Patient Profile Name: Katerine Zempie Sex: Female Gender: Female Age: 27 years Height: 4’8 ft (below average) Weight: 123 pounds (Overweight) Ethnicity: Hispanic Medical History: - Had 5 children, and breastfed 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. Symptoms of Medical History: Prediabetes: - Increased thirst - Frequent urination(not consistently but occasionally throughout the week) - Fatigue(extreme tiredness) - Blurred vision(Uses eyewear) Levothyroxine:(medicine for loss of thyroid) - Sweating(occasionally) - Pounding heartbeats or fluttering in your chest(after daily exercise or during midday) Thyroid Loss(after surgery:1 week) - Numbness and tingling(facial areas) Lifestyle Behaviors:(Diet) - Eats at least 2 cups of sugar (96 teaspoons) with added meals every week. - Takes effort to eat at least one piece of fruit(banana or apple) per day. Also considered sugar. - 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) - Does at least 7-9 hours of sleep (Average) - Does one hour of intense exercise (Running) - Does 5 hours of electronics (phones, TV, etc) - Does 2 hour of productive activity(art, reading, etc) Medical Concerns/Family History: - Family mainly suffers from Thyroid disease. - Family suffers bad eyesight.(ie glasses) - Mother was diagnosed with stage 4 stomach cancer and 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, 4 have been diagnosed to be a diabetic and at least three are from a higher generation. According to the experimental probability, 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 diagnosed the disease later on in life. Risk Assessment: The American Diabetes Association has created a 60 second risk assessment for diabetics. It does not enter into specifics and only ask about general information of the patient. These being high blood pressure, weight, etc. It would be best to research or talk to a medical professional about the patient's conditions rather then basing the patient's condition on this assessment.
“File: Our 60-Second Type 2 Diabetes Risk Test” Photographed May 27, 2018, American Diabetes Association, donations.diabetes.org, Web, June 1, 2018
The image reflects what are the chances of the patient gaining type two diabetes based upon the questions from the assessment.
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 or Diabinese. ACTOS and Diabinese are drugs that lowers blood sugar, and can prevent high blood sugar/type 2 diabetes. - ACTOS Actos active ingredients would be Pioglitazone hydrochloride, while the inactive ingredients would be Lactose Monohydrate, Hydroxypropyl Cellulose, and much more. The intended effect of the drug is to lower high blood sugar and prevent type two diabetes. However, certain side effects are headache, sinus infection, muscle pain, and much more. When taking the drug, use at least 15-30 mg doses once a day. In order to preserve it, please keep it between 59 °F and 86°F so it wouldn’t spoil. - Diabinese Tablet Diabinese Tablet active ingredients would be Glimepiride and Chlorpropamide, and certain inactive ingredients would be Calcium Carbonate and much more. The intended effect of the drug is to lower blood sugar and prevent diabetes. It also helps people with different body conditions or illnesses that are affected by type 2 diabetes. However, certain side effects are nausea, diarrhea, vomiting, and much more. For the dosage, take it once a day at breakfast. The instructions could be gained from medical professional 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 such as; 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 - Corn chips, - Potato chips - 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. To lower the chances of diabetes, she must simply do certain activities. First, she should try to lose at least 5 to 7 percent of her body fat. For herself, she would have to lose 16.5 pounds at best. 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 assigned or given 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.
Photographer unknown, “iStock.com/lisas212”, 11/26/10, iStockPhoto, Chris Kresser, chriskresser.com, Web, June 1, 2018
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 96 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 43.75% 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. 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 Height: 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.
“ACTOS” 1/11/2018, RxList Inc, rxlist.com, Web, May 31, 2018 “Checking your blood Glucose” February 7, 2018, American Diabetes Association, diabetes.org, Web, May 31, 2018 “DIABINESE®” 4/25/2017, RxList Inc, rxlist.com, Web, May 31, 2018 “Diabinese” Feb 28, 2018, Drugs.com, drugs.com, Web, May 31, 2018 “Diabinese Tablet” Date Unknown, First Databank Inc, WebMD, webmd.com, Web, May 31, 2018 “How Much is too Much” Date Unknown, University of California San Francisco, Sugar Science: The unsweetened truth, sugarscience.ucsf.edu/, Web, May 31, 2018 Jensen S. “How do glucometers work?” October 18, 2011, MIT School of Engineering, engineering.mit.edu, Web, May 31, 2018 “LABEL: CHLORPROPAMIDE- chlorpropamide tablet”, December 1, 2009, National Institute of Health, DailyMed, dailymed.nlm.nih.gov, Web, May 31, 2018 “MEDICATION GUIDE ACTOS® (ak-TŌS) (pioglitazone hydrochloride) tablets” January 2011, Takeda Pharmaceuticals America, Inc, accessdata.fda.gov, Web, May 31, 2018 NIDDK, niddk.nih.gov/, Web, May 31, 2018 “No Thyroid Gland: What Next?” Date Unknown, 2018 Holtorf Medical Group, holtorfmed.com, Web, May 31, 2018 “Pioglitazone” May 2, 2018, Drugs.com, drugs.com, Web, May 31, 2018 Phillips Q. “ Diabetes Drugs Without a Prescription?” March 14, 2012, Madavor Media, Diabetes Self Management, diabetesselfmanagement.com, Web, May 31, 2018 “Preventing Type 2 Diabetes” November 2016, U.S. Department of Health and Human Services, NIDDK, niddk.nih.gov/, Web, May 31, 2018 Theobald M. “ The Best and Worst Foods to Eat in a Type 2 Diabetes Diet” 12/1/2017, Everyday Health, everydayhealth.com, Web, May 31, 2018 “Thyroid surgery: Recovery” Date Unknown, The American Association of Endocrine Surgeons, endocrinediseases.org/, Web, May 31, 2018
Tinsley G. “Is It Possible to Increase Your Height After 18?” August 10, 2017, Healthline Media, healthline.com, Web, May 31, 2018 “Why Levothyroxine — i.e. Synthroid — Treatment Isn’t Working for You” Date Unknown, 2018 Holtorf Medical Group, holtorfmed.com, W eb, May 31, 2018 “File: Our 60-Second Type 2 Diabetes Risk Test” Photographed May 27, 2018, American Diabetes Association, donations.diabetes.org, Web, June 1, 2018