Polytechnic College of Davao del Sur, Inc.

McArthur Highway, Brgy. Kiagot, 8002 Digos City, Davao del Sur, Philippines

In Partial Fulfillment of the Requirements in NCM109

Diabetes Mellitus II
A Case Study

Presented by:

Ubas, Ericka
Amorganda, Justine Hope
Anggay, Noraila
Ayangco, Grant
Bellonid, Lucile Ann
Bordon, Desiree Dell
Candilasa, Cate Clarice Jeanna
Canumay, Gwen
Calle, Christian Hurvey
Cavan, Glyzah Erl Monic

Presented to:

Romel Cañete
Clinical Instructor

October 28, 2023

 ACKNOWLEDGMENT

This study becomes a reality with the kind support and help of many individuals. The
researchers would also like to extend a sincere thanks to all of them.

First and foremost, we want to offer this endeavor to the God Almighty for the
wisdom he bestowed upon us, the strength, peace of mind, and good health in order to finish this
study.

The researchers would also like to express their deep and sincere gratitude to their
Clinical Instructor, Mr. Romel Cañete, RN, for providing them invaluable supervision, and
support during the course of their case study. His dynamism, vision, sincerity and motivation
have deeply inspired them. He have taught them the methodology to carry out the research and to
present the research work as clearly as possible. The researchers would also like to thank him for
his empathy, motivation, patience, and knowledge that he has imparted. It was a great privilege
and honor to work and study under his guidance.

Last but not the least, to the researcher’s parents, for their deep consideration for the
undying support throughout the making of the case study. As well as for their words of
encouragement to all those nights that they’ve spent making the case study.

RESEARCHERS
 Introduction

Medical professionals communicate patient cases that are uncommon or haven't been

discussed before in academic publications called clinical case reports or case studies. Writing a

clinical case report requires both obtaining patient consent and safeguarding patient privacy.

A case report is a detailed report of the symptoms, signs, diagnosis, treatment, and

follow-up of an individual patient. Case reports usually describe an unusual or novel occurrence

and as such, remain one of the cornerstones of medical progress and provide many new ideas in

medicine. Some reports contain an extensive review of the relevant literature on the topic. The

case report is a rapid short communication between busy clinicians who may not have time or

resources to conduct large scale research. A case report ends with a conclusion or with summary

points, depending on the journal's specified format. This section should briefly give readers the

key points covered in the case report. Here, the author can give suggestions and

recommendations to clinicians, teachers, or researchers. (Volkland D, 1997.)

Case studies are an invaluable record of the clinical practices of a profession. While case

studies cannot provide specific guidance for the management of successive patients, they are a

record of clinical interactions which help us to frame questions for more rigorously designed

clinical studies. Case studies also provide valuable teaching material, demonstrating both

classical and unusual presentations which may confront the practitioner. (Dr. Brian Budgell, DC,

PhD)
 Identification of the Case

In this case study, Mr. A.E., a 63 year old male, has been diagnosed with Type 2 Diabetes
Mellitus and is experiencing symptoms associated with type 2 Diabetes Mellitus, such as
dizziness, cough, obesity, and fatigue.
The objective of this case study is to illustrate different aspects of Type 2 Diabetes
Mellitus with an emphasis on diagnosis and treatment with current as well as emerging
treatment options.

