Case Study 3: Holistic Management of Type 2 Diabetes with Comorbidities Patient Profile: Sarah, a 55-year-old woman, presents to her primary care nurse practitioner with complaints of increased thirst, frequent urination, and fatigue over the past few weeks. She has a family history of type 2 diabetes mellitus (T2DM), with her father and two siblings diagnosed with the same condition. She has a BMI of 30.9 and a sedentary lifestyle. Laboratory tests reveal elevated fasting blood glucose levels of 140 mg/dL, an HbA1c of 8.5%, and a total cholesterol level of 207 mg/dL, and triglycerides of 158 mg/dL Her blood pressure measures is 135/78 mmHg, Case Scenario: Sarah is your patient now, and you have just diagnosed her with type 2 diabetes. You (as her PCP) initiate a comprehensive treatment plan according to the latest guidelines to mitigate long-term complications. Questions:
1. According to the latest guidelines, what would be the initial pharmacologic and non- pharmacological treatment for Sarah’s type 2 diabetes?
2. According to the latest guidelines, what additional preventive (pharmacological and non- pharmacological) measures would need to be taken to mitigate Sarah’s risk of cardiac consequences, considering her lipids and hypertension state?
3. Which referrals, if any, would be necessary for Sarah’s comprehensive management, and what specific assessments or interventions would these referrals entail?
4. When would you recommend scheduling Sarah for a follow-up appointment to assess her response to treatment ?
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