Metabolic Case Study Case

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East Tennessee State University *

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5014

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Health Science

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Dec 6, 2023

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Running Head: Metabolic Case Study Metabolic Case Study Case Roxy Shortridge East Tennessee State University NRSE 5014 – 915 Dr. Kim Hudson-Gallogly September 20, 2023

Running Head: Metabolic Case Study 1.) Based on the above information, what is the most likely cause of this patient’s symptoms? What were the most pertinent findings that led you to this diagnosis? (Please explain) a. A 10-year-old male is seen for a routine sports physical. The patient reports no changes in health from his previous physical which was completed one year ago. He does not currently take any prescription or over-the-counter medications. His mother reports a well-balanced diet, and that the patient has been physically active this summer playing football. After reviewing the lab results the patient altered his diet by not eating fast food, soda, or processed food. The mother now reports that the patient has increased his water consumption and urination. He also collapsed from abdominal pain a few days ago. Based off the patient’s history, signs and symptoms, and laboratory results the patient most likely has type 1 diabetes (T1D). The patient has had increased thirst and urination, weight loss, stomach pain. The patient had elevated blood glucose levels, glucose, ketones, and protein in his urine. All these signs and laboratory values correlate with a diagnosis of diabetes. “It is essential that diabetes self-management education and support, medical nutrition therapy, and psychosocial support be provided at diagnosis and regularly thereafter in a developmentally appropriate format that builds on prior knowledge by individuals experienced with the biological, educational, nutritional, behavioral, and emotional needs of the growing child and family.” (American Diabetes Association, 2020). Based off of the sudden onset of symptoms, laboratory values reported, and the patient’s age, type 1 diabetes would be the diagnosis I would make as the healthcare provider.

Running Head: Metabolic Case Study 2.) Describe the pathophysiology and epidemiology of your diagnosis above? What age group is most likely to receive this diagnosis (describe the prevalence of this disease within this specific age group)? a. “Among the autoimmune diseases, the most common serious disease is the type 1 diabetes (T1D).” (Dariya, et al., 2019). The pathophysiology behind type 1 diabetes is a result of the body’s immune system attacking the beta cells of the islets of Langerhans in the pancreas. This leads to insulin secretion decreasing until the body can no longer maintain normal blood glucose levels. The age group that is most commonly diagnosed with this condition is children and adolescents under the age of 20 years old. “283,000 children and adolescents younger than age 20 years—or 35 per 10,000 US youths—had diagnosed diabetes. This includes 244,000 with type 1 diabetes.” (CDC, 2022). Type I diabetes was known as ‘juvenile’ diabetes for many years as children are primarily diagnosed with this condition. 3.) Who would you refer this patient to (what specialty)? What type of medication management should this patient expect (long term)? What education should this patient/family receive? a. As the healthcare provider I would refer this patient to an endocrinologist to primarily manage their diabetes. I would also refer the patient to a nutritionist who can educate the patient and family on diet and exercise including carbohydrate counting. I would collaborate with a dentist, eye doctor, foot doctor and pharmacist to ensure that the patient is receiving the care and education that is needed to control their blood glucose levels. I would expect this patient to be managed using oral medication, and possibly insulin if needed. The patient and family would need to be educated on the signs and symptoms of hypoglycemia such as excessive sweating,

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Running Head: Metabolic Case Study lightheadedness, increased heart rate, blurred vision, confusion, and weakness. It is important to also know the signs and symptoms of hyperglycemia such as excessive thirst, headache, fruity breath, and fatigue. It is important to also educate and discuss diet modifications that are needed to maintain proper glucose control. “Frequent blood glucose monitoring is a cornerstone of intensive diabetes management and is associated with lower hemoglobin A1c values and decreases the occurrence of both hypo- and hyperglycemia.” (Marks & Wolfsdorf, 2020). Educating the patient and family on proper medication administration and how to obtain a blood glucose level is imperative when caring for a patient with type I diabetes. 4.) What are the long-term risks if this diagnosis is not properly managed? a. A complication that can occur from diabetes can be diabetic ketoacidosis. “Diabetic ketoacidosis (DKA) is a serious complication of diabetes that can be life-threatening. DKA develops when you don’t have enough insulin to let blood sugar into your cells.” (CDC, 2023). There are several long-term risks of not properly managing diabetes mellitus type I. These can include blindness, stroke, heart and blood vessel disease, kidney failure, amputations, wound complications, and nerve damage.

Running Head: Metabolic Case Study References American Diabetes Association. (2020, December 4). 13. children and adolescents: Standards of medical care in diabetes-2021 . https://diabetesjournals.org/care/article/44/Supplement_1/S180/30606/13-Children-and- Adolescents-Standards-of-Medical CDC. (2022, September 30). Prevalence of diagnosed diabetes . Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/data/statistics-report/diagnosed-diabetes.html CDC. (2023, September 5). What is type 1 diabetes? . Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html Dariya, B., Chalikonda, G., Srivani, G., Alam, A., & Nagaraju, G. P. (2019). Pathophysiology, etiology, epidemiology of type 1 diabetes and computational approaches for immune targets and therapy . Critical ReviewsTM in Immunology. https://www.dl.begellhouse.com/journals/2ff21abf44b19838,73650a9a449aa3f2,440b2529 5ae82d86.html? utm_source=TrendMD&utm_medium=cpc&utm_campaign=Crit_Rev_Immunol_TrendM D_1 Marks, B. E., & Wolfsdorf, J. I. (2020, February 26). Monitoring of Pediatric Type 1 diabetes . Frontiers. https://www.frontiersin.org/articles/10.3389/fendo.2020.00128/full

Metabolic Case Study Case

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