Norma James: Introduction Norma James is 65 years old and

Norma James: Introduction Norma James is 65 years old and was diagnosed with T2D several years ago following a 1-month history of weight loss (4.5 kg), polyuria, polydipsia, and polyphagia. In addition, she has a history of hypertension and atrial fibrillation. Among the three primary concepts involved in DM, which ones are potentially affecting Ms. James’s blood glucose level? Considering Ms. James’s age explains possible factors that may contribute to the progression of DM. What comorbidities does Ms. James have? What happens to DM-related complications during the duration of DM in older adult patients? Norma James: Application Ms. James has T2D that is treated with an oral glucose-lowering medication. She is taught how to test her blood glucose level using a portable glucose monitor. Additionally, she attends Classes on nutrition and on integrating exercise into her daily schedule. What is the insulin mechanism of action in T2D? What treatment will help to control Ms. James’s hyperglycemia? Is Ms. James’s pancreas still producing insulin? Norma James: Outcome Ms. James has bilateral peripheral neuropathy that affects her lower extremities. Although it had initially caused severe pain, the neuropathy has now progressed to numbness in both lower extremities. Ms. James notices a skin ulcer on her right ankle that has been present for several weeks; she begins to place “wound butter” on the ulcer, on the recommendation of a cashier at a convenience store. The ulcer becomes infected, requiring dressing changes by a visiting nurse and a 10-day course of antibiotics. The ulcer does heal; however, Ms. James’s nurse practitioner outlines a plan of care on DM management, emphasizing good foot care practices. Explain the type of neuropathy Ms. James is experiencing. What contributed to the worsening symptom of Ms. James’s right ankle ulcer? What were the signs and symptoms of diabetic neuropathy Ms. James experienced? Apart from the medical treatment administered, what factor is important to prevent the progression of diabetic neuropathy?

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