Y.L., a 34-year-old Asian woman, comes to the clinic with
complaints of chronic fatigue, increased thirst, constant hunger,
and frequent urination. She denies any pain, burning, or low-back
pain on urination. She tells you she has a vaginal yeast infection
that she has treated numerous times with over-the-counter
medication. She works full time as a clerk in a loan company and
states she has difficulty reading numbers and reports, resulting in
her making frequent mistakes. She says, “By the time I get home and
make supper for my family, then put my child to bed, I am too tired
to exercise.” She reports her feet hurt; they often “burn or feel
like there are pins in them.” She has a history of gestational
diabetes and reports that, after her delivery, she went back to her
traditional eating pattern, which is high in
carbohydrates.
In reviewing Y.L.'s chart, you notice she has not been seen
since the delivery of her child 6 years ago. She has gained
considerable weight; her current weight is 173 pounds. Today, her
BP is 152/97 mm Hg, and a random plasma glucose is 291 mg/dL. The
primary care provider suspects that Y.L. has developed type 2
diabetes mellitus (DM) and orders the following laboratory
studies:
Laboratory Test Results
Fasting glucose 184 mg/dL
HbA1C 8.8%
LDL 155 mg/dL
Total cholesterol 256 mg/dL
Triglycerides 346 mg/dL
HDL 32 mg/dL
UA +glucose, − ketones
13. What are some changes that Y.L. can make to reduce the risk or slow the progression of both macrovascular and microvascular disease? TYPE II DIABETES MELLITUS 14. Given all the information in the foregoing scenario, what DM-related complication do you believe Y.L. is most at risk for, and why? 15. What monitoring will be needed for Y.L. regarding nephropathy and retinopathy?
Y.L., a 34-year-old Asian woman, comes to the clinic with complaints of chronic fatigue, increased thirst, constant hung
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Y.L., a 34-year-old Asian woman, comes to the clinic with complaints of chronic fatigue, increased thirst, constant hung
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