P.J is a 53 year old man who has had type 2 diabetes for which he was diagnosed two years ago. He has also had hyperthyroidism and obesity problems. P.J is a lawyer and says that he his job restricts him from having free time to do exercise or any light activity. He is a regular user of alcohol and uses five sticks of cigarette per day. He is however planning to quit alcohol in the next 12 months. He says that for the last three nights he has woken up at 4.00am due to elevated blood glucose levels beyond 350 mg/dl. At the time of presentation, the patient records a blood pressure of 168/100mmHG. He has a weight of 249 lb as well as a regular pulse of 83 beats per minute.
The lab results indicate traces of protein for urinalysis test, serum cretinine at 1.2mg/dl, normal electrolytes as well as normal thyroid-stimulating hormone levels. The patient however admits that he had ‘so much booze last weekend’ to celebrate the triumph of his local football team. The patient was also on prednisone which was due to complete in the next two days. It was noted that the dose could be the cause of elevated glucose levels and that would subside once the dose was over (Al-Hazzaa, Hazzaa M., et al, 1). P.J was however required to take the Metformin which is an -glucosidase inhibitor (Jarvis, 117). He would take this at the advice of the primary healthcare provider if he feels that the symptoms are not going down in the next two days.
In P.J’s case, his alcohol related problems as well as the lack of physical activity all imply increased risk of progression of diabetes. The serum creatinine levels are a prime warning of the risk of kidney dysfunction which could fasten with poor management and particularly alcohol use and continued obesity. With this lifestyle and the lack of will to change the patient may not actually help their state of health. Alcohol use will for instance lead to elevations in blood glucose as well as well as blood pressure due to increased fluid levels in the blood (Riekert, 28).
References
Al-Hazzaa, Hazzaa M., et al. "Lifestyle factors associated with overweight and obesity among Saudi adolescents." BMC Public Health 12.1 (2012): 1.
Jarvis, Carolyn. Physical Examination and Health Assessment–. Elsevier Health Sciences, 2015.
Riekert, Kristin A., Judith K. Ockene, and Lori Pbert, eds. The handbook of health behavior change. Springer Publishing Company, 2013.
