Topic- Type 2 Diabetes
Unlike Lynch Syndrome, multiple gene combinations are responsible for the development of type 2 diabetes mellitus (NIDDM). The primary genetic variants lie in one of two processes, insulin sensitivity and insulin secretion. Both modifiable and non-modifiable risk factors play a role in the development of NIDDM. Researchers have thus far discovered over 40 SNPs associated with NIDDM (and are finding a new one almost every month)! It all sounds easy right? Let’s say you have a combination of SNPs that has been found to be associated with NIDDM. This SNP combination has been found to raise the risk of NIDDM by 7% above average risk. You are certainly not destined for diabetes. However, having this knowledge would be key to increased preventative behaviors (like a healthy diet, regular exercise, and maintaining a normal weight) that are shown to decrease the risk of NIDDM.
Create a scenario for diabetes and diagnosis and final diagnosis for this scenario using the tables below….
Name: Pt. Encounter Number:
Date: Age: Sex:
SUBJECTIVE
CC:
Reason given by the patient for seeking medical care “in quotes”
HPI:
Describe the course of the patient’s illness, including when it began, character of symptoms, location where the symptoms began, aggravating or alleviating factors, pertinent positives and negatives, other related diseases, past illnesses, and surgeries or past diagnostic testing related to the present illness.
Medications: (List with reason for med )
PMH
Allergies:
Medication Intolerances:
Chronic Illnesses/Major traumas
Hospitalizations/Surgeries
“Have you ever been told that you have diabetes, HTN, peptic ulcer disease, asthma, lung disease, heart disease, cancer, TB, thyroid problems, kidney problems, or psychiatric diagnosis?”
Family History
Does your mother, father, or siblings have any medical or psychiatric illnesses? Is anyone diagnosed with: lung disease, heart disease, HTN, cancer, TB, DM, or kidney disease?
Social History
Education level, occupational history, current living situation/partner/marital status, substance use/abuse, ETOH, tobacco, and marijuana. Safety status
Lab Tests
Urinalysis—pending
Urine culture—pending
Wet prep—pending
Special Tests
Diagnosis
o Include at least three differential diagnosis
o Final diagnosis
Evidence for final diagnosis should be documented in your Subjective and Objective exams.
PLAN including education
o Plan:
Further testing
Medication
Education
Nonmedication treatments
Follow-up
