Select one of the two questions from the discussion questions listed below.
Be sure to respond to the question using the lessons and vocabulary found in the reading. Justify your answers using examples and reasoning. Support your answers with examples and research and cite your research using APA format.
Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ posts. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.
Discussion Question 1
There are multiple issues to consider in caring for someone with diabetes II. Your course textbook lists these as:
- Race and Ethnic Group
- Obesity
- Coronary Artery Disease and Heart Failure
- Hyperlipidemia
- Hypertension
- Nephropathy
- Neuropathy
- Retinopathy
From this group, select two specific issues and explain the importance of that variable in the treatment of diabetes. Explain how a provider needs to approach the patient and how these considerations would influence the selection of agents for the treatment of diabetes and related complications.
Discussion Question 2
AG is a sixty-nine-year-old male who presents for an initial visit with a complaint of blurred vision, fatigue, and lack of energy. He is currently being treated for hypertension, hypothyroidism, and gouty arthritis. He is currently retired and married, with three adult children. His vital signs are unremarkable, with a body mass index (BMI) of 30. His current medications include lisinopril 20 mg daily, allopurinol 300 mg daily, and levothyroxine 0.888 mg daily.
As per his blood work today, his A1c level is 7.8%, his fasting blood sugar is 202, his total cholesterol is 180 mg/dL, his high-density lipoprotein (HDL) is 27 mg/dL, his low-density lipoprotein (LDL) is 193 mg/dL, and his triglycerides are 302 mg/dL. Answer the following questions:
- What additional blood work would you like to complete at this point? Is there any additional information that should be collected from the patient?
- Evaluate the current therapy and make recommendations concerning any needed changes.
- What lifestyle modifications or changes do you think would be appropriate for this patient?
Expert Solution Preview
Introduction:
As a medical professor responsible for creating assignments and answers for medical college students, it is important to consider the various factors that affect the treatment of patients with diabetes. In this discussion, I will be addressing Discussion Question 1.
Discussion Question 1: From this group, select two specific issues and explain the importance of that variable in the treatment of diabetes. Explain how a provider needs to approach the patient and how these considerations would influence the selection of agents for the treatment of diabetes and related complications.
Answer:
Hypertension and obesity are two specific issues that have a significant impact on the treatment of patients with diabetes. Hypertension is prevalent in patients with diabetes and is a significant risk factor for cardiovascular disease, a leading cause of morbidity and mortality in diabetic individuals. Treatment of hypertension in patients with diabetes has been shown to reduce the risk of cardiovascular disease and death.
Obesity is also widespread, and it is a major contributor to the development and worsening of diabetes. The presence of obesity, particularly central obesity, is associated with insulin resistance, which characterizes type 2 diabetes. Obesity also increases the risk of developing diabetes-related complications.
Providers need to approach patients with both diabetes and hypertension or obesity with a comprehensive and individualized approach. To achieve positive patient outcomes, providers must initiate multifaceted treatment strategies that encompass both pharmacologic and non-pharmacologic approaches. These strategies may include the use of medications such as ACE inhibitors, ARBs, and thiazide diuretics to control blood pressure, and medications such as metformin and GLP-1 receptor agonists for diabetes management in patients with obesity.
Lifestyle interventions like dietary modifications and regular exercises should be considered as a component of treatment for both patients as such interventions can reduce blood pressure and improve glycemic control while preventing excessive weight gain. Therefore, healthcare providers should approach patients with hypertension and obesity with a combination of pharmacologic and non-pharmacologic interventions in tailored patient-centric treatment regimes.
References:
National Institute of Diabetes and Digestive and Kidney Diseases. (2021). High blood pressure & kidney disease. Retrieved from https://www.niddk.nih.gov/health-information/kidney-disease/high-blood-pressure
Centers for Disease Control and Prevention. (2021). Obesity and genetics. Retrieved from https://www.cdc.gov/genomics/resources/diseases/obesities/index.htm
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