Patients with Type II Diabetes Mellitus often struggle with adhering to dietary and
medication regimens, and they face psychosocial challenges including stigma, depression, and
anxiety related to their chronic condition. Diabetes distress is different from depression and
stems from the challenges of managing the disease. It's linked to HbA1c levels and influences
how likely someone is to engage in self-care practices (Berry et al., 2015). Several factors,
including genetics, environment, and metabolism, interplay and elevate the risk of developing
type 2 diabetes mellitus. Those with a family history of diabetes, older age, obesity, and a
sedentary lifestyle are especially vulnerable. Ethnic minorities tend to have a higher
susceptibility, partly due to genetic reasons and partly due to adopting American lifestyles with
unhealthy diets and limited physical activity (Fletcher & Lamendola, 2002). In 2013, globally,
382 million adults were identified with diabetes, and this figure is projected to rise to 592 million
by 2035. Diabetic individuals have a higher probability of experiencing both major and minor
vascular complications, leading to a shorter lifespan. For example, the likelihood of encountering
severe heart conditions or strokes is 2 to 4 times higher for them. Tragically, 70%-80% of those
with Type 2 Diabetes (T2D) succumb to these ailments. The American Heart Association lists
diabetes among the top six controllable cardiovascular risk factors. In research terms, having
T2D is as risky as having had a previous heart attack. Additionally, around 40% of diabetics
suffer from chronic kidney issues, and between 60%-70% experience varying degrees of nervous
system damage. Furthermore, diabetes places a financial strain on healthcare, consuming about
11% of global healthcare spending (Hegazi et al., 2015).
 Background/History

PATIENT PROFILE

History Collection:

Name : Px E.A.

Age : 63 years old

Sex : Male

Education : College Level

Occupation : Businessman

Religion : Roman Catholic

Marital Status : Widow

Address : 0867 Chapter 7-A, Aplaya, City, Davao Del Sur

Date of Admission : October 17, 2023

Diagnosis : Type 2 Diabetes Mellitus

Ward Name : Medical Ward

History of Health status:

● Present Medical History : Pt is diagnosed with Type 2 Diabetes Mellitus

● Past Medical History : Admitted several times due to dizziness and cough

● Present Surgical History : N/A

● Past Surgical History : N/A

 Family History:

Name of family Age Sex Relationship Occupation

member

E, M. 28years old Female Daughter Cashier

E, J. 35years old Female Daughter Teacher

E, G. 38years old Male Son Technician

No hereditary illness
Personal History:

● Habits : Online games

● Sleep : 5hrs-12hrs

● Nutrition : Processed foods

● Elimination Pattern : 1-3 times a day

Anatomy and Physiology

Diabetes, when not appropriately managed, can pose severe threats to multiple body
systems. Prolonged high blood sugar can adversely affect several areas such as the eyes, nervous
system, heart, and kidneys. The blood vessels in the eyes can be damaged by diabetes, leading to
conditions such as cataracts, glaucoma, and retinopathy. In extreme cases, it can result in total
vision loss. While laser treatments can manage diabetic retinopathy, they can't restore already
lost vision. Hence, regular eye examinations are crucial for those with diabetes.
Excessive glucose can harm the small vessels in the nerves. This can manifest as sensations of
numbness, pain, or tingling, particularly in extremities like the hands and feet. In some instances,
this might lead to the loss of feeling in the affected area, which could result in ulcers and, in
severe circumstances, necessitate amputation. High sugar levels can also disrupt the digestive
system's nerves, leading to digestive issues ranging from nausea to constipation.
Individuals with type 2 diabetes are at a heightened risk, almost five-fold, of encountering heart-
related complications. Consistently poor blood sugar regulation can lead to atherosclerosis,
where blood vessels narrow, compromising blood flow to the heart. This can cause conditions
like angina or, in cases where the vessel gets entirely blocked, lead to heart attacks or strokes.
Elevated sugar levels burden the kidneys as they filter blood, which over time can compromise
their functioning. The affected kidneys can become less effective, leading to leakage and
blockage. In extreme cases, this can progress to total kidney failure.
In summary, uncontrolled diabetes can have cascading effects on various body systems,
emphasizing the importance of regular monitoring and effective management.
 Etiology & Symptomatology

In a healthy person, blood glucose levels are normalized by insulin secretion and
tissue sensitivity to insulin. With Type 2 diabetes, the mechanisms become faulty; the
pancreatic beta-cell, which releases insulin, becomes impaired and tissues develop insulin
resistance. This pathology has a genetic link, although it is somewhat unclear.

