Answer

Patient 1

Initial Diagnosis

The patient presents with type I diabetes evidenced by weight loss, fatigue, polydipsia, and breath smelling fruity. Also, she might have Ketoacidosis secondary diagnosis indicated by her fruity-smelling breath, Kussmal inhalations and is tired and weak.

Pathophysiologic Explanation Clinical Symptoms

Juvenile diabetes usually is discovered when a kid suffers from ketoacidosis. Glucose loss in urine and incapability of the cells to use glucose because of insulin shortage cause the body to starve. After the body recognizes this reduction in glucose levels, hormonal compensatory means are sparked and expand catabolism by hastening lipolysis and lipogenesis. Respiratory compensation to battle the metabolic acidosis gets in and the patient starts taking deep hasty breaths. The present patient is experiencing weight loss because the body’s cells cannot pull the glucose required for fueling it out of the bloodstream, so it begins breaking down body fat and other tissues for energy (Banday et al., 2020). To lessen sugar in the blood, the kidney continuously filters it out and dumps it into urine. Hence, this develops more urine and the necessity to pee more, like the present patients’ experience. The patient feels tired and weak because the brain, muscles and other body parts are not receiving adequate energy to work accurately.

Tests to Confirm Diagnosis, Rationale for Each Test Ordered, and Results

The A1C test, which depicts the average blood sugar level for the last two or three months should be done. A1C results beneath 5.7 are normal, while above 6.5 alludes to diabetes. An antibody test is done to distinguish between juvenile diabetes. The test demonstrates if the kid’s immune system is confronting the pancreas. The kid will test positive for various autoantibodies. An outcome of 200 mg/dL signifies diabetes for blood sugar test.

 Recommended Treatments and Rationale

Diabetic education and counselling of the teenager and parent to guarantee observance to insulin and dodge the mental impact of any behavioural alterations is recommended. Dietary alterations and intake of low-fat, high-fibre food and constant exercises to instigate weight loss and evade the formation of insulin resistance is also recommended. Continuous glucose monitoring to recognize the start of complications and improve early interventions is necessary. In addition, the kid will need to check their blood glucose four to ten time daily to decide on insulin dosages, exercise selections and food. Hence, a home glucose meter can be used to do this. Also, the child will need to take insulin daily by injecting herself.

Patient 2

Initial Diagnosis

The patient has typical characteristics of patients diagnosed with type II diabetes.

 Pathophysiologic Processes, Signs/Symptoms, and Lab Results Obtained

Diabetes type 2 is described by peripheral insulin resistance, impaired control of hepatic glucose manufacture and decreasing β-cell function, ultimately leading toβ -cell failure. When the cells cannot keep the sugar, it builds-up in the blood triggering high blood sugars (Kahn et al., 2014). Thus, this extra sugar destroys the blood vessels inner lining and causes organs damages that are given blood by those vessels. Therefore, this happens often in small vessels that deliver blood to the eyes, nerves and kidneys when diabetes is poorly handled, and the patient blood sugar is high. Likewise, this explains why the patient indicated feeling a burning sensation in his feet, which means neuropathy and uncontrolled diabetes. Also, the patient started having reduced urine amounts and frequented the bathroom, and the lab work indicated a reduced GFR rate and microalbuminuria. Thus, these signs signify kidney damage called nephropathy.

Effect of Symptoms on Life Expectancy and Rationale

Ageing, low energy consumption, obesity, smoking, alcohol drinking are independent risk elements of pathogenesis. The peripheral neuropathy experienced by the patient can have a significant effect on the patient’s life expectancy and quality of life (Kahn et al., 2014). The reduced sensation the patient feels on his foot can lead to a sore or blister on their feet. If left untreated, the infection can spread to the bone, and the foot might be amputated. Managing the disease can increase his life expectancy by exercising, eating healthy, monitoring blood sugar, and taking anti-diabetic drugs.