugar; no colas. Drink five glasses of water a day, which are to amount to 2 liters. Stay hydrated! (Coffee does not count.) Do not take any herbal supplements. Take only prescribed medications. Do not allow myself to be constipated. Dialysis makes being backed up hurt worse.

I have not been able to follow this diet plan. I have cut back on my quantities, but I am maintaining my weight as usual. My body is once again in “not losing” mode.

To help ward off my depression, I force myself to get up at 5:30 a.m. to feed Shadow, make the coffee, turn on the TV, take my blood sugar and shots, and then sit down to read. I try to shower and dress before I read, but do not always manage to do so.

As I explained to you, I retired six years ago when my eyesight became too fuzzy to see what I was doing. Because my depth perception and side vision are impaired, I have allowed my husband to do all the driving. I do not want to cause an accident! I thought maybe I could drive after many shots of various medicines in my eyes, but I still do not feel safe driving.

As you found out, I can no longer read the fine print of newspapers, magazines, or books. I have to use the iPad where I can make the print bigger, and sometimes that is still too small. I no longer use the computer, as I cannot see the screen, much to my regret.

Actually, Mateo, if I could drive, I would visit you much more often.

Love and hugs,

Oma