"Managing Long-Term Conditions in a Diabetic Patient: A Case Study"

ASSIGNMENT 1, PART A

Patient scenario #4 - Diabetes
Patient Profile
Name: Tasi Lotoa
Age: 52 years old
Ethnicity: Samoan
Occupation: Road Construction Worker
Marital Status: Married, father of three adult children, all living at home, 2 with partners and young
children
Address: Otara (Quintile 5)
Medical History
1. Type 2 Diabetes: Diagnosed 2014
2. Hypertension: Diagnosed 2016
3. Hypercholesterolaemia: atorvastatin increased 3 months ago
4. Peripheral Vascular Disease (PVD): Diagnosed 2022, with mild intermittent claudication
5. Fracture L) elbow, reduction under general with internal fixation 2021
6. Smoking: current smoker (homegrown tobacco <5> 7. Alcohol: AUDIT screening not completed
8. Bowel Cancer Screening: 2023 negative (Te Whatu Ora Waikato)
Current Medications
- Metformin 1000 mg BID
- Lantus 20 units OD
- Lisinopril 20 mg OD
- Aspirin 75 mg OD
- Atorvastatin 40 mg OD
- Gabapentin 300 mg BID
Presenting Symptoms
Mr. Lotoa presents to the GP clinic for a Long term Conditions consultation with the Nurse
Practitioner and states the following complaints:
- Increasing pain and numbness in his lower extremities, particularly his feet
- Increasing difficulty walking due to leg pain, impacting ability to work
- Recent weight gain of 5kg over the past 3 months
- Elevated blood glucose readings despite adherence to medication regimen
- Episodes of exhaustion, dizziness and headaches
Physical Examination
Vital Signs:
- Blood Pressure: 150/95 mmHg
- Heart Rate: 88 bpm
- Respiratory Rate: 18 breaths per minute
- Temperature: 37C
- Oxygen Saturation: 97% on room air
- Capillary Blood Glucose: 17 mmol/L