Shiyun Kim, PharmD, BCACP, BCPP, CDE
James Lee, PharmD, BCACP
University of Illinois at Chicago College of Pharmacy
世界上哪种
动物的眼睛最大?
Diabetes Cases – July 5, 2017CASE 1
M.L. is a Asian female who presents to the Internal Medicine Clinic clinical pharmacist for follow-up regarding hypertension (HTN). She was screened for diabetes at a recent health fair and was told to discuss her blood sugar reading with her health care provider. However, she does not remember the blood sugar reading. She tells you her sister was recently diagnosed with Type 2 diabetes.
PMH: HTN x 6 months, GDM (gestational DM) 7 years ago瓜达尔港对
中国的
意义 PSH: Tubal ligation 7 years ago
FH: Mother: Type 2 DM
Sister: Type 2 DM
M. Grandmother: Diabetes, unsure what type, was using insulin
SH: Smokes 1ppd x 15 years, occ EtOH, denies illicit substance use
Caffeine: Drinks 2 cups of coffee/ day, 1-2 regular Pepsi sodas/day
Diet: Does not always eat breakfast, usually eats fast food for lunch
NKDA (no known drug allergies)
Medications
HCTZ 25mg po daily
Vitals: Ht 5’5” Wt: 180 lbs (81.7kg) BMI 30 BP 144/82 P 82 R 20 Temp 98.6 F
1.What risk factors does ML have for DM?
2.A Fasting Blood Glucose (FBG) measurement was obtained from ML today: 140mg/dL. What is ML’s diagnosis?
3.What specific lifestyle modification interventions would you suggest?
4.Which labs should you order?
5.What medication therapy for her blood glucose would you initiate? (state dose and regimen)
6.How would you optimize her current anti-hypertensive regimen? (state
medication class and monitoring parameters) 新自由主义
7.What specific education should you provide for ML today?
8.When would you follow-up with ML?
CASE 2
ML returns for follow-up appointment. She is unsure if she is eating the best foods to control her BG. She is tolerating her new medications well. She is trying to eat breakfast, but has been mostly been eating a donut or potato chips on her way to work. She is increasing her physical activity to 10 minutes three days a week by walking after work. She has been eating 1 banana and chips for snacks. 汾渭
盆地 She brought in her BG readings.
SMBG:
Fasting BG 160-180mg/dl
After meals 200-240mg/dl
1.What aspects of ML management of diabetes could be improved?
2.How would you adjust ML’s current medication therapy? (Give dose and regimen)
3.What are the clinical benefits of your recommendations? 霰弹
4.When would you like to follow up with ML?
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