Case Study Type 2 Diabetes Mellitus

The race is also a risk factor where certain races such as Hispanics, the blacks, Native American, African Americans and the Pacific Islanders have the highest risk of developing T2DM when compared to the whites (Goldstein & Müller-Wieland, 2016). Besides, the risk of getting T2DM increases with age especially at the age of 60 years. The elderly engage in less exercise yet they are gaining weight and losing the muscle mass. However, T2DM is seen to be increasing among the adolescents and the children. Prediabetes is another risk factor where the level of blood sugar is higher than normal but it is not considered as diabetes (endocrineweb. The impaired beta-cell function leads to postprandial hyperglycemia and subsequent fasting hyperglycemia in people with insulin resistance (uptodate.

com). Chronic hyperglycemia is responsible for further prevention of insulin secretion by the beta cells of the pancreas. The pathogenesis of T2DM is described by insulin resistance, insufficiency of insulin and glucose toxicity. Possible complications of T2DM T2DM has effects on the heart, kidneys, eyes, blood vessels as well as the nerves. Other possible complications include foot damage and skin conditions. In Melanie's case, the complication of T2DM includes Baker's cyst where there is excess synovial fluid in the knee and hence preventing movement. Levels of treatment options for T2DM The three levels of management of T2DM include eating healthy foods, engaging in regular exercise as well as diabetic drugs or insulin therapy (medtronic-dibates. com).

These treatment options will ensure the blood sugar level is kept within the range. com). In T1DM, the body’s immune system views the beta cells which produce insulin as invaders and therefore fights them. Consequently, the beta cells are impaired leading to impaired insulin secretion. In T2DM, there is a production of insufficient insulin or insulin resistance. Another difference is that individuals with T1DM produce no insulin whereas in T2DM insulin is still produced. Bakers cyst is a condition where there is an accumulation of excess synovial fluid in the popliteal bursa. Bakers cyst is also known as popliteal fluid. Another reason why blood glucose level is high is due to inability to move. It has been indicated that the Bakers cyst had prevented Melanie from moving around.

The Bakers Cyst had been increasing in size for the last eight months and thus restructuring her from moving. Metformin Metformin is a biguanide given in T2DM as the first-line medication such as in Melanie’s case. Its mechanism of action includes lowering production of glucose by the liver as well as improving the sensitivity of body tissues to insulin. Metformin suppresses hepatic gluconeogenesis by activating the AMPK enzyme responsible for insulin signalling. Metformin enhances insulin sensitivity by increasing peripheral uptake of glucose and lowering fatty-acid oxidation (healthline. com). Consequently, Cimetidine and metformin should not be given concurrently. Glipizide Glipizide is part of the sulfonylurea class of antidiabetics. It is a second generation sulfonylurea since it undergoes enterohepatic circulation, more patent and has a shorter half-life when compared to the first generation sulfonylureas.

Glipizide is a short and rapidly acting medication. Glipizide enhances the sensitivity of beta cells of the pancreas to produce more insulin. 8mmol/L. Blood glucose test is issued to measure the amount of glucose in the blood. BGL test is used in the diagnosis of diabetes where if it is 7mmol/L or higher imply the patient has diabetes. The change resulted from healthy eating as well as a physical movement after the surgery. Melanie visited the clinic when she was not stressed. T1DM was referred to as early-onset diabetes because it occurred during childhood. T1DM was also said to be insulin dependent diabetes because the patients require insulin for life since the beta cell s have lost integrity and no longer secret insulin.

On the other hand, T2DM was previously called insulin-independent diabetes because it did not rely on insulin as previously thought and that there is insulin resistance. T2DM was also referred to as mature onset diabetes due to high prevalence in adulthood and the elderly people over the age of 60 and above. These terms that were used are misleading since T2DM responds to insulin and in fact insulin therapy in given type 2 diabetes alongside other medications. Drugs & Medications. (n. d. Retrieved from https://www. webmd. webmd. com/diabetes/guide/glycated-hemoglobin-test-hba1c Metformin: Side Effects, Dosage, Uses, and More. (n. d. Retrieved from https://www. webmd. com/diabetes/type-2-diabetes-guide/type-2-diabetes-complications UpToDate. (n. d. Retrieved from https://www. org/tests-procedures/cortisone-shots/about/pac-20384794 Type 2 diabetes - Symptoms and causes.