Specific patients Case Management (Instruction Below, and patients Essay

Specific patients Case Management (Instruction Below, and patients info faxed) - Essay Example The presented complexity of health problems experienced by the patient is very similar to the case presented by Dr. Sheehan (2008) of Joslin Diabetes Center, Inc. where the case talks about a patient having type 2 diabetes, dyslipidemia, hypertension and all of the microvascular complications. There are essentially two primary defects in type 2 diabetes. One is insulin resistance. At the level of the liver, there is uncontrolled liver glucose output; in skeletal muscle, there is defective skeletal muscle glucose uptake, and nonoxidative glucose metabolism. There are defects in the adipocyte in terms of storing fat, excessive lipolysis, and high levels of free fatty acids in the circulation that can worsen insulin resistance. The adipose tissue can release inflammatory cytokines. Additionally, we have known for a great many years that there are defects in glucagon regulation at the level of the pancreas. The alpha cell, which makes glucagon, overproduces glucagon both in the fasting a nd the fed state. This is another major defect in type 2 diabetes (Sheehan, 2008). Long-term research has demonstrated the benefits of maintaining good control over blood glucose levels. The United Kingdom Prospective Diabetes Study (UKPDS) found that the diabetes-related complications of retinopathy, nephropathy, and neuropathy were reduced significantly in study subjects with type 2 diabetes who practiced intensive blood glucose control. In addition, for every percentage point reduction in A1C (a blood test that measures the three-month average of blood glucose levels), study participants achieved a 35% reduction in the risk of complications (American Diabetes Association, 2002). The best nursing theory applicable in this case is Dorothea Orem’s Self-Care Deficit theory. The theory essentially defines the need for nursing care. Since Mrs. X experiences some limitations or deficit which interferes with her ability to maintain self-care, she