Pathophysiology & Clinical Findings of the Disease

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Review the lab findings and decide if the diagnosis is Type 2 or Type 1 Diabetes Mellitus.
Explain the pathophysiology associated with your chosen diagnosis
Identify at least three subjective findings from the case which support the chosen diagnosis.
Identify at least three objective findings from the case which support the chosen diagnosis.
Management of the Disease

*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.

Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.
Describe the mechanism of action for each of the medication classes identified above.
Identify two (2) “Evidence A” recommended non-pharmacological treatment options for this patient.
Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations

Sample Solution

Hypothetical Case Scenario

Assuming the following lab results:

  • Fasting blood glucose: 250 mg/dL
  • Hemoglobin A1c: 9%
  • Negative C-peptide level
  • Positive GAD antibodies

Diagnosis: Type 1 Diabetes Mellitus

Pathophysiology: Type 1 diabetes is an autoimmune condition where the body’s immune system destroys the insulin-producing beta cells in the pancreas. Insulin is crucial for glucose uptake by cells. Without insulin, glucose accumulates in the blood, leading to hyperglycemia.

Subjective Findings Supporting Type 1 Diabetes

  1. Polyuria: Increased urination due to excessive glucose in the blood.
  2. Polydipsia: Increased thirst due to dehydration caused by excessive urination.
  3. Polyphagia: Increased appetite due to cellular starvation despite increased food intake.

Objective Findings Supporting Type 1 Diabetes

  1. Hyperglycemia: Fasting blood glucose of 250 mg/dL.
  2. Poor glycemic control: Hemoglobin A1c of 9%.
  3. Autoimmune markers: Positive GAD antibodies.

Management of Type 1 Diabetes

Pharmacological Treatment:

  • Insulin therapy: The cornerstone of type 1 diabetes management.
    • Rapid-acting insulin (e.g., lispro, aspart): Mimics the body’s natural insulin response to meals.
    • Long-acting insulin (e.g., glargine, detemir): Provides basal insulin coverage throughout the day.

Non-Pharmacological Treatment:

  • Self-monitoring of blood glucose (SMBG): Regular blood glucose monitoring to adjust insulin doses and lifestyle.
  • Carbohydrate counting: Matching insulin doses to carbohydrate intake to maintain blood glucose control.

Clinical Practice Guideline Support: The American Diabetes Association (ADA) Standards of Medical Care in Diabetes provides comprehensive guidelines for the management of type 1 diabetes, including the use of insulin therapy, SMBG, and carbohydrate counting.

Conclusion

Based on the hypothetical lab results, the diagnosis of Type 1 Diabetes Mellitus is supported. The pathophysiology involves the autoimmune destruction of insulin-producing cells, leading to insulin deficiency and hyperglycemia. Management focuses on insulin therapy, SMBG, and carbohydrate counting to achieve optimal glycemic control.

 

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