Diabetes Update Case Study
K.R. is a 50 year old homemaker. She has always been a little overweight, but now that she is in menopause, her weight has increased to 180 lbs. Her height is 5’5”. She was diagnosed with Diabetes Mellitus about 2 years ago. Initially Kelly did well with just one medication, diet and exercise. However, at her last two visits her Hgb A1C was greater than 8% with fasting blood sugars of 190 mg/dL. Therefore, Januvia has been added to her medications. KR has also been admonished to increase her exercise to 20 minutes of aerobic exercise three times a week. Although she did join a gym her busy schedule is such that she can only do aerobic exercise for 15 minutes 2 times during the weeks.
Medications:
Metformin 500 mg tablets PO BID
Januvia 50mgs PO BID
Describe the pathophysiology of the microvascular changes that are seen with DM. What symptoms would she
have as these develop?