Etiology
Type 2 diabetes affects all parts of the body. It can cause serious, potentially life-threatening
complications. These include:

1. Atherosclerosis — Atherosclerosis is fat buildup in the artery walls. This can impair
blood flow to the all the organs. The heart, brain and legs are most often affected.
2. Retinopathy — Tiny blood vessels in the retina (the back of the eye that sees light) can
become damaged by high blood sugar. The damage can block blood flow to the retina,
and can lead to bleeding into the retina. Both damage the ability of the retina to see light.
Caught early, retinopathy damage can be minimized by tightly controlling blood sugar
and using laser therapy. Untreated retinopathy can lead to blindness.
3. Neuropathy — This is nerve damage. The most common type is peripheral neuropathy.
The nerves to the legs are damaged first, causing pain and numbness in the feet. This can
advance to cause symptoms in the legs and hands. Damage to the nerves that control
digestion, sexual function and urination can also occur.
4. Foot problems — Sores and blisters on the feet occur for two reasons:
If peripheral neuropathy causes numbness, the person may not feel irritation in the foot.
The skin can break down, form an ulcer, and the ulcer can get infected.
Blood circulation can be poor, leading to slow healing. Left untreated, a simple sore can become
infected and very large. If medical treatment cannot heal the sore, an amputation may be
required.
Nephropathy — Damage to the kidneys. This is more likely if blood sugars remain elevated and
high blood pressure is not treated aggressively.
Epidemiology
Type 2 diabetes continues to increase in prevalence, incidence, and as a leading cause of
human suffering and deaths. Despite significant investments in clinical care, research, and public
health interventions, there appears to be no sign of reduction in the rate of increase. Certain
regions of the world, such as Western Europe and island states in the Pacific, are experiencing a
disproportionately high burden. This epidemic will require an urgent and unwavering
commitment to aggressive solutions at national levels with public policies, public health funding,
and economic incentives for local communities to start diabetes prevention programs. Healthy
eating options need to be subsidized, and unhealthy foods need to be taxed or otherwise
disincentivized. Healthcare organizations and individual healthcare providers from multiple
disciplines (doctors, nurses, pharmacists, dieticians, and diabetes educators) must be given time
and resources to collaborate as they educate and care for individual and groups of patients.
Unless urgent measures are instituted to reduce unhealthy eating, sedentary lifestyles, rapid
urbanization, and other factors related to economic development, the burden of diabetes is
expected to continue rising.

Symptomatology
The symptoms of diabetes are related to high blood glucose levels. They include:
 Excessive urination, thirst and hunger
 Weight loss
 Increased susceptibility to infections, especially yeast or fungal infections
 Extremely high blood sugar levels also can lead to a dangerous complication called
hyperosmolar syndrome. This is a life-threatening form of dehydration. In some cases,
hyperosmolar syndrome is the first sign that a person has type 2 diabetes. It causes
confused thinking, weakness, nausea and even seizure and coma.
 The treatment of type 2 diabetes also can produce symptoms. Too much glucose-
lowering medicine, relative to dietary intake, can lead to the complication of low blood
sugar (called hypoglycemia). Symptoms of hypoglycemia include:
 Sweating
 Trembling
 Dizziness
 Hunger
 Confusion
 Seizures and loss of consciousness (if hypoglycemia is not recognized and corrected)

