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    Case Study On Diabetis and Anemia

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    Afna Syed
    This case study documents a 52-year-old female patient admitted for giddiness, dizziness, frequent urination, and anemia who has a history of type 2 diabetes, hypothyroidism, and breast surgery. During her hospital stay from 9/8/17 to 12/8/17, her blood sugar levels were monitored and controlled through insulin injections and oral medications. Her hemoglobin levels improved but remained low, and she was treated with iron supplements. At discharge, she was instructed to continue her diabetic, thyroid, and iron medications, and follow-up on controlling her blood sugar, diet, and symptoms.

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    Case Study On Diabetis and Anemia

    Uploaded by

    Afna Syed
    133 views21 pages
    This case study documents a 52-year-old female patient admitted for giddiness, dizziness, frequent urination, and anemia who has a history of type 2 diabetes, hypothyroidism, and breast surgery. During her hospital stay from 9/8/17 to 12/8/17, her blood sugar levels were monitored and controlled through insulin injections and oral medications. Her hemoglobin levels improved but remained low, and she was treated with iron supplements. At discharge, she was instructed to continue her diabetic, thyroid, and iron medications, and follow-up on controlling her blood sugar, diet, and symptoms.

    Original Description:

    It is detailed study done on a patient having Type-2 Diabetes Mellitus and Anemia.

    Original Title

    Case Study on Diabetis and Anemia

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    This case study documents a 52-year-old female patient admitted for giddiness, dizziness, frequent urination, and anemia who has a history of type 2 diabetes, hypothyroidism, and breast surgery. During her hospital stay from 9/8/17 to 12/8/17, her blood sugar levels were monitored and controlled through insulin injections and oral medications. Her hemoglobin levels improved but remained low, and she was treated with iron supplements. At discharge, she was instructed to continue her diabetic, thyroid, and iron medications, and follow-up on controlling her blood sugar, diet, and symptoms.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    133 views21 pages

    Case Study On Diabetis and Anemia

    Uploaded by

    Afna Syed
    This case study documents a 52-year-old female patient admitted for giddiness, dizziness, frequent urination, and anemia who has a history of type 2 diabetes, hypothyroidism, and breast surgery. During her hospital stay from 9/8/17 to 12/8/17, her blood sugar levels were monitored and controlled through insulin injections and oral medications. Her hemoglobin levels improved but remained low, and she was treated with iron supplements. At discharge, she was instructed to continue her diabetic, thyroid, and iron medications, and follow-up on controlling her blood sugar, diet, and symptoms.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 21

    Case Study

    on
    Diabetes mellitus
    and
    Anemic Condition.
    Demographic details
    • Name-xyz
    • Age-52 years
    • Gender-Female
    • Ward-C
    • Ip.no-000
    • DOA-9/8/17
    • DOD-12/8/17
    Subjective evidence
    Reasons of admission :-
    1. Giddiness since 1 day.
    2. Dizziness
    3. Frequent urination since 2 days
    4. Anemic correction.
    Medical history:
    K/c/o:-Diabetes mellitus since 9 years.
    :-Hypothyroidism since 1 year.
    :-Surgery of breast lump done 10 years ago.
    Social history
    • Smoking-Nothing significant.
    • Alcohol-Nothing significant.
    • Tobacco -Nothing significant.
    • Other drug allergies -Nothing significant.
    • Family history-Nothing significant.
    Objective evidence
    DAY- 1[9/8/17]
    O/E:-
    General condition-conscious and oriented.
    Vital signs
    • BP-130/80mmhg
    • RR-18cycles/min
    • PR-92beats /min
    • P (+),I (-),C (-),C (-),L (-),E(-).
    • HEENT-S1,S2(+).
    • CVS-NAD.
    • RS-B/L Clear.
    • GU-NAD.
    • CVS-S1,S2(+).
    • P/A-Soft , NAD.
    Laboratory Investigations
    Parameters Results Normal range

    Hb 8.5g/dl 12-16g/dl

    FBS 236mg/dl 70-100mg/dl

    PPBS 314mg/dl 90-130mg/dl


    o Impression-Type 2 Diabetes mellitus , anemia.
    o Advice-Inj.Insugen of 10 units , GRBS to be
    checked every 8hours
    DAY-2 [10/08/17]
    O/E:-
    • BP-110/60mmhg
    • HR-82beats/min
    • Temp-98.6°f
    • P (+),I (-),C (-),C (-),L (-),E (-).
    Laboratory Investigations
    Parameters Results Normal range
    7AM- 185mg/dl
    GRBS 1PM-279mg /dl More than
    7PM-170mg/dl 200mg/dl
    oAdvice:-Drug treatment
    Name of the drug Dose Route of administration Frequency
    (Brand name)

    1)Inj.Insugen N Subcutaneously 0-0-14


    2)Tab.Glimisave M2 Per OS(P/O) 1-0-1

    3)Tab.Glytrin 20mg Per OS(P/O) 1-0-1

    4)Tab.Pioz 15mg Per OS(P/O) 1-0-0

    5)Tab.Livogen Z Per OS(P/O) 1-0-1


    DAY-3 [11/8/17]
    O/E:-
    • BP-100/70mmhg.
    • HR-76beats/min.
    • RR-23cycles/min.
    • Temp-98°F.
    • P (-),I (-),C (-),C (-),L(-),E(-).
    Laboratory Investigations
    Parameters Results Normal range
    7AM-121mg/dl More than
    GRBS 1PM-279mg/dl 200mg/dl
    7PM-170mgdl

    oImpression -Patients sugar levels doing well.


    -Pallor improved.
    oAdvice:-
    • Hb to be checked tomorrow.
    • Increase the dose of Insugen by 4 Units.
    DAY-4 [12/8/17]
    O/E:-
    • BP-110/70mmhg
    • HR-80beats/min
    • RR-24cycles/min
    • Temp-98.6°f
    Laboratory Investigations
    Parameters Results Normal range

    Hb 9.7g/dl 12 -16mg/dl
    7AM -111mg/dl More than
    GRBS 1PM-165mg/dl 200mg/dl

    oImpression-
    • Blood sugar levels controlled.
    • Pallor improved.
    • Hb is low.
    oAdvice:-
    • Advised for more iron intake.
    • Ready for discharge.
    Discharge medications :-
    Name of the drug Dose Route of Frequency Duration of
    (Brand name) Administration use
    1)Inj.Insugen N Subcutaneously 0-0-14 To Continue
    2)Tab.Glimisave M2 Per OS(P/O) 1-0-1 To Continue

    3)Tab.Glytrin 20mg Per OS(P/O) 1-0-1 To Continue

    4)Tab.Pioz 15mg Per OS(P/O) 1-0-0 To Continue

    5)Tab.Livogen Z Per OS(P/O) 1-0-1 To Continue

    6)Tab.Thyrox 25mg Per OS(P/O) 1-0-0 To Continue


    Assessment:-
    • Patient is a known case of diabetes mellitus since 9
    years and is also having complain of Anemia and
    Hypothyroidism.
    • As the patient was suffering from Hypothyroidism,
    no T3 and T4 levels were checked during her stay,
    but Tab.Thyrox was given to maintain T3 andT4
    levels.
    • As the patient was anemic, Hb count was done on
    the 1st day and no test was done on 2nd and 3rd day
    but 1pint of blood bag was given on 2nd day.
    • Respiratory rate and BP should have been monitored
    closely as it was fluctuating during her stay.
    • Because of anemia the patient was suffering from
    hypotension and no measures were taken.
    • When Tab.Pioz given in combination with Tab.Glimisave has
    an ADR of peripheral edema.
    • Drug-drug interaction of Inj.Insugen and Tab.Pioz may
    increase the risk of Heart failure.
    • To many anti-diabetic drugs can cause Hypoglycemia,which
    is to be administered closely.
    • Renal function test was to be done, as the patient was
    suffering from both diabetes and anemia, so the patient may
    be suffering from Kidney disease.
    • As the she was diabetic for 9 years, so she might be taking
    medicine for diabetes which causes the deficiency of
    vitamen-B12, which may also be reason for Anemia.
    Assessment on Medications
    MEDICATIONS CLASS USES ADR’S

    1)Tab.Glimisave Anti-diabetic It improves target cell Hypoglycemia,


    (Glimipride) (Sulfhonyleurea) response to insulin, Hepatitis,Dizziness,H
    decreases hepatic eadache,Anorexia,Co
    glyconeogenisis etc. nstipation,Nausea.

    2)Tab.Glytrin Anti-diabetic It increases the insulin Hypoglycemia, Liver


    (Tenegliptin) (Dipeptiylpeptida production after meals dysfunction, Peptic
    se inhibitors) are taken. ulcer,Gastric
    ulcer,faltulence,
    Anorexia.
    3)Tab.Pioz Anti-diabetic It improves target cell Hypoglycemia,
    (Pioglitazone) (Thiozolidinedion response to insulin, Edema,Upper
    es) decreases hepatic respiratory tract
    glyconeogenisis etc. infecton,Headache.
    4)Tab.Thyrox Thyroid and anti- It increases the BMR, Angina
    thyroid drugs increases utilization of pain,Tachycardia,
    glycogen stores etc. Sweating,
    Restlessness,Skeletal
    muscle cramps.
    MEDICATIONS CLASS USES ADR’S
    5)Tab.Livogen Hematicines and Producing blood GI irritation,
    (ferrous salt+folic Hematopicties cells and platelets Constipation, Dark
    acid) in body. stools ,Nausea.
    6)Inj.Insugen Anti- It improves target Hypoglycemia,
    diabetic(regular cell response to Hypokalemia,
    insulin+nph) insulin, decreases Peripheral edema,
    hepatic Tachycardia
    glyconeogenisis etc
    Planning
    Points to physician:-
    • As the patient had past medical history of
    Hypothyroidism T3 and T4 levels should have
    been checked before giving any medications.
    • Measures to treat Hypotension should have
    been taken.
    • To many drugs of class anti-diabetic were
    given which may cause severe Hypoglycemia,
    Patient to be administered closely.
    • T.Pioz is used in combination with T.Glimisave
    ADR is Edema.
    • DDI of Inj.Insugen with T.Pioz given together
    causes Heart failure.
    Points to patient:-
    • T.Thyrox to be taken before 30 min of food.
    • Avoid more sugar intake that is 22 grams per day.
    • Prefer iron rich food.
    • Time to time BP,GRBS and Hb should be checked.
    • Not to discontinue any tablet without consulting
    physician.
    • In case of unconsciousness or dizziness, sugar
    intake should be done
    THANK YOU

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