Diabetes Management

CASE SUMMARY: Mr. Alfonzo Giuliani, a 68-year-old male, presents with complaints of blurred vision, increased thirst and hunger, fatigue, and weakness. Patient has a maternal history of diabetes. Co-morbid diagnoses include: hypertension, gouty arthritis, dyslipidemia, hypothyroidism, and obesity. Patient referral for Diabetic education, Population Health Nurse for health coaching for goal setting and to continue with in office education regarding dietary changes to improve blood sugar and overall health, education on cessation of alcohol consumption. Patient will return to office in two weeks for evaluation for effectiveness of medication treatment and monitoring of side effects and adverse reactions. 5334 CASE SUMMARY TABLE 1. Symptoms: List two pertinent signs and symptoms • Blurred vision • Increased thirst • Increased hunger • Fatigue • Weakness • Family history of diabetes • HA1C of 7.8% • Random blood sugar of 202 mg/dL 2. Recommended Drugs: **Drug of choice – list at least 3 recommended drugs List recommended drugs as indicated for this diagnosis • Glucophage (metformin) 500mg one tablet two times a day may increase by 500mg weekly up to 2000mg/day (Vallerand, Deglin, & Sanoski, 2017). • Amaryl (glimperide) initially 1-2mg daily and may be increased every one to two weeks up to 8mg/day with a range of 1-4mg daily being usual (Vallerand, Deglin, & Sanoski, 2017). • Januvia (sitagliptin) 100mg once a day (Vallerand, Deglin, & Sanoski, 2017). 3. Drug Categories and Subcategories: Identify the category of each recommended drug. • Glucophage (metformin) is therapeutically it is an antidiabetic, pharmacologically it is a biguanide, and it is a pregnancy category B medication (Vallerand, Deglin, & Sanoski, 2017). • Amaryl (glimepiride) is therapeutically an antidiabetic, pharmacologically a sulfonylurea, and a pregnancy category C medication (Vallerand, Deglin, & Sanoski, 2017). • Januvia (sitagliptin) is therapeutically an antidiabetic, pharmacologically an enzyme inhibitor, and a pregnancy category B medication (Vallerand, Deglin, & Sanoski, 2017).