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 her first three. - Had her thyroid(1 lobe) removed after being hit with 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. Medical History:(Symptoms) - Prediabetes: a. Increased thirst b. Frequent urination(not consistently but occasionally throughout the week) c. Fatigue(extreme tiredness) d. Blurred vision(Uses eyewear) - Levothyroxine:(medicine for loss of thyroid) a. Sweating(occasionally) b. Pounding heartbeats or fluttering in your chest(after daily exercise or during midday) - Thyroid Loss(after surgery:1 week) a. Numbness and tingling(facial areas) Lifestyle Behaviors:(Diet) - 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. - 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) - Takes at least 7-9 hours of sleep (Average) - Takes one hour of intense exercise (Running)
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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.How her genetics and physical lifestyle are affect 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 diagnosed to be a diabetic and at least three are from a higher generation. In other words, there is a 3/11 (or a 27.27%) chance of a person of her generation to receiving diabetes. It should also be acknowledged that all of the diabetics received the disease later on in life. Risk Assessment: The American Diabetes Association has created a 60 second risk assessment for diabetics. It should be considered a source, but it’s best to research or talk to a medical professional about the patient's conditions.The assessment doesn’t ask specific details about the patient.
Medications:
Unfortunately, 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 risks with diabetes that can increase other diseases within the body. So for this patient, it would be recommend to her these prescriptions as a temporary choice. Since this patient has prediabetes, a well adjusted 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 monohydrate - Hydroxypropyl Cellulose - Carboxymethylcel lulose calcium - Magnesium stearate
Intended Effects: To level out the high blood sugar and to prevent type 2 diabetes for patients who have prediabetes. Side Effect: - cold-like symptoms (respiratory tract infection) - Headache sinus infection - muscle pain - Much more
Dosage: - Initial dose: 15 mg or 30 mg orally once a day. - Maximum dose: 45 mg orally once 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.
In case of this patient gaining 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 they are affected
Dosage: - Taken once per day with breakfast. Non-specific dosage Instructions: -
Always keep source of sugar available. Follow doctor
Aluminum Lake - And much more Ingredients: Active - Glimepiride - Chlorpropami de
from. Side Effect: - Nausea, - Loss of appetite, - Diarrhea, - Vomiting - Weight gain
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. The patient also must count out certain parts of said diet in order to have stable blood sugar levels. For example, those who already have diabetes must have their portion of carbohydrates be at least 45 and 65 percent of their meals (exact number depending on the person). There are also certain foods the patient could either avoid or eat with or without type 2 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 patient. The patient must count out both sugar and carbohydrates. This will allow our patient to stay stable in the glucose levels within their blood. Lifestyle Recommendations​: For our patient, she seems to be doing fine genetically. 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, she would be at trail for a lancer. A lancer is a machine that tries to measure the glucose 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 is buying with technology built in, so any brand could be fine. How it works is that the strip being contained within the lancer has an enzyme called glucose oxidase. It reacts to how much glucoses there is within one droplet of blood, and sends signals through an electrode(a metal rod or conductor that chances signals of electricity through the machine or object). It then shows a certain number or percentage on the screen. Goals and Timeline: After reviewing the patient's status and information, there are certain checkmarks she should accomplish during 6 months. Then check with medical professional to see if the trail 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 she must do. 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 sugary 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 the substance 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 every three weeks to see how she is doing. She must 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 there 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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