MN 6010 PU Primary Care For The Pre Diabetic Patients Discussion
REPLY TO THIS DISCUSSION
Health promotion is heavily dependent on disease prevention, especially for a patient with a family history of a particular disease. In primary care, the provider is responsible for routine screening, including diagnostics or labs. I recall a recent time in the clinical setting caring for a forty-year-old female patient with a family history of diabetes on her paternal side and breast cancer on her maternal side. According to the USPSTF, women should have the choice to start mammography biennially (USPSTF, 2016). In this case, the patient was recommended to have her mammogram due to her family history. The provider and I ordered routine and additional labs, including CBC, CMP, HgBA1C, TSH, lipid panel, and vitamin D levels. The ordered labs gave us an idea of her blood glucose levels. For an individual to be considered a true type 2 diabetic, they must meet specific criteria, which include fasting blood glucose greater than 126, HgBA1C greater than 6.5, and random blood glucose on two separate occasions greater than 200 (Mayo Clinic, 2023). The patient had a fasting blood glucose of 140 and an HgBA1C level of 7. The provider started her on metformin 500mg daily at bedtime and instructed her on possible gastrointestinal effects, such as nausea, vomiting, and diarrhea. The patient was also instructed to exercise moderately for at least thirty minutes daily for a minimum of three to four times a week.
Often, a patients economic status might affect their care. The estimated 2017 cost of diagnosed diabetes is $327 billion, including $237 billion in direct medical costs and $90 billion in reduced productivity (American Diabetes Association, 2023). In this case, the patient was a single mother with financial stressors. The American Diabetes Association is an excellent resource for patients newly diagnosed or diagnosed with diabetes. The patient was given resources for funding programs, and Good Rx is another resource for medications if a patient does not have medical insurance.
References
American Diabetes Association. (2023, January 26). The cost of diabetes. American Diabetes Association: https://www2.diabetes.org/about-us/statistics/cost-diabetes
Mayo Clinic. (2023, May 10). Type 2 diabetes. Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/typ…
The United States Preventative Services Task Force. (2016, January 11). Breast cancer: Screening. The United States Preventative Services Task Force: https://www.uspreventiveservicestaskforce.org/usps…
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