The rise of diabetes has no boundaries. Whether in developed or developing countries, the disease burden of diabetes type 2, obesity, uncontrolled Hypertension, and Hyperlipidemia have been on the rise and this is really stretching the economies of all countries in the world. The latest statistics released in 2013 indicated that at least 780 million people were diagnosed with diabetes, obesity, uncontrolled Hypertension and Hyperlipidemia. Reports also indicate that these numbers are likely to double by 2035 ( American Diabetes Association, 2014). This paper will focus on the etiology, epidemiology, and pathophysiology of the diagnosis of diabetes, obesity, uncontrolled Hypertension, and Hyperlipidemia .
Etiology of the Diagnosis of Obesity, Uncontrolled Hypertension, and Hyperlipidemia
Obesity is a disorder which develops in the body when an individual consumes more calories than what he or she burns through normal daily activities of exercise. Obesity can be caused be caused by inactivity or unhealthy eating habits and poor diet. For this 54-year-old to be obese, it means that he has been inactive for long. He has been enjoying a sedentary lifestyle which has piled more calories on his body. It is also clear that he has been on an unhealthy diet.
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Hypertension is a medical term which means that blood exerts a lot of force against the walls of the blood vessels as it flows. According to medical guidelines, hypertension is defined as blood pressure greater than 130 over 80 millimeters of mercury ( Allende, 2010) . It is caused by genetic factors, poor diet, obesity or chronic kidney disease that stops the filtration of blood. This is true with the patient, who lives in one of the countries that heavily depend on processed foods.
Uncontrolled hyperlipidemia is a condition cholesterol levels are high in the blood. Hyperlipidemia starts to develop in the body of an individual when too much bad cholesterol is formed or eaten in unhealthy foods. It is the main cause of heart diseases in the U.S that results to the high number of deaths.
Pathophysiology of the Diagnosis of Obesity, Uncontrolled Hypertension, and Hyperlipidemia
The symptoms of obesity in a person’s body become evident when the body mass index (BMI) is 30 or more. Someone with a BMI of 30.0-34.9kg is classified as obese class I, 35.0-39.9 is classified under obese class II while one with a BMI of 40.0 and above is said to be extremely obese (class III). Obese people are more likely to develop several health problems such as type 2 diabetes, heart disease, high blood pressure, and stroke ( American Diabetes Association, 2019) .
Hypertension symptoms are not easy to notice hence its name, “silent killer.” In case the disease is undetected, it can damage the cardiovascular system together with the internal organs like the kidney. Hypertension causes anxiety, blushing, sweating and sleeping problems. When this disease reaches the hypertensive crisis level, the patient can start experiencing headaches and nosebleeds.
Hyperlipidemia is another disease whose symptoms are not evident. One can have yellowish fatty growths around the joints and eyes if he has inherited the hyperlipidemia disease. Hyperlipidemia can be detected during regular blood tests or if the patient incurs a cardiovascular event such as a stroke or heart attack ( American Diabetes Association, 2019) .
Epidemiology of the Diagnosis of Obesity, Uncontrolled Hypertension, and Hyperlipidemia
Obesity in the U.S affects some groups of people more than others. According to CDC reports, the prevalence of obesity was highest among the Hispanics and non-Hispanic blacks. Some of the combinations that have facilitated the development of the disease among these people include genetics, inactivity, lifestyle, age, and certain medications ( American Diabetes Association, 2014) . Some of the complications of the disease include diabetes type 2, cancer and breathing disorders.
Hypertension is common in more common in some states that it is in other in America. The disease is more likely to attack people who have other medical conditions such as diabetes and prehypertension. Examples of unhealthy behaviors that trigger the disease include tobacco smoking, being obese, too much alcohol and eating foods with low potassium and rich in sodium. Hypertension is associated with heart failure, stroke, amputation, and kidney failure.
Hyperlipidemia affects 1 out of 3 Americans with one or more protein fats. In the U.S.., more than 100 million adults have high LCL-C levels. Out of this population, only half of them manage to acquire treatment and control the disease. Adults are the most affected group since over 30 million of them have cholesterol levels that exceed 240mg/dl ( American Diabetes Association, 2014) . The risk factors include smoking, lack of exercise and obesity.
Diagnostic Criteria for Obesity, Uncontrolled Hypertension, and Hyperlipidemia
Obesity, Uncontrolled Hypertension, Hyperlipidemia and diabetes type 2 leads to a hyperglycemic state and it is associated with macrovascular and microvascular complications. These diseases are determined by a standard blood screening procedure and blood pressure. It’s the followed by a pre-diabetes state that is determined using sole fasting plasma glucose of 100-125 mg/dl. In the absence of diabetes, an HbA1c is used.
History and examination of obesity, Hypertension, Hyperlipidemia and Diabetes Type 2
The key diagnostic criteria of obesity, Hypertension, Hyperlipidemia, and diabetes type 2include the presence of risk factors, candida infections, asymptomatic, and skin infections. The other diagnostic indicators include fatigue, polydipsia, blurred vision, and polyphagia ( American Diabetes Association, 2014) . The people who are at risk of developing diabetes type 2 are the obese, old age, pre-diabetes, and pregnant mothers.
