Asthmatic Woman Diabetes Case Study Nursing Assignment Help

Assignment Task

Case study in Diabetes
A 39 year old asthmatic woman presented for a follow-up evaluation of her diabetes. She had first presented one year earlier with blurred vision, polyuria and had a random blood glucose level of 15.6mmol/L and her HbA1c was 8.0%. At that time she commenced metformin treatment, 500mg twice daily and her HbA1c dropped to 7.4% within three months of commencing metformin treatment. Since then she has had three HbA1c determinations of 7.1%, 7.4% and 7.8% prior to her latest evaluation. Her metformin treatment was increased to 1500mg/daily and three months after this her HbA1c was 7.7%. She has a family history of cardiovascular disease and was put on atorvastatin 40 mg/daily at 36 years of age. Her total cholesterol level at that time was 10.5mmol/L.Her asthma is routinely controlled with inhaled medications, including fluticasone propionate and salmeterol inhalation powder, 250/50 mcg/daily and montelukast sodium, 10 mg daily. However, over the last year her asthma has worsened and she has intermittently taken prednisone, 40mg/daily. Her weekly exercise consists of two 15 minute brisk walks weekly and she has a BMI of 32.4.
Questions
Use the above data and your knowledge to explain your answers to the following questions.

• Is the current treatment regime effective in controlling the patient’s diabetes?
• Would you recommend any changes to her treatment?
• What is/are the main contributing factors to the development of this patient’s diabetes?
• The patient has other clinical issues that are being treated. Would these contribute to her diabetes?
• Is there any general advice you would give the patient?

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