NU610 UNIT 7 – DIABETES TREATMENT
Instructions:
You have a newly diagnosed, type 2 diabetic, 16-year-old female in your clinic. The patient is the goalie of her high school soccer team. Her BMI is 37.
- Your treatment plan for the new diagnosis of type 2 diabetes – structure your plan using the format outlined in the SOAP note assignment instructions (e.g. diagnostics, therapeutics, educational, consultation/collaboration)
- Citations for each of the evidence-based practice (EBP) interventions included in your plan
- For each article, you cited in support of an element of the plan, provide your thoughts about the strength of the evidence presented in the article(s)
- Please be sure to validate your opinions and ideas with citations and references in APA format.
Resources
Type 2 Diabetes in Children and Adolescents- A Focus on Diagnosis and Treatment – Endotext – NCBI Bookshelf
Type 2 diabetes – Diagnosis and treatment – Mayo Clinic
Brief NU610 UNIT 7 DQ 1 DISCUSSION generic Solution
Assessment: A 16-year-old female with a new diagnosis of Type 2 Diabetes Mellitus (T2DM) and obesity (BMI 37).
Plan:
Diagnostics:
- Obtain baseline HbA1c, a comprehensive metabolic panel, a lipid panel, and a urine albumin-to-creatinine ratio (UACR) to assess glycemic control, kidney function, and cardiovascular risk.
- Patient to begin self-monitoring of blood glucose (SMBG) before meals and at bedtime.
Therapeutics:
- Initiate Metformin 500 mg PO daily with the evening meal, titrating upwards weekly as tolerated to a target dose of 1000 mg twice daily. This is the first-line pharmacologic treatment for youth with T2DM (American Diabetes Association [ADA], 2022).
- Prescribe comprehensive lifestyle modifications, including medical nutrition therapy (MNT) and a structured physical activity plan that accounts for her soccer schedule.
Educational:
- Provide intensive diabetes self-management education on T2DM pathophysiology, using a glucometer, interpreting blood glucose values, and recognizing/treating hypoglycemia and hyperglycemia.
- Educate on the importance of medication adherence and potential side effects of Metformin.
- Discuss the role of nutrition in managing blood glucose and achieving a healthy weight (Forlenza et al., 2018).
Consultation/Collaboration:
- Refer to a pediatric endocrinologist for co-management.
- Refer to a Registered Dietitian and a Certified Diabetes Educator (CDE).
- Provide a school action plan for the school nurse and soccer coach.
Evidence Strength & References
The evidence supporting this plan is strong. The American Diabetes Association’s (2022) Standards of Care represents the highest level of evidence (Level A), as it is a position statement based on a comprehensive review of randomized controlled trials and expert consensus. The recommendation for Metformin is grounded in extensive clinical data.
The guideline from Forlenza et al. (2018) is also a high-quality source, synthesizing current evidence for managing T2DM in youth. It provides robust, evidence-based direction for lifestyle and educational interventions, which are foundational to pediatric diabetes care.
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