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DM-II

Hassan M. AlShehri
251040006

• Evidence of peripheral neuropathy and hard exudates.Case: • 56 yr woman • Polyuria + Polydipsia. • RBS 450mg/dl DX DM-II . -15Kg in one month but have good appetite • Complained of: Numbness in her feet + blurred vision. neovascularzation in the eye. Pulse 80/m. respiratory and gastrointestinal system was normal. BP 120/100 mmHg The rest of CVS. • Hx of DM in the family • Physical Examination • Obese.

Pathophysiology: • DM is a chronic metabolic disorder with abnormal regulation of glucose. malnutrition in utero. resulting in hyperglycemia. impaired regulation of hepatic gluconeogenesis and a relative impairment of beta-cell function. age and pregnancy) and genetics factors. It’s characterize by peripheral insulin resistance. with interaction of environmental (life style. • DM-II: is a multifactorial in nature. .

and blurred vision *High blood pressure(stage 2) . and weight loss Numbness in her feet.Problems List: *High blood glucose Polyuria. polydipsia.

Therapeutic Objectives: Blood sugar control Blurried vision management Peripheral neuropathy man management Blood pressure control .

B) Pharmacologic 1)Oral hypoglycemic 2)Insulin .Management of DM-II A) Non pharmacologic: 1)Diet (MNT) 2)Exercise If patient’s glycemic target is not achieved in 3-4 weeks of MNT and exercise. pharmacologic therapy is needed.

Management of DM-II(oral hypoglycemic) Group Efficac Safety Suitabili Cost Total y ty Sulfonylureas 4 2 0 2 8 Biguanides 4 3 5 3 15 Alpha. 1 2 4 1 8 Glucosidase Inhibitors Thiazolidinedio 5 1 3 0 9 nes(glitazones) Meglitinides 4 3 0 1 8 Incretin 4 5 4 0 13 mimetic .

Personal drug: Biguanides: Metformin .

HTN Control: Group Efficacy Safety Suitabili Cost Total Diuretics 4 2 ty 4 3 13 B. 4 0 3 2 9 blockers ACEI 4 4 5 2 15 Ca 4 1 3 2 10 channel blockers Alpha. 1 0 0 2 3 Blocker ARB 3 3 3 2 11 .

ACEI: Group Efficacy Safety Suitabili Cost Total Captopril 5 3 2 ty 1 11 Enalapril 5 4 2 1 12 Lisinopr 5 4 5 1 15 il .

P. P. once daily.O.O.5 mg tablet. Doctor: XXX Signature :XXX . once daily for 10 days 5 mg tablet. Lisinopril 2. once daily. P. Referral to ophthalmology. Referral to neurology.O.Prescription: Patient Name: Sex: Female Age: 56 MR: XX Date: 21/12/2008 Dx: DM-II Rx: Metformin 500 mg tablet.

Information: Eduction about the disease. Stop smoking Side effects of drugs. follow up . Diet: Low in sugar Exercise.

Thank You .