Pathophysiology

Medical Management
 Medical management for patients with Type 2 Diabetes Mellitus (T2DM) aims to
maintain blood glucose levels within a target range, manage symptoms, prevent complications,
and improve overall quality of life. Here's an overview of the medical management strategies:
Lifestyle Interventions:
Diet: Individualized meal planning, emphasizing whole foods, regular meal timings, controlled
carbohydrate intake, and minimal processed or sugary foods.
Physical Activity: Encourage regular aerobic exercise (like walking or cycling) and strength
training, tailored to the patient's abilities and preferences.
Oral Antidiabetic Agents: Multiple classes of oral medications may be used alone or in
combination.
Metformin: Often the first line of treatment. It decreases liver glucose production and increases
insulin sensitivity.
Sulfonylureas (e.g., glipizide, glyburide): Stimulate the pancreas to produce more insulin.
Thiazolidinediones (e.g., pioglitazone, rosiglitazone): Improve insulin sensitivity.
DPP-4 inhibitors (e.g., sitagliptin, saxagliptin): Enhance the effect of incretin hormones, which
help regulate blood sugar levels.
SGLT2 inhibitors (e.g., empagliflozin, dapagliflozin): Cause the kidneys to remove sugar
from the body through the urine.
Alpha-glucosidase inhibitors (e.g., acarbose): Slow down the breakdown of complex sugars in
the intestine.
Injectable Medications:
Insulin: Several types, including rapid-acting, short-acting, intermediate-acting, and long-acting,
might be prescribed, depending on the patient's needs.
GLP-1 receptor agonists (e.g., liraglutide, exenatide): Mimic the effects of the incretin
hormone, which helps lower post-meal blood sugar levels.
Blood Glucose Monitoring:
Self-monitoring of blood glucose (SMBG) using a glucometer is crucial for assessing the
effectiveness of treatment and making necessary adjustments.
Continuous glucose monitoring (CGM) devices provide real-time glucose readings and can alert
patients to highs and lows.
Blood Pressure Control: Many individuals with T2DM also have hypertension. Controlling
blood pressure can prevent cardiovascular complications.
Lipid Management: Statins or other lipid-lowering medications may be prescribed to manage
cholesterol levels and reduce the risk of cardiovascular diseases.
Regular Screening & Monitoring:
Regular HbA1c testing to assess long-term glycemic control.
Annual eye exams to screen for diabetic retinopathy.
Periodic foot exams to detect neuropathy and prevent ulcers.
Kidney function tests to detect early signs of nephropathy.
Patient Education & Support:
Diabetes self-management education (DSME) and support programs can help patients
understand their condition and improve self-care behaviors.
Psychological support or counseling might be necessary, considering the emotional and mental
challenges that can accompany T2DM.
Vaccinations: Due to increased risk of certain infections, patients with T2DM are often advised
to get vaccinations like the annual flu shot, pneumococcal, and hepatitis B vaccines.
Management of Comorbidities: Conditions like obesity, polycystic ovary syndrome, or sleep
apnea, which often coexist with T2DM, should be managed appropriately.
Sick Day Management: Guidance on how to manage medication, blood sugar monitoring, and
hydration during illnesses or infections.

Laboratory Findings

HEMATOLOGY RESULT
EXAMINATION RESULT NORMAL VALUES UNITS
White Blood Cell 12.8 H 5.0-10.0 10^9/L
Lymphocyte 8.2L 10.0-58.5 %
Monocyte 3.3 L 4.8-11.6 %
Segmenters 88.1 H 41.8-79.7 %
 Eosinophil 0.1 L 0.3-7.5 %
Basophil 0.3 0.1-0.6 %
Red Blood Cell 4.82 4.2-6.3 10^12/L
Hemoglobin 159 140-180 g/L
Hematocrit 0.458 0.400-0.540 L/L
MCV 95.1 80.0-97.0 fL
MCH 33.0 H 26.0-32.0 pg
MCHC 347 310-360 g/L
RDW 15.1 H 11.5-14.5 %CU
Platelet Count 190 150-400 10^9/L
MPV 6.7 L 7.0-10.0 fL

X-RAY RESULTS

Heart size is enlarged (CTR 0.57) with lateral displacement of the radiologic apex. Calcifications
are seen in the aortic arch. Pulmonary vascularity is normal. Questionable opacities are noted in
the right upper lobe. The rest of the lungs are clear. The lateral costophrenic sinuses are sharp.
Hili are not enlarged. Marginal spurs are noted in the spine.

IMPRESSION:
~ QUESTIONABLE OPACITIES, RIGHT UPPER LOBE. SUGGEST ALV.
~ ATHEROSCLEROSIS OF THE AORTA.
~ LV CARDIOMEGALY.
~ DEGENERATIVE JOINT DISEASE.

