Nursing: Incidence of Diabetes | Discussion
1. Identify what this individual is most at risk for based on the information presented in this case above.
The patient has the following results of the blood test: a fasting plasma glucose level of 137 mg/dL, an HDL level of 27 mg/dL, LDL level of 247 mg/dL, a serum triglyceride level of 210 mg/dL. Such results give implications that the patient may have some health issues, including the risk of the development of diabetes in the patient. In this regard, the following risks have to be taken into consideration to diagnose whether the patient does have diabetes or not.Nursing: Incidence of Diabetes | Discussion
The doctor may conduct the random blood sugar test. A blood sample will be taken at a random time. Regardless of when the patient last ate, a random blood sugar level of 200 milligrams per deciliter (mg/dL) — 11.1 millimoles per liter (mmol/L) — or higher suggests diabetes.Nursing: Incidence of Diabetes | Discussion
Fasting blood sugar test will also provide more accurate result. The blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes (Magliano, et al., 2008). If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, the patient has diabetes. Also, the patient should undergo the oral glucose tolerance test. For this test, the patient has to fast overnight, and the fasting blood sugar level is measured (Magliano, et al., 2008). Then the patient has to drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes (Magliano, et al., 2008).
2. Explain the significance of this individual’s weight and waist diameter. Explain how this individual is at increased risk for insulin resistance.Nursing: Incidence of Diabetes | Discussion
The measurement of the individual’s weight and waist diameter can help to diagnose diabetes. Increases in both waist circumference and weight were significantly associated with diabetes incidence. If the patient experienced the increase of both weight and waist diameter, then the risk of the development of diabetes 2 is high. The increase of weight and waist diameter indicates to the fact that the individual is likely to have impaired fasting glucose that is the symptom of type 2 diabetes. Although visceral adiposity and waist circumference are strong risk factors for type 2 diabetes, the consequence of an increase in waist circumference among individuals with IFG at baseline has not been fully investigated, in particular in those who are not overweight or obese at baseline (4,5) (Lorenzo, et al., 2003). Nevertheless, the increased weight and wais diameter may indicate to the presence of problems and possible symptoms of type 2 diabetes. Therefore, the patient needs further examination to make the more accurate diagnosis concerning the risk of having type 2 diabetes.
3. Explain briefly the differences between hypoinsulinemia, hyperinsulinemia, hyperglycemia, and hypoglycemia as each relate to an individual with type 1 diabetes mellitus and type 2 diabetes mellitus.
In relation to diabetes, hyperglycemia refers to chronically high blood glucose levels. Most medical professionals define hyperglycemia by using the blood glucose goals that you and your physician have established and combining those goals with the blood glucose target ranges (Ferrannini, et al., 2009).
Hypoglycemia refers to dangerously low blood glucose levels that drop below 70 mg/dL. Significant hypoglycemia is considered below 54 mg/dL. It is an acute complication of diabetes and occurs in individuals who use insulin or specific kinds of oral diabetes medication. If patients use oral diabetes medications, they have to consult their physician or diabetes educator whether hypoglycemia should be a concern (Ferrannini, et al., 2009).Nursing: Incidence of Diabetes | Discussion
Hyperglycemia is an abnormally high blood glucose (blood sugar) level. Hyperglycemia is a hallmark sign of diabetes (both type 1 diabetes and type 2 diabetes) and prediabetes (Ferrannini, et al., 2009).
Hypoglycemia also known as low blood sugar, is when blood sugar decreases to below normal levels. This may result in a variety of symptoms including clumsiness, trouble talking, confusion, loss of consciousness, seizures, or death (Ferrannini, et al., 2009).
References:
Ferrannini E, et al. (2009). Plasma glucose levels as predictors of diabetes: the Mexico City diabetes study. Diabetologia, 52, 818–824.
Lorenzo C, et al, (2003). The metabolic syndrome as predictor of type 2 diabetes: the San Antonio Heart Study. Diabetes Care, 26(3), 153–3159.
Magliano DJ, et al. (2008). Glucose indices, health behaviors, and incidence of diabetes in Australia: the Australian Diabetes, Obesity and Lifestyle Study. Diabetes Care, 31, 267–272.Nursing: Incidence of Diabetes | Discussion