Diabetes Assignment | Homework For You
Case 1: George is an Aboriginal man with T2DM. George’s daughter, Caroline, was very concerned about his diet and diabetes. Housebound with severe COPD needing home oxygen, he was too breathless and tired to eat much at any one time. His diabetes management was impacted by the use of steroids for COPD and he was on maximum oral doses of gliclazide and metformin.
His elevated blood glucose levels made him more careful about his choice of foods. Deciding what he could eat was becoming a challenge and he was frustrated as he previously managed his diabetes well. Caroline spoke to the diabetes team for advice about his medication. The diabetes team agreed that the way forward was to accept the need for steroids and initiate insulin to manage the high glucose readings. Insulin would allow George more freedom around the choice of foods, with the introduction of nutritional supplements to help maintain his weight. George found insulin easier to manage than “swallowing all those tablets” and a twice daily mixed insulin with a higher dose in the morning allowed for better glucose management, reducing George’s anxiety about food choices and having high readings.