BLOOD CHEMISTRY

PARAMETERS RESULT UNITS

Random Blood Sugar 25.2 @2PM mmol/l
2 Hours Post Prandial Mmol/l
Nursing Theory

Adults with Diabetes Mellitus clients can achieve optimal health by knowing the
appropriate treatment for her/his condition. According to self-care theory, nurses has role as
advocates / educators for clients to control his/her Diabetes Mellitus. The Conditions that may
affect the client's self-care can be derived from the internal and external factors, internal factors
include age, height, weight, culture / ethnicity, marital status, religion, education, and
employment. The external factors include family support and cultural communities where clients
live.

Clients with these conditions require self-care continuum or continuous nature. The existence of
good self-care will achieve a prosperous condition; the client requires 3 self-care needs based on
Orem's theory.

Orem’s Self-Care Deficit Theory

3 Self-Care Needs Based on Orem's Theory.

 Universal self-care requisites - Which generally needs required by the client during its
life cycle to maintain a balanced condition / homeostasis that includes the
need for air, water, food, elimination, rest, and social interaction and face life-threatening
risks. In the DM client, the requirement that changes can be minimized by performing
self-care such as exercise / exercise, appropriate diet, and monitoring blood
glucose levels.
 Developments of self-care requisites – The client with DM have problem especially in
role function in their life. Physical problem in clients with diabetes such as; increase in
urination (polyuria), polyphagia, polydipsia, fatigue, weakness, skin wounds, vaginal
infections, or blurred vision (if high glucose levels).
 Health deviation self-care requisites - Needs related to health deviation such as
hyperglycemic syndrome which can lead to loss of fluid and electrolytes (dehydration),
hypotension, sensory changes, seizures, tachycardia, and hemiparesis. On the client with
diabetes there is an imbalance between the needs to be met with capabilities. Client with
 DM will decline and get many complications that can reduce their quality of life.
According to Orem nurse's role in this case is to assess the ability of self-care and classify
them according to the client's ability. After reviewing and get complete information then
nurses began work to restore the ability of self-care clients to actual condition.

Nursing Assessment

PERSONAL DATA

Name: Estrada, Alejandro SR.

Religion: Roman Catholic
Age: 63 years old
Gender: Male
Birthday: February 13, 1960
Height: 172cm
Weight: 80 kg
BMI: 27.4
Address: Chapter 7-A Barangay Aplaya, Digos City, Davao Del Sur, 8002
Estimated Monthly Income: 10,000

Vital Signs
Temp: 36
BP:130/80
RR: 70
PR: 20

Nursing Management
-NCP

-DRUG STUDY

Health Teachings

General Care

 Along with a healthy diet, regular exercise, and medication as prescribed:

Understanding T2DM:
T2DM is a chronic condition where the body either resists the effects of insulin or doesn't
produce enough insulin to maintain normal glucose levels.
It's essential to understand that uncontrolled blood sugar can lead to long-term complications.

Monitoring Blood Sugar:

Regularly monitor blood glucose levels as advised by the healthcare provider.
Understand the target range for blood sugar levels and know what to do if levels are too high or
too low.

Dietary Management:
Consume a balanced diet with whole grains, lean proteins, healthy fats, and plenty of fruits and
vegetables.
Limit the intake of sugary beverages, processed foods, and excessive amounts of unhealthy fats.
Learn to read food labels to understand carbohydrate content and manage portion sizes.
Consider consulting with a registered dietitian who can provide personalized meal planning.

Physical Activity:
Engage in regular physical activity, such as walking, swimming, or cycling, for at least 150
minutes a week.
Include strength training exercises at least twice a week.
Always consult a healthcare provider before starting any new exercise regimen.

Medications:
Understand the purpose, dosage, and timing of medications.
Take medications consistently as prescribed.
Inform the doctor of any side effects or if the medication doesn’t seem to be working.
Regular Check-ups:
Schedule regular check-ups to monitor blood sugar levels, blood pressure, cholesterol levels, and
kidney function.
Regular eye and dental exams are also crucial as diabetes can affect these areas.

Foot Care:
Check feet daily for cuts, blisters, red spots, and swelling.
Wash feet daily in lukewarm water and keep them dry and moisturized (but not between the
toes).
Avoid walking barefoot and wear comfortable, well-fitted shoes.

Managing Stress:
Chronic stress can elevate blood sugar levels. Techniques such as deep breathing, meditation,
and yoga can be beneficial.
Sleep plays a crucial role in managing stress and maintaining good health. Aim for 7-9 hours of
sleep per night.

Avoiding Alcohol and Tobacco:

Limit alcohol or consume it with food and always in moderation.
Seek assistance to quit smoking, as tobacco can exacerbate complications.

Complication Awareness:
Be aware of potential diabetes complications, such as neuropathy, nephropathy, retinopathy, and
cardiovascular issues.
Seek immediate medical attention for symptoms like chest pain, shortness of breath, vision
changes, or persistent pain or numbness in any body part.

Self-advocacy and Support:

Actively participate in diabetes self-management education programs.
Consider joining support groups or online communities for motivation and shared experiences.

Sick Day Management:

Illness can elevate blood sugar levels. Have a plan for adjusting medication, monitoring blood
sugar, and what to eat during illnesses.
Empowering individuals with T2DM with this knowledge is essential. However, it's crucial to
adapt these teachings to individual needs, taking into account the patient's culture, literacy level,
and other personal considerations.

DISCHARGE PLAN

A discharge plan is vital for patients with Type 2 Diabetes Mellitus (T2DM) to ensure
continuity of care and optimize management of their condition once they leave the hospital or
clinic setting. A comprehensive discharge plan should encompass several aspects:

1.Medication Management:

 List of current medications with dosages, timing, and possible side effects.
 Importance of adherence to medication.
 Procedure for glucose monitoring and target blood sugar levels.

2.Dietary Recommendations:
 Referral to a registered dietitian for a personalized meal plan if needed.
  Guidelines on carbohydrate counting or the plate method.
 Importance of regular meal timings and avoiding excessive sugars and unhealthy fats.
3. Physical Activity:
 Recommend a personalized exercise plan, emphasizing the benefits of regular physical
activity.
 Precautions while exercising, such as monitoring blood sugar levels.
4. Self-Monitoring:
 Instructions on how to use a glucometer and the frequency of self-monitoring.
 Logging and interpreting the results and when to notify the healthcare provider.
5. Sick Day Management:
 Guidance on managing blood sugar during illness, which might include more frequent
monitoring and potential medication adjustments.
6. Follow-up Appointments:
 Schedule regular check-ups with the primary care provider, endocrinologist, or diabetes
educator.
 Details of other essential follow-ups: podiatrist for foot care, ophthalmologist for eye
exams, and dentist.
7. Foot Care:
 Daily foot examination for cuts, blisters, or infections.
 Importance of wearing well-fitted shoes and avoiding walking barefoot.
8. Complication Awareness:
 Be aware of potential long-term complications of diabetes and the importance of early
detection and management.
9. Support and Education:
 Referral to diabetes education programs or support groups.
 Information about online resources, apps, or communities for additional support.
10. Emergency Contacts:
 List of numbers to call in case of emergencies, including healthcare provider, diabetes
educator, or local hospital.

11. Lifestyle and Stress Management:

 Tips on stress reduction, such as relaxation techniques or counseling referrals.
 Importance of avoiding smoking and limiting alcohol intake.
12. Supplies and Refills:
 Ensuring the patient has all necessary supplies: glucometer, test strips, lancets,
medications, and a method to safely dispose of sharps.
 Information on when and how to refill medications and supplies.

Exercise

 Lose weight if you need to and keep a healthy weight.

  Exercise as your provider recommends.
 Learn how to do proper skin and foot care every day.
o Check your feet and lower legs for red skin areas and open sores.
o Wear comfortable, well-fitting shoes to help prevent foot injury.
o Break in new shoes gradually.
o Ask your provider about how to trim your toenails properly.

 . Find ways to make your life less stressful.

Treatment

 In most cases, type 2 diabetes treatment begins with weight reduction through diet and
exercise. A healthy diet for a person with diabetes is:
 Low in saturated fats and cholesterol
 Without any trans fats
 Low in total calories
 Nutritionally balanced with abundant amounts of:
 Whole-grain foods
 Monounsaturated oils
 Fruits and vegetables

Hygiene

1. Hand Washing

▪ People with diabetes are immune compromised, which means they are at greater risk

of getting infections
2. Diet and Hydration:

 Discuss dietary guidelines to prevent dehydration and maintain bowel regularity.

Encourage the patient to consume adequate fluids and follow any dietary

recommendations provided by their healthcare provider.

3. Cleansing and Moisturizing Feet
 Caring for your feet daily allows you to catch small problems before they become
serious.

4. Dental Hygiene Practices

 Daily dental hygiene practices can help reduce the risk of oral health problems.

Diet

 Limit foods that are high in sugar

 Eat smaller portion sizes
 Be conscious of carbohydrates one eats
 Eat whole grains, fruits, and vegetables everyday
 Limit fat intake
 Limit salt intake
 Lose weight if you need to and keep a healthy weight

Significant Others

● Follow-Up Appointments: Schedule and communicate follow-up appointments with the

healthcare provider, emphasizing the importance of attending these appointments.

Explain the purpose of each visit.

● Emergency Preparedness: Educate the patient and caregiver on recognizing potential

complications or emergencies and provide clear instructions on what to do in such

situations. Ensure they have contact information for healthcare providers.

 ● Home Health Services: If necessary, coordinate home health services, such as wound

care and monitoring, to support the patient's recovery at home.

● Discharge Instructions: Review all instructions and information with the patient and

caregiver, ensuring they are well-prepared for self-care at home. Provide written

materials for reference.

Prognosis

Your treatment plan is likely to require adjustment over time. Insulin resistance
increases with age. And the insulin-producing cells in the pancreas may wear out as the pancreas
tries to keep up with the body's extra insulin needs.
After the first few years, the majority of people with type 2 diabetes require more than one
medicine to keep their blood sugar controlled.
The prognosis in people with type 2 diabetes varies. It depends on how well an
individual modifies his or her risk of complications. Heart attack, stroke and kidney disease can
result in premature death. Disability due to blindness, amputation, heart disease, stroke and nerve
damage may occur. Some people with type 2 diabetes become dependent on dialysis treatments
or require a kidney transplant because of kidney failure.

Evaluation

1. Nutritional Well-Being:
 ● The patient is maintaining a well-balanced diet and hydration, as recommended by their

healthcare provider or dietitian. There are no significant signs of malnutrition or

dehydration.

2. No Complications:

● There are no reported complications or issues related to the type 2 diabetes mellitus

3. Adherence to Medication Regimen:

● The patient adheres to their prescribed medication regimen, and any medications for

underlying medical conditions.

4. High Quality of Life:

● The patient reports a high quality of life and a successful return to normal daily activities,

demonstrating physical and emotional well-being.

5. Minimal Need for Healthcare Intervention:

● The patient requires minimal healthcare intervention for complications or issues related

to type 2 diabetes mellitus.

6. Patient Satisfaction:

● The patient expresses satisfaction with their care and the outcomes of the type 2 diabetes

mellitus medication and intervention.

A positive evaluation result indicates that the patient has successfully adapted to life after

medication and is experiencing a good quality of life with minimal complications or concerns.

These results reflect effective healthcare management and support throughout the patient's

recovery journey.
 Implication of the Study

As student nurses, exploring this particular medical condition expanded our

understanding and clarified many aspects of its infectious nature. This insight improved our
clinical skills by equipping us with detailed information about the condition, preparing us to care
for patients with similar health challenges. Such knowledge has significantly enriched our skill
set, enabling us to apply effective and safe techniques in patient care. By examining this case, we
could identify the health needs of both the patient and their family, devise a care strategy,
execute it, and evaluate the results of our interventions. This experience has further refined our
abilities, comprehension, and critical thinking, guiding us in delivering the highest quality of care
as nursing student

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