# List what diagnostic datap rovided supports that Simon has Diabetes.

DIABETES MELLITUS Case Study (Add-On Clinical Case Study)
Sensation: normal.Laboratory TestsDay of Doctor’s visit:Urinalysis: 4+ glucose, negative for ketones and protein. Random blood glucose: 456 mg/dL.Total cholesterol 243 mg/dL, HDL 20 mg/dL, triglycerides 416