lOMoAR cPSD| 63316909
Week 6 Case Study Template
Pathophysiology & Clinical Findings of the Disease
1. Based on the review of the history, physical and lab findings what is the most likely
diabetes diagnosis for this patient?
Diabetes is classified into two categories: type 1 and type 2 diabetes. Type 1 diabetes is a
genetic illness that generally shows early in childhood, but type 2 diabetes is
fundamentally a diet-related disease that occurs over time (McCance et al., 2019). Type 1
diabetes is a carbohydrate metabolism illness characterized by a reduction in insulin
production, creating hyperglycemia and ketoacidosis and the likelihood of heart failure
and coronary artery disease. Type 2 diabetes is a glucose intolerance dysfunction that
often occurs in adulthood, generally after 40, and is exacerbated by obesity and a
sedentary lifestyle (McCance et al., 2019). After reviewing the patient's medical history,
physical examination, and test results, this patient is most likely suffering from type 2
diabetes. The patient's urine sample tested positive for glucose. His fasting glucose was
132, A1C was 7.2, and OGTT at 220 mg/dL. He had symptoms of severe thirst, hunger,
and frequent urination, all of which are indicators of Type 2 diabetes. The patient
reported dry mucous membranes, tachypnea, and a fruity breath odor on physical
examination. Because the patient is physically sedentary, obese, and has a history of
hypertension and hyperlipidemia, all of which are risk factors for Type 2 DM (CDC,
2021).
2. Explain the pathophysiology associated with the chosen diabetes diagnosis.
Type 2 diabetes is caused by a breakdown of feedback loops between inadequate insulin
secretion and insulin resistance, which results in abnormally high glucose levels in the
blood. Type 2 diabetes' most common risk factors include age, obesity, hypertension,
, lOMoAR cPSD| 63316909
Week 6 Case Study Template
sedentary lifestyle, and family history. It is developing due to a combination of two
essential elements: insulin secretion by pancreatic B-cells and insulin resistance, or the
failure of insulin-sensitive tissues to respond to insulin (McCance et al., 2019). Insulin
resistance is defined as a blood glucose level's impaired or reduced response to
circulating insulin (Galicia-Garcia et al., 2020). Insulin release is lowered when
pancreatic B -cells malfunction, decreasing the body's ability to maintain normal glucose
levels. Insulin resistance plays a role in increased glucose synthesis in the liver and
reduced glucose absorption in muscle, liver, and adipose tissue (McCance et al., 2019).
Adipose insulin resistance refers to adipose tissue's poor response to insulin stimulation.
Even in the presence of high insulin levels, this can result in decreased lipolysis
suppression, reduced glucose absorption, and increased free fatty acid release into
plasma. Insulin resistance in skeletal muscle is produced by muscular desensitization to
the insulin generated by the pancreas to induce glucose absorption, resulting in high
blood glucose levels (Ferrannini et al., 2020). Insulin resistance in the liver reduces
glycogen synthesis, fails to control glucose production, increases lipogenesis, and
increases the synthesis of pro-inflammatory proteins, including c-reactive protein (CRP).
Adipocytokines and cytokines, which are pro-inflammatory proteins, are produced
abnormally (Galicia-Garcia et al., 2020). When paired with other factors such as
oxidative stress from obesity, an inflammatory state can develop, causing the liver to
respond differently to insulin. Hyperglycemia is increased when both B-cell dysfunction
and insulin resistance are present, resulting in the onset of type 2 diabetes.
3. Identify at least three subjective findings from the case which support the chosen
diagnosis.
Week 6 Case Study Template
Pathophysiology & Clinical Findings of the Disease
1. Based on the review of the history, physical and lab findings what is the most likely
diabetes diagnosis for this patient?
Diabetes is classified into two categories: type 1 and type 2 diabetes. Type 1 diabetes is a
genetic illness that generally shows early in childhood, but type 2 diabetes is
fundamentally a diet-related disease that occurs over time (McCance et al., 2019). Type 1
diabetes is a carbohydrate metabolism illness characterized by a reduction in insulin
production, creating hyperglycemia and ketoacidosis and the likelihood of heart failure
and coronary artery disease. Type 2 diabetes is a glucose intolerance dysfunction that
often occurs in adulthood, generally after 40, and is exacerbated by obesity and a
sedentary lifestyle (McCance et al., 2019). After reviewing the patient's medical history,
physical examination, and test results, this patient is most likely suffering from type 2
diabetes. The patient's urine sample tested positive for glucose. His fasting glucose was
132, A1C was 7.2, and OGTT at 220 mg/dL. He had symptoms of severe thirst, hunger,
and frequent urination, all of which are indicators of Type 2 diabetes. The patient
reported dry mucous membranes, tachypnea, and a fruity breath odor on physical
examination. Because the patient is physically sedentary, obese, and has a history of
hypertension and hyperlipidemia, all of which are risk factors for Type 2 DM (CDC,
2021).
2. Explain the pathophysiology associated with the chosen diabetes diagnosis.
Type 2 diabetes is caused by a breakdown of feedback loops between inadequate insulin
secretion and insulin resistance, which results in abnormally high glucose levels in the
blood. Type 2 diabetes' most common risk factors include age, obesity, hypertension,
, lOMoAR cPSD| 63316909
Week 6 Case Study Template
sedentary lifestyle, and family history. It is developing due to a combination of two
essential elements: insulin secretion by pancreatic B-cells and insulin resistance, or the
failure of insulin-sensitive tissues to respond to insulin (McCance et al., 2019). Insulin
resistance is defined as a blood glucose level's impaired or reduced response to
circulating insulin (Galicia-Garcia et al., 2020). Insulin release is lowered when
pancreatic B -cells malfunction, decreasing the body's ability to maintain normal glucose
levels. Insulin resistance plays a role in increased glucose synthesis in the liver and
reduced glucose absorption in muscle, liver, and adipose tissue (McCance et al., 2019).
Adipose insulin resistance refers to adipose tissue's poor response to insulin stimulation.
Even in the presence of high insulin levels, this can result in decreased lipolysis
suppression, reduced glucose absorption, and increased free fatty acid release into
plasma. Insulin resistance in skeletal muscle is produced by muscular desensitization to
the insulin generated by the pancreas to induce glucose absorption, resulting in high
blood glucose levels (Ferrannini et al., 2020). Insulin resistance in the liver reduces
glycogen synthesis, fails to control glucose production, increases lipogenesis, and
increases the synthesis of pro-inflammatory proteins, including c-reactive protein (CRP).
Adipocytokines and cytokines, which are pro-inflammatory proteins, are produced
abnormally (Galicia-Garcia et al., 2020). When paired with other factors such as
oxidative stress from obesity, an inflammatory state can develop, causing the liver to
respond differently to insulin. Hyperglycemia is increased when both B-cell dysfunction
and insulin resistance are present, resulting in the onset of type 2 diabetes.
3. Identify at least three subjective findings from the case which support the chosen
diagnosis.
