You are a physician OR
a nurse at a family medical practice. Ms Tabitha Taborlin is a 45-year-
old patient at your practice.
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Patient Details
Name: Tabitha Taborlin (Ms)
Marital status: Single
Next of kin: Gregory Taborlin (69, father)
Date seen: 08 April, 2018
Diagnosis: Type 1 diabetes mellitus
Past medical history: | Essential hypertension
Type 1 diabetes mellitus (non-compliant with insulin regimen)
Multiple episodes of diabetic ketoacidosis (DKA)
Scanned with CamSocial background:
Schoolteacher, lives alone in apartment
Does not exercise, BMI
18.2 (underweight - 48kg)
Smokes moderately (2 cigs daily)
Medical background:
Long history of Type 1 diabetes (since 7 y.o.) and
noncompliance with insulin regimen.
On
45 units
Lantus nightly and preprandial correctional scale Humalog with
12 unit nutritional baseline.
02/04/2018: admitted DKA (glucose 530 mmo/L)
Appointment today:
\V fluids and insulin administered. Discharge stable - HbAIc.
Doing well since discharge.
Still not using insulin. Has insulin available.
Not following recommended diet.
Discussed diabetes education,
necessity of glucose testing, insulin administration, smoking
cessation education.
Discussed microvascular/macrovascular complications of
diabetes.
vvuaimicu wiur vamPlan:
Discharge today - provide educational pamphlets and refills for
Lantus and Humalog.
Referral to endocrine specialist for stricter glycemic control and
possible insulin pump.
Follow-up in 1 month.
Scanned with CamUsing the information given in the case notes, write a referral letter to
Dr. Sharon
Farquad, Endocrinologist at Endocrine Specialists and Associates, 115
Burke St. Omaha.
Scanned with Cam