Name: K.Z.(Katerine Zempie) Sex: Female Gender: pronoun female Age: 27 years Height:4’8 ft (below average) Weight: 123 pounds (Below average) Ethnicity: Hispanic Medical History: - Had 5 children, and breastfeed at first three. - Had her thyroid(1 lobe) removed after being hit by thyroid disease. She takes T4 treatment called Levothyroxine once a day for the past 3 years. - Was diagnosed with prediabetes at the age of 25 - Was diagnosed with gestational diabetes during pregnancy of last child. Lifestyle Behaviors:(Diet) - She eats at least 4-5 cups of sugar (240 teaspoons) with added meals every week. - Takes effort to eat at least one piece of fruit(banana or apple) per day - she eats healthy, and tries to exercise 1 hr a day before going to bed. - Mainly consumes certain substances such as sugar packets with coffee or high amounts of jam with eggs/toast for breakfast. Lifestyle Behaviors: (Physical) - She takes at least 7-9 hours of sleep (Average) - Takes one hour of intense exercise (Running) - 5 hours of electronics (phones, TV, etc) - Takes 2 hour of productive activity(art, reading, etc)
Medical Concerns/Family History: - Family mainly suffers from Thyroid disease - Family suffers bad eyesight(ie glasses)(mostly females) - Mother was diagnosed with stage 4 stomach cancer. Died two years later. - Mother and grandmother both diagnosed with diabetes. Purpose of Consultation: Trying to see her chances of type 2 diabetes. If her genetics and physical lifestyle are doing to her. What changes in her life she should take.
Familiar Risk: Out of the eleven people shown through the family tree, at least 4 have been shown to be a diabetic and and at least three from a higher generation. In other words, there is a 3/11 (or a 27.27%) chance of a person of her generation to receive diabetes. Though, it should be fundamental that all of the diabetics received the disease later in life. Risk Assessment: The American Diabetes Association has created a 60 second risk assessment for diabetes. Though it could be considered a source, it’s best to research or talk to a doctor about your conditions, as this assessment doesn’t ask specific details about the patient.
Medications: Sadly, there isn’t many drugs that are OTC(drugs without prescriptions but still approved by the FDA) and can prevent diabetes. The reason for no OTC drugs is due to the fact there’s a risk with diabetes that can increase other diseases within the body.So for our patient, it would be best to recommend her these prescriptions as a temporary choice. Since our patient has prediabetes, a good prescription would be ACTOS. ACTOS is a drug that lowers blood sugar, and can prevent high blood sugar/diabetes. ACTOS Ingredients: Active - Pioglitazone hydrochloride Ingredients: Inactive - lactose
Intended Effects: To level out the high blood sugar and to prevent type 2 diabetes for people who have prediabetes.
Dosage: - Initial dose: 15 mg or 30 mg orally once a day - Maximum dose: 45 mg orally once
-
monohydrate Hydroxypropyl Cellulose Carboxymethylcel lulose calcium Magnesium stearate.
Side Effect: - cold-like symptoms (respiratory tract infection) - Headache sinus infection - muscle pain - Much more
a day Instructions(Storage): - Do not take it if you have severe heart failure. - Keep it between a degree of 59°F to 86°F. - If you take too much, please go to emergency room or doctor. - Takes 2-3 months to see full effect
Of course, in case our patient does gain type 2 diabetes, the best recommendation would be Diabinese Tablet Diabinese Tablet Ingredients:Inactive Intended Effect: - Calcium - Diabinese tablets is Carbonate used with a proper diet - Colloidal and exercise program to Silicon control high blood sugar Dioxide in people with type 2 - Croscarmello diabetes. It also helps se Sodium people with certain body - D&C Yellow problems or conditions No. 10 that are affected from Aluminum the type 2 diabetes. Lake Side Effect: - And much - Nausea, more - Loss of appetite, Ingredients: Active - Diarrhea, - Glimepiride - Vomiting - Chlorpropami - Weight gain de
Dosage: - Taken once per day with breakfast. Non-specific dosage Instructions: -
Always keep source of sugar available Follow doctor specific instructions.
Nutrition Plan: For a healthy diet, the patient must not only stray away from certain foods that have high trans fats or extreme amounts of sugar, but also count out certain parts of said diet in order to stay stable for blood sugar. For example, those who already have diabetes must have carbohydrates
be at least 45 and 65 percent of their meals (exact number depending on the person). There are also certain foods you could either avoid or eat with or without diabetes What to Eat: - Whole grains, - Nuts and seeds, - Lean protein, - Fat-free or low-fat dairy - Small portions of fresh fruits - Healthy fats
Not to Eat: - Soda, - Candy, - Packaged or processed snacks 1. Corn chips, 2. Potato chips 3. And similar things as well.
In the end, the proportions of the meal must depend on the person, whether they are at risk or already have type 2 diabetes. It’s always good to count out either sugar or carbohydrates, so that a person could be stable in the gloutose within their blood. Lifestyle Recommendations​: For our patient, she seems to be doing fine. Though, to lower the chances of diabetes, she must simply do certain activities. One of them being trying to lose at least 5 to 7 percent of their body fat. For example, if a person is 200 pounds, they must lose at least 14 pounds. Since she is already doing more than the needed exercise, all she has to worry about is her diet. Checking blood sugar: In case our patient wants to see their pre-diabetes, they should ask for a lancer. A lancer is a machine that tries to measure the glotus in your blood, and creates percentage of how much there is in your blood. There are at least four simple steps to taking the machine. 1. After washing your hands, insert a test strip into your meter. 2. Use your lancing device on the side of your fingertip to get a drop of blood. 3. Touch and hold the edge of the test strip to the drop of blood, and wait for the result. 4. Your blood glucose level will appear on the meter's display. This is the general way on how to use lancers as there are multiple brands. There are extremely small differences if one thinking of buying one with technology within brands, so anyone could be fine. How it works is that the strip being contained within the lancer has an enzyme called glucose oxidase. What it does is it reacts to how much glucoses there is within one droplet of blood, and sends signals through an a electrode(a metal rod or conductor that chances signals of electricity through the machine or object). This way, a person could restrict or allow what they can eat. Goals and Timeline: After reviewing the patient's status and information, there are certain checkmarks I would like her to accomplish in the next 6 months. Then check to see if it could work permanently.
Lower amounts of sugar needed for meals: The patient uses a high amount of sugar that is above average for most women. In order to stay health, the average women must eat at least 6 teaspoons per day, and 42 teaspoons per week. However, our patient has passed far beyond normal expectations, as she consumes 240 teaspoons a week. This is highly dangerous and might be the main reason for herself gain prediabetes already. There are three parts I would like her to take. 1. Reduce the amount of sugar and use only ⅙ or 16.7% of the amount needed. This could be achieved by simply avoiding all meals for the next couple of weeks. This also means the patient should use the lancer to see how she is doing so far, and if the blood sugar or glucose lowered. 2. Reduce at least 10% of her average consumption of sugar everyday, so not get extremely sick when leaving it completely. She could do this by cutting or reduce the amount of jam needed for breakfast, or pure sugar needed for coffee. 3. Work on gaining more height in the next month or so. Though a person doesn’t gain much height after 18 or 20, there are still chances of one’s epiphyseal plates growing. If the patient hasn’t fully grown, the best way to help would be to change her diet, since environmental factors have a 20-40% effect on height. This could easily be gain by eating protein such as certain grains, white meat, and much more. Do check ups with doctor: The patient should also have annual visits with her medical profession to see if the progress is going well. This is only temporary until the six months end, and that the patient should come in every three weeks to see how she is doing. She should have 1. A spreadsheet that records what her lancer states on blood sugar. Should have used the lancer one every day at night. 2. A record list of what the patient ate everyday, and if is should be changes. Should also include substances put on main meals. Start Gaining Weight: The patient is underweight, and might be do to her metabolism already being accustomed to sugar within the digestive system. The patient should now eat grains and protein more the 5 times a day in order to become average. The average woman weighs at about 166 pounds. She should record the food she’s eaten and adjust it based on medical professional analysis, as listed above.
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