PATIENT MANAGEMENT- DIABETES MELLITUS

Question 1

DM patient with drifted 21, pain on 21

Patient taking metformin

a. What questions will you ask to assess the diabetic control?

Answer 1

 If the patient is seeing doctor
 How often is the patient taking medication
 Fasting glucose level (normal is 80 – 100 mg/dL but if DM: 126 mg/dL or greater)

 2 hour plasma glucose level (200mg/dL or greater)
 Hba1c level

Question 2

DM patient with drifted 21, pain on 21

Patient taking metformin

b. The patient feels unhappy and no motivation to take drugs (but with no suicidal intention), what psychological condition (depression)?

Answer 2

 Depression

Question 3

DM patient with drifted 21, pain on 21

Patient taking metformin

c. List five ways that you can do for the patient concerning the general medical conditions

Answer 3

Question 4

DM patient with drifted 21, pain on 21

Patient taking metformin

d. Describe clinical photos and x-ray finding

Answer 4

NA

Question 5

2. How would you routinely check blood glucose level of diabetic patient?

Answer 5

• Preprandial glucose test: Glucometer allows self-monitoring at home (fasting glucose 4-7mmol/L; 6 is normal) 8 hours after eating
• Postprandial glucose test to determine amount of glucose left exactly 2 hours after meal (should have gone down to normal in healthy people); maximum 10mmol/L
• Glucose tolerance test (OGTT)- 75g glucose given and blood samples taken to determine how quick it is removed from blood, return to normal within 2-3 hrs in normal situation
• Long term assessment made by estimation of blood level of glycosylated hemoglobin (HbA1c) it is normal adult hemoglobin that binds glucose, remains in circulation for life of erythrocyte and is a cumulative index of diabetic control over 3 months; tested every 3-6 months; <4.8% is normal; maximum: 7