There are a few diagnostic investigations that have been conducted. They include the following; HbA1c, fasting plasma, random plasma, two-hour-post load glucose. Other investigations to consider are fasting lipid profile, urine ketones, random C-peptide and the urinary albumin excretion ( American Diabetes Association, 2019) . There are two treatment algorithms that have been used to suppress the disease. At the initial stage, non-pregnant are diagnosed at the initial stages.
Goals of Drug Therapy
The main goals of drug therapy to obesity , Uncontrolled Hypertension, and Hyperlipidemia is to evade acute decomposition, stop or delay the emergence of late disease complications, reduce mortality and uphold a better life. It is therefore beneficial for diabetic, obese, Hypertension, and Hyperlipidemia patients to address cardiovascular risks factors even if he is not closely monitored ( Allende, 2010) .
Diet and exercise are the primary principles in the treatment of diabetes type 2, obesity, Hypertension, and Hyperlipidemia. The patient must be put in a customized diet in order to achieve the general objectives of the treatment. The patient must balance the calorie content with regard to his body mass index in conjunction with regular physical activity. At all times, the patients must avoid all carbohydrates that are absorbed quickly.
Physical exercise helps to stop the development of obesity, Hypertension, and Hyperlipidemia in adult life. Since the patient has all these diseases, he should exercise regularly for at least 30 minutes per day. Physical exercise will, therefore, give the patient a reason to enjoy a good and quality life.
Qualified healthcare personnel should lead the way by providing dialectological education which is important in achieving therapeutic objectives. For instance, self-testing of, blood pressure and blood glucose can alert the patient about the time of the day when the control of glycemia is poor ( American Diabetes Association, 2019) .
Description
PRIMARY CARE CLINIC
KEISER UNIVERSITY SCHOOL OF NURSING
Date: 1/22/19
Patient Name: Keith Peterson
Birthdate: 12/24/79
Obesity, Uncontrolled Hypertension, Hyperlipidemia and diabetes type 2
Name of Medication: Repaglinide 300mg, orlistat 100mg, Atorvastatin 120mg.
SIG: 2 tablets by mouth every 2-4 hours as needed for insulin secretion. Take 30 minutes before meals. Take no more than 7 tablets per day. When you are skipping a meal or your blood sugar is below the limit, do not take the drugs.
# dispensed: 100 Refill: None
Signature:
Mechanism of Action of Repaglinide, Orlistat, and Atorvastatin
The mechanism of action of repaglinide acts by inducing the liberation of insulin from the pancreas cells inhibiting ATP-Sensitive K + channels hence activating Ca++ channels with high intercellular calcium to discharge insulin although repaglinide act differently by binding sites ( Allende, 2010) . Orlistat is the second for obesity. It works by hindering pancreatic lipase, an enzyme that is responsible for splitting fats in the intestine. Due to the solubility of some fats, orlistat effectively minimizes their absorption. Atorvastatin is a fully synthesized compound. It catalyzes the reduction of 3-hydroxy-3-methylglutaryl-coenzyme A . It acts by reducing blood levels and as well as raising HDL-cholesterol levels.
Watch Outs of Repaglinide, Orlistat, and Atorvastatin
The patient must read the leaflet that contains information about the medicine before taking them and every time he goes for a refill. The medicine is taken via the mouth and the patient must take Repaglinide 30 minutes before eating any meal and Atorvastatin and Orlistat after meals. The patient must eat at least three meals a day. The patient must not take the dose if he is likely to miss a meal or his blood sugar is low. The patient must inform the doctor about other products he may be using such as non-prescribed or herbal drugs.
Monitoring the patient for medication effectiveness
There are two ways that I will use to monitor my patient who has been put under repaglinide, Atorvastatin and Orlistat . Since this medicine is strong and very effective, I will use passive monitoring as the first method. Here I will explain to the patient on what he may need to do if the treatment he is undertaking is inconveniencing him. I will provide him with the office and personal number so that he can call the clinic and alert me on the progress. Active monitoring is the second method I will use. Here I will make an appointment with the patient to establish whether he is responding positively to the treatment. Since this is a long term treatment, the patient will be coming for a check-up after every 7 days at the hospital. Here I will use the opportunity to check whether he is working on his weight by following the dietary plan that I issued him with. I will also measure his sugar levels and give new recommendations. This treatment is expected to last for a period of 80 days.
References
Allende-Vigo, M. (2010). Pathophysiologic mechanisms linking adipose tissue and cardiometabolic risk. Endocrine Practice , 16 (4), 692-698.
American Diabetes Association. (2014). Diagnosis and classification of diabetes mellitus. Diabetes care , 37 (Supplement 1), S81-S90.
American Diabetes Association. (2019). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care , 42 (Supplement 1), S13-S28.
