Type 2 Diabetes Mellitus in Jill
Type 2 diabetes is a syndrome that changes the metabolism of fats, carbohydrates, energy, and proteins and results from lack of insulin resistance or due to defective insulin action within the peripheral tissue. Defective production of insulin due to peripheral and pancreatic β-cells insulin resistance represents the major factors in the pathogenesis of type 2 diabetes. Insulin resistance can lead to an increased level of fatty acids, elevated fat breakdown, and reduced transport of glucose into the muscle cells, leading to increased production of glucose in the liver (Khemka & Banerjee, 2017).
Visceral fat is the fat located within the abnormal cavity. Extreme visceral fats increase an individual’s risk of type 2 diabetes (Ormazabal et al., 2018). As indicated by the lap report, Jill’s visceral fat is excess with the Total cholesterol (TC) of 240, indicating high blood cholesterol and low HDL of 35. Moreover, Jill’s LDL cholesterol level is 160 which is high. Her triglyceride level is 200, yet the normal range should be lower than 150. All these factors show that Jill has visceral fat. Diabetes and Thyroid Essay Example
Jill’s VLDL results are 45while the normal range of VLDL is below 30. This indicates that she has obesity. The LDL for Jill is 160 yet the normal range is below 100 indicating that her LDL is high. Moreover, insulin resistance is evident for Jill as indicated by a fasting insulin level of 30. The normal insulin level in females is 8.4 and a higher level indicates an increased predisposition to diabetes (Ormazabal et al., 2018). The metabolic syndrome in Jill is indicated by the higher level of VLDL and low levels of HDL.
Question 2
(a)
The diagnosis of Crystal is hypothyroidism. The diagnosis was arrived at using the laboratory data and the symptoms Crystal is manifesting. Hypothyroidism is characterized by fatigue, dry skin, weight gain, constipation, increased sensitivity to cold, hoarseness, among other symptoms (McAninch & Bianco, 2016). Crystal manifests the majority of these symptoms. For the laboratory results, a high level of TSH indicates hypothyroidism. TSH level (6.5) is high.
(b)
For Crystal, the hypothyroidism does not require treatment. The TSH level for Crystal is less than 10mIU/L and thus it is mild subclinical hypothyroidism where a wait-and-see strategy is recommended to see whether a normalization happens (Calissendorff & Falhammar, 2020). Crystal should implement lifestyle changes such as increased physical exercises and adopting a healthy diet.
The second option is for Crystal to seek treatment. The appropriate treatment for Crystal is levothyroxine. The reason why Crystal requires treatment is that the clinical data indicates that she is at risk of cardiovascular condition and thus treatment is highly recommended (Hennessey & Espaillat, 2018).
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However, the most recommended option to manage Crystal’s condition is not to treat the diagnosis. This is because with lifestyle modification she might be able to normalize her condition. Additionally, treatment using levothyroxine will not treat symptoms such as weight gain (Calissendorff & Falhammar, 2020).
Question 3
(a)
The diagnosis for Crystal is hypothyroidism. For the laboratory results, a high level of TSH and a low level of T4 indicate hypothyroidism. TSH level (22) is abnormally high while FT4 is low (0.4) for Crystal. A high level of TSH indicates the under-activity of the thyroid. Positive thyroid peroxidase antibodies (TPO) and thyroglobulin antibody tests also indicate hypothyroidism. T3 is also produced in hypothyroidism because the body changes levothyroxine into adequate T3. The LDL level for Crystal is 190 while the triglycerides level is 275. In hypothyroidism, there is an increased level of both LDL and triglycerides (McAninch & Bianco, 2016).
(b)
The lipids are abnormal because the thyroid hormone is involved in the regulation of synthesizing, metabolizing, and mobilizing lipids. In hypothyroidism, there is an elevation of serum total cholesterol, triglyceride levels, apolipoprotein B, low-density lipoprotein (LDL), and lipoprotein(a) levels (Duntas & Brenta, 2018). Diabetes and Thyroid Essay Example
(c)
The diagnosis is hypothyroidism but the condition has deteriorated as indicated by the worsening laboratory results. For example, the TSH level has increased abnormally from 6.5 to 22. A negative feedback loop controls the levels of thyroxine. In hypothyroidism, low levels of thyroxine within the blood circulation lead to the stimulation of the hypothalamus to release TSH (McAninch & Bianco, 2016). This leads to high levels of TSH as seen in Crystal.
(d)
Crystal requires treatment using levothyroxine, a synthetic thyroid hormone. Levothyroxine will help in restoring sufficient levels of the involved hormones and also reverse the symptoms and signs of hypothyroidism. Moreover, levothyroxine will also lower the high cholesterol levels for this patient and also reduce the weight gain (Hennessey & Espaillat, 2018).
(e)
Crystal will be educated regarding the risks of untreated hypothyroidism. Failure to treat hypothyroidism can lead to cardiovascular disease, reduced lung function, muscle problems, mental decline, fertility problems, and goiter due to enlargement of the thyroid gland (Domingo et al., 2019).
University of Phoenix Material
Case Study Paper Guidelines
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NRP/511: Advanced Pathophysiology
Wk 4 Assignment – Case Study 1: Diabetes and Thyroid
Write a 700-word paper answering each question associated with the case studies in Case Study 1: Diabetes and Thyroid.
Review the Case Study Guidelines document (see attached) to guide you in completing the assignment.
Provide at least 2 scholarly peer reviewed references for all sources cited and format according to APA guidelines.