DIABETES

MELLITUS
WHAT IS DIABETES MELLITUS?
• Diabetes mellitus is a metabolic disease that causes high blood sugar
levels in the body due to defects in insulin production and /or function.
• Diabetes occurs in one of the following situations:
-The pancreas produces little insulin or no insulin at all;
-The pancreas makes insulin,but insulin made does not works as
should .This condition is called insulin resistance.
WHAT ARE THE SYMPTOMS OF
DIABETES
• The symptoms of diabetes
include:
-Increased thirs
-Increased hunger
-Dry mouth
-Frequent urination
-Unexplained weight loss
-Blurred vision
-Fatigue
-Slow-healing sores or cuts
WHAT ARE THE TYPES OF
DIABETES?
• There are two main types of diabetes:
• Type 1 diabetes (formerly known as insulin-dependent) in which the
pancreas fails to produce the insulin which is essential for survival. This
form develops most frequently in children and adolescents, but is being
increasingly noted later in life.
• Type 2 diabetes (formerly named non-insulin-dependent) which results
from the body's inability to respond properly to the action of insulin
produced by the pancreas. Type 2 diabetes is much more common and
accounts for around 90% of all diabetes cases worldwide. It occurs most
frequently in adults, but is being noted increasingly in adolescents as well.
• Other types of diabetes might result from pregnancy(gestational
diabetes),surgery ,use of certain medication or various illnesses.
WHAT CAUSES DIABETES?
• The causes of diabetes are not
known.The following factors may
increase your chance of getting
diabetes:
-family history of diabetes
-being overweight
-physical stress
-age(risk increase with age)
-alcohol
-injury to the pancreas(such as
infection,tumor,surgery,or accident)
 PERSONAL DETAIL
• First name:Aida
• Last name:Morrison
• Sex:Female
• Age:40
• Data of birth 03/10/1979
• Occupation:Pharmacy assistant
• Marital status:Married
• Height:1,66m
• Weight:72kg
• Symptoms:fatigue,polyuria,polydi
psia
PRESENTING COMPLAINT
• Doctor:Good morning,Mrs.Morrison.I’m doctor Eveline
Harris.How can I help you?
• Mrs Morrison:Good morning.I haven’t been feeling very well.
• Doctor:Ok.Please have a seat and let’s begin our discussion.Tell
me,Mrs.Morrison how old are you?
• Mrs Morrison:I’m 40 years old.
• Doctor:Can you tell me your weight and height,please?
• Mrs.Morrison: Sure.I weight72kg and my height is 1.66meters.
• Doctor:What do you do for a living?
• Mrs.Morrison: I’m a pharmacy assistant
• Doctor: Now, tell me what is the problem that bothers you?
• Mrs.Morrison: I feel exhausted most of the time.I go to the
bathroom very ofen,especially during the night.I’m thirsty most
of the time .
• Doctor:When did the symptoms start?
• Mrs.Morrison:I’m not sure.About 3-4months ago.I can’t
remember exactly.I was going through a difficult period that
time due to some family problems and now that everything is
back to normal I realized that I’m not feeling well.
• Doctor:Do you have any other symptoms?
• Mrs.Morrison:Yes .Also,I’ve had these furuncles on my legs
for weeks.They disappeared by themselves but came back.
• Doctor:Do you still have them?
• Mrs.Morrison:Yes,I do.
• Doctor:Can I take a look?
• Mrs Morrison:Of course.
• Doctor:I see. Have you been to another doctor in this period?
• Mrs Morrison:No,because these symptoms didn’t bother me
as much as they do now.
PAST MEDICAL HISTORY
• Doctor:Do you suffer from any diseases,Mrs Morrison?
• Mrs.Morrison:Yes ,I’ve been having hypertension since I was 34years old.
• Doctor:Do you take antihypertensive medication?
• Mrs.Morrison:Yes,my cardiologist prescribed me 25mg of Egilok twice a day.
• Doctor:Do you take any other drugs?
• Mrs Morrison:No
• Doctor:Do you remember having any other diseases?
• Mrs.Morrison:I had measles and chickenpox when I was elementary
school.That’s all,I think.
• Doctor:Any surgeries?
• Mrs.Morrison:Yes,I had appendicitis when I was 9th grade and ac-section with
my second child.
• Doctor:Allergies?
• Mrs.Morrison :No.
FAMILY HISTORY
• Doctor:Ok.Are there any diseases that have been running in your
family?
• Mrs.Morrison:Well,my father has type 2diabetes.
• Doctor:What about your mother?
• Mrs.Morrison:She died 8years ago of breast cancer.
• Doctor:Are you the only child?
• Mrs.Morrison:No.I have a brother and a sister.They’re both
younger than me.
• Doctor:What about them?Are they healthy?
• Mrs.Morrison:Both are healthy.
• Doctor:That’s good.
 SOCIAL AND PERSONAL
HISTORY
• Doctor:Now,tell me Mrs.Morrison do you live in the city?
• Mrs.Morrison:Yes,I live in the city.
• Doctor:Do you live with your family?
• Mrs.Morrison:Yes,I live with my husband and my dauthers.
• Doctor:You said you are a pharmacy assistant.Is your job stressful?
• Mrs.Morrison:Not at all.I love my job because it allows me to spend
time with my family.
• Doctor:Do you smoke?
• Mrs.Morrison:No.
• Doctor:Do you drink?
• Mrs.Morrison:No.
• Doctor:That’s very good.Do you eat a lot of fast-food or sweets?
• Mrs.Morrison:Well,I’m not a chocolate lover ,but I do eat fast-food.
• Doctor:Do you exercise?
• Mrs Morrison:Not everyday.I try to walk on the treadmill at least
once a week and sometimes I’m walking home from my work.
• Doctor:Thank you for your information,Mrs Morrison.Now,if you
allow me I would like to take your blood pressure and measure your
glycemia.
• Mrs.Morrison:Of course!
• Doctor:Coud you roll up your left sleeve?
• Mrs.Morrison:Yes.
• Doctor:139 over 80.It’s a bit elevated.Did you take your
antihypertensive drugs this morning?
• Mrs.Morrison:Yes,I did
• Doctor:Let’s measure your glycemia.167,it’s to high.What did you
have for breakfast this morning?
• Mrs.Morrison:I had scrambled eggs,a slice of bread and a coup of
coffe.
• Doctor:I understand.We will have to do some lab tests and
when you get the results you will come to see me again.
• Mrs.Morrison:Ok,I will do everything you say.What tests I
need to do?
• Doctor:I wrote down on this paper that you need the fasting
blood glucose level and glycohemoglobin.Please give this
paper to the laboratory.
• Mrs.Morrison:Thank you.
• Doctor:Usually you get the results after 3 days,so I would like
you to make another appointment with my nurse for this
Friday.Will that be all right?
• Mrs.Morrison:Of course.I am free this Friday afternoon.
• Doctor:Excellent.Then I’ll see you this Friday.Good bye and
don’t worry.Everything is going to be all right.
• Mrs Morrison:Thank you,doctor.Good–bye!
 Diagnosis
• Next appointment
• Doctor:Hello,Mrs Morrison.It’s good to see you!How are you feeling
today?
• Mrs.Morrison:Hello,doctor.I’m fine,thank you.
• Doctor:Please take a seat.I recived the results for the blood tests you
have done.
• Mrs.Morrison:So,what are the results?
• Doctor:As I assumed you have type2 diabetes.Your fasting blood
glucose level is 188,the normal level is between 75 and 115.Also,your
glycohemoglobin is 7 and it should be bellow 6.
• Mrs.Morrison:Oh,that sounds really bad.
• Doctor:Don’t worry!Your situation is not that bad,so we can keep it
under control.
• Mrs.Morrison:I will do anything you say ,doctor.
• Doctor:First I would like to explain you what diabetes
means.Diabetes is a metabolic disease in which there are high
blood sugar levels.Symptoms of high blood sugar include
frequent urination,increased thirst and increased hunger.If left
untreated,diabetes,can cause many complication that include
cardiovascular disease ,chronic kidney failure ,foot ulcers and
damage to the eyes.
• Mrs.Morrison:Do you think that I’ll be all right?I mean,I
already told you about my father has type 2diabetes and last
month he had his left leg amputated.
• Doctor:For sure.You have to respect some basic rules and
never skip your treatment.
Treatment
• Mrs.Morrison:Ok,What is the treatment?
• Doctor:You have to take 1000mg of Siofor one a day.Also,you must
continue the antihypertensive treatment.Then you have to be more
careful of what you eat.You have to give up on sweets and fats,so
enough with fast-food.You have to respect this nutrition plan that I wrote
for you.
• Mrs.Morrison:I promise I will do my best to respect the diet.
• Doctoe:Very good.Now ,I would like to explain your diet.First,you have
to eat three meals a day at regular times.This helps your body better use
the insulin it produces or gets throughmedication.Your portion should be
smaller,you don’t have to be full when you get up from the table.Focus
on the healthy carbohydrates such as fruits,vegetables.I know is’s a lot
of information so I wrote in the diet plan everything you should or
shouldn’t eat.
• Mrs.Morrison:I understand.Thank You.
• Doctor:Also,you should exercise dialy,at least 30 minutes.This
will make your heart and bones strong,help to relieves
stress,improve blood circulation.
• Mrs.Morrison:I’ll try my best.
• Doctor:Good.Then for the next month you will have to measure
your glycemia every morning before your meal.Do you know
how to use a glucometer?
• Mrs.Morrison:Yes,I do.
• Doctor:Good.Do you have any questions?
• Mrs.Morrison:No.Everything is clear.
• Doctor:Then I would like to see you again after a month.Do
you agree?
• Mrs.Morrison:Of course.
• Doctor:Please make an appointment with my nurse.
• Mrs Morrison:Ok,doctor.Thank you so much!
• Doctor:I’m glad I could help you.Take care and don’t
forget to follow your diet!
• Mrs Morrison:I promise I won’t forget.Good-bye!
• Doctor:Good-bye!
BIBLIOGRAPHY
• https://
www.who.int/health-topics/news-room/fact-sheets/detail/dia
betes
• http://www.diabetes.org/
• https://medlineplus.gov/diabetes.html
• https://www.google.com/search?q=diabetes&rlz=1C1GCEA
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UKEwi6sLv9rMDhAhWJ-6QKHWTdA6UQ_AUIDigB&biw=136
6&bih=657#imgrc=IKVIczFLpLL8LM: