Races and ethnic groups in DM
Sample Solution
Case Study: C.B. and Potential Diabetes Mellitus Type 2
Prevalence of Diabetes Mellitus in Different Racial and Ethnic Groups:
While diabetes mellitus (DM) can affect anyone, some groups have a higher prevalence compared to others. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), certain racial and ethnic groups in the United States have a higher risk:
- Hispanic/Latino: 12.8%
- Black (non-Hispanic): 12.2%
- American Indian/Alaska Native: 11.5%
- Non-Hispanic Asian: 8.0%
- Non-Hispanic White: 7.4%
These statistics highlight the importance of considering C.B.'s Winnebago Indian heritage as a potential risk factor for developing DM.
Clinical Manifestations Suggestive of Diabetes Mellitus Type 2 in C.B.:
- Elevated fasting blood sugar (141 mg/dL): Normal fasting blood sugar is below 100 mg/dL.
- High cholesterol (225 mg/dL): Desirable LDL cholesterol level is below 100 mg/dL.
- Increased thirst and urination: Classic symptoms of uncontrolled diabetes due to excess glucose in the blood.
- Foot weakness and numbness: Potential diabetic neuropathy, a complication of chronic hyperglycemia.
- Recent weight gain: May contribute to insulin resistance,
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- a hallmark of type 2 diabetes.
These signs and symptoms, coupled with C.B.'s family history of diabetes and lack of follow-up after previous abnormal results, raise strong suspicion for a diagnosis of type 2 diabetes. Further investigations like HbA1c and oral glucose tolerance test are needed for confirmation.
Impact of Bacterial Pneumonia on Glycemia:
Bacterial pneumonia can trigger stress hormones like cortisol and glucagon, leading to increased blood sugar levels (hyperglycemia) in diabetic patients. This phenomenon is called stress-induced hyperglycemia. Therefore, C.B.'s glycemic control is likely to worsen if she develops pneumonia, requiring close monitoring and adjustments to her diabetes management plan.
Recommended Initial Therapy for C.B.:
Non-pharmacologic:
- Lifestyle modifications:
- Healthy diet: Emphasize fruits, vegetables, whole grains, and lean protein while limiting processed foods and sugary drinks.
- Regular physical activity: Aim for at least 150 minutes of moderate-intensity exercise per week.
- Weight management: Losing even 5-10% of body weight can significantly improve insulin sensitivity.
Pharmacologic:
- The specific medication choice depends on individual factors like severity, comorbidities, and response to therapy. Options may include:
- Metformin: First-line medication for type 2 diabetes, promoting insulin sensitivity and reducing glucose production.
- Sulfonylureas: Stimulate insulin secretion from the pancreas.
- DPP-4 inhibitors: Enhance insulin secretion and reduce glucagon production.
- SGLT2 inhibitors: Help the kidneys eliminate excess glucose through urine.
Disclaimer: This information is for educational purposes only and does not constitute medical advice. Please consult a qualified healthcare professional for diagnosis and treatment of any medical condition.
It's important to note that C.B.'s case requires a comprehensive evaluation by a healthcare professional to develop a personalized treatment plan considering her specific medical history, cultural background, and individual needs.