Case Study 23 Type 2 Diabetes Mellitus

Case Study 23 Type 2 Diabetes Mellitus-19
Another important role of insulin is in the peripheral tissues where it facilitates glucose into cells, transport of amino acids across muscle membranes to synthesise into protein and transport of trigylcerides into adipose tissue.Thus insulin is a storage or anabolic hormone (Brown & Edwards 2008).

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Hyperosmolarity and depletion of intracellular water are a result which triggers sensors in the brain to interpret this as thirst (polydipsia) (Hill 2009).

An increase in hunger (polyphagia) is stimulated due to insulin deficiency activating catabolism of proteins and fats increasing appetite (Hill 2009) and polyuria ( frequent urination) is due to excess glucose creating an osmotic diuresis in the kidneys (Hill 2009) drawing large amounts of water with it.

Secondly the inability of the pancreas to secrete enough insulin due to Beta cells becoming fatigued from the overproduction created by the resistance of the cells to uptake insulin (Brown & Edwards 2008).

Lastly the liver can not regulate appropriate levels of glucose to match blood glucose levels creating an overflow into the bloodstream as insulin resistance continues and hyperglycaemia develops (Capriotti 2005).

Firstly education is important to emphasise to the patient the importance of close monitoring and management as diabetes can become a chronic disease with multiple health issues and a poor quality of life (AIHW 2006).

Brown & Edwards (2008 P.1352) points out that patient teaching enables them to take control and to become confident in participating in their own care; this also provides the basis for a successful treatment plan.For this reason weight loss can dramatically improve blood glucose levels (Farrell 2005).Aboriginal people are advised to adopt their traditional bush food eating.As Mr Daley is a newly diagnosed patient, there is a real need to focus on education.Education has been identified as a significant factor in the effective control of blood glucose levels.(Jerreat 2009 ) Managing diabetes can be challenging and support is needed if the individual is to have a close to normal life (AIHW 2006).Three major metabolic abnormalities are seen to contribute to play a role in Diabetes mellitus, Firstly insulin resistance which can be seen as the bodies tissues do not respond to the action of insulin (Brown & Edwards 2008).This resistance according to (Capriotti 2005) encourages the pancreas to secrete increasing amounts of insulin as a regulatory response to control glycaemic levels.This exposure to foods high in fat and sugars, alcohol and nicotine use along with a sedentary lifestyle have placed them in a high risk category of developing diabetes and at an earlier age than non indigenous people (Thomson 2003).Aboriginal people had the genetic makeup to survive when food was scarce but now this once efficient metabolism, exposed to a western influence is now working against them (Thomson 2003).The newly diagnosed patient should be informed of the importance of these symptoms which if left unnoticed or ignored can lead to hyperosmotic non-ketotic state (Hill 2009).The patient would have a high glycaemic measurement of 30mmol/l or greater and in desperate need of rehydration to prevent the onset of a diabetic coma (Hill 2009).


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