The patient is a female teenager who goes to high school and frequently attends soccer practice, as she is the goalie of the soccer team. Being overweight at such a young age, the patient has a high risk of type 2 diabetes development due to fatigue, stress, and a lack of proper diet due to the former factors. There is still not much information on the patient’s disease anamnesis, so more data should be estimated during further tests and physicals.
Objective Data
The patient is admitted to the facility with a severe spike in blood sugar. The patient’s BMI is 37, constituting the case of severe obesity, especially considering her age. The random blood sugar test performed after a routine screening indicated the blood sugar rate >200 mg/dL, indicating the diagnosis of type 2 diabetes mellitus. The patient does not stick to healthy nutrition habits and resorts to overeating as a means of combating stress.
Assessment
During the initial screening of the patient, it was established that the patient always had a high BMI rate, yet she did not consider it a problem due to her regular physical practice and the position of a goalie on the soccer team. However, several weeks prior to the screening, the patient started struggling with sudden fatigue, numbness in arms and legs, occasional nausea, and a frequent urination urge. As a result of the initial physical, the patient was preliminarily diagnosed with prediabetes, so she was referred to a random blood sugar test. Since the results demonstrated an extremely high sugar amount in sugar, immediate intervention is required.
Plan
The first part of the intervention plan is the immediate referral to more specific blood and hormonal tests. A high BMI rate that indicates extreme obesity at such a young age can be caused by serious hormonal imbalance. Moreover, hormonal disruptions and changes during puberty can lead to a higher risk of acute insulin response and consequential type 2 diabetes (Valaiyapathi et al., 2020). The patient should then be referred to an endocrinologist to eliminate the hormonal issues as a treatment barrier. It would also be necessary to look into the family history of diabetes predisposition in order to discover the contributing factor to the medical condition.
Another crucial part of the intervention plan is patient education and developing a roadmap for diabetes tracking. In the beginning, the patient should be advised on the matter of medication and insulin-free intervention, including physical activity, diet, and proper rest-to-work ratio in order to reduce stress levels. Currently, the patient is not used to healthy nutrition habits, so the prescription would include a detailed diet outline, including the reduction of sugary food and beverages and balanced eating patterns. For example, according to Milencovic et al. (2021), adherence to the Mediterranean diet has a positive effect on type 2 diabetes treatment and prevention, so it should be considered as an option. As far as physical activity is concerned, it is evident that the current physical activity patterns function poorly, so it is advisable the patient seeks a more balanced approach to training besides her soccer practice.
Considering the overall emotional state of the teenager, a part of the treatment should address therapy and counseling. Once the test results are in, and education intervention is conducted, the patient is expected to come back for another blood sugar testing and therapist appointment in three weeks. In case there is no blood sugar stabilization, the treatment plan will involve a series of “β-cell function and insulin sensitivity” enhancement medications (Valaiyapathi et al., 2020, p. 220). In case no complications or side effects are manifested, regular appointments should be held every three weeks.
References
Milenkovic, T., Bozhinovska, N., Macut, D., Bjekic-Macut, J., Rahelic, D., Velija Asimi, Z., & Burekovic, A. (2021). Mediterranean diet and type 2 diabetes mellitus: A perpetual inspiration for the scientific world. A review. Nutrients, 13(4). Web.
Valaiyapathi, B., Gower, B., & Ashraf, A. P. (2020). Pathophysiology of type 2 diabetes in children and adolescents. Current Diabetes Reviews, 16(3), 220-229. Web.