D. T. complains about limb weakness and numbness, and these symptoms appeared about twenty days ago, which is indicative of the development of some chronic condition. The management plan for this patient should include medical examinations to clarify the diagnosis and hospitalization in case of further deterioration of her health. Due to the woman’s complaints and her family health history, it is pivotal to focus on diabetes and its complications.
Management and Diagnostics
A number of procedures is required to make a diagnosis and choose treatment options. To begin with, the patient is at risk of diabetes, and her blood sugar levels are to be monitored to exclude any current abnormalities (Volmer-Thole & Lobmann, 2016). Based on the localization of the alarming symptoms and the woman’s history of elevated blood sugar during and after pregnancy, her health concerns can be an early manifestation of the diabetic foot syndrome (DFS) or diabetic neuropathy (Volmer-Thole & Lobmann, 2016). The recommended diagnostic tests include further external examinations to check for any signs of foot injuries, skin rashes, or foot ulcers (Volmer-Thole & Lobmann, 2016). Due to the client’s occupation, external injuries of the affected foot present a potential concern.
The patient may need to be checked for diseases causing lower limb weakness and non-related to diabetes. For instance, chronic joint inflammations and non-diabetic neuropathies have to be excluded to design an effective treatment plan (Pop-Busui et al., 2017). Neurological assessments and tests to check the patient’s muscle strength/tone, foot sensitivity, and t-reflexes should be conducted (Volmer-Thole & Lobmann, 2016). Electromyography and nerve conduction studies are also required to check for diabetic neuropathy (Pop-Busui et al., 2017). Thus, it is critical to define whether the complaint has to deal with diabetes or is caused by other health issues.
Patient Education Plan
Apart from the required diagnostic procedures, the patient is to receive specific recommendations helping her to reduce health risks and avoid further problems. Patients with diabetic neuropathy and other complications, including DFS, are strongly advised to implement a range of lifestyle modifications (Pop-Busui et al., 2017). Firstly, the healthcare specialist is to talk to D. T. to explain different factors that increase the risks of diabetes complications and other diseases.
The patient’s BMI score is 36, which indicates the presence of obesity. Abnormalities in weight status present a significant concern, and the patient should be recommended to decrease the consumption of high-fat and sweet foods (Van Gaal & Scheen, 2015). Other lifestyle changes to be encouraged include smoking cessation since a person’s smoking status is predictive of diabetes complications (Van Gaal & Scheen, 2015). More than that, the patient should be informed about the negative impact of alcohol consumption on her blood pressure and general health. In addition to the included points, it is pivotal to educate D. T. on the principles of blood sugar monitoring at home, including the use of glucometers (Pop-Busui et al., 2017). Therefore, due to a variety of controllable risk factors, lifestyle education is critically important in her case.
Cultural and Lifespan Considerations
D. T. is not a representative of ethnic or religious minorities, and this is why specific recommendations to reduce health disparities are not critical. Despite the absence of discrimination, the patient’s ethnicity has some implications for her condition. For instance, according to some research results, compared to people from other ethnic groups diagnosed with diabetes, Caucasians are more likely to experience an abnormal weight gain (Van Gaal & Scheen, 2015). This assumption stresses the need for effective and justified dietary recommendations. As for lifespan considerations, the patient is forty-two, and this fact should be considered to provide nutritional guidance since the body’s ability to lose extra weight decreases with age (Sasaki, 2015). Therefore, some factors that are not controlled by the patient should also inform the chosen education plan.
Health Promotion/Health Care Maintenance Needs
The patient has a variety of health promotion needs as is clear from her current lifestyle and dietary habits. To begin with, since D. T. is an obese person with a history of elevated blood sugar levels, healthcare specialists working with her are expected to help the woman to find a healthy approach to weight reduction that would work properly (Van Gaal & Scheen, 2015). Continuing on the healthcare maintenance needs, since the patient is a long-term smoker and alcohol user, it can be quite challenging for her to break these pernicious habits without specialists’ help. Therefore, the patient’s health promotion and maintenance needs relate to healthy nutrition, changes in habits, and diabetes self-care activities.
Follow-Up and Referral
After consulting with endocrinologists and nutrition specialists to receive diabetes education and necessary lifestyle recommendations, the patient is to start controlling her blood sugar levels at home. She has to come for a follow-up consultation to report on her health condition and the presence of pain. In case of further complications related to the symptoms, the patient can be referred to other specialists, including urologists, gastroenterologists, or surgeons (Pop-Busui et al., 2017). Therefore, given the potential consequences of her condition, the patient’s health may need to be monitored by a large team of professionals.
To sum it up, the patient’s symptoms can be related to neuropathy that occurs in diabetes patients. Apart from neurological diagnostic interventions, the woman has to receive comprehensive education aimed at improving her lifestyle and routine self-monitoring of blood sugar levels. Considering the presence of obesity, special attention is to be paid to her current dietary habits and measures helping to prevent further weight gain.
Pop-Busui, R., Boulton, A. J., Feldman, E. L., Bril, V., Freeman, R., Malik, R. A.,… Ziegler, D. (2017). Diabetic neuropathy: A position statement by the American Diabetes Association. Diabetes Care, 40(1), 136-154.
Sasaki, T. (2015). Age-associated weight gain, leptin, and SIRT1: A possible role for hypothalamic SIRT1 in the prevention of weight gain and aging through modulation of leptin sensitivity. Frontiers in Endocrinology, 6, 1-10.
Van Gaal, L., & Scheen, A. (2015). Weight management in type 2 diabetes: Current and emerging approaches to treatment. Diabetes Care, 38(6), 1161-1172.
Volmer-Thole, M., & Lobmann, R. (2016). Neuropathy and diabetic foot syndrome. International Journal of Molecular Sciences, 17(6), 1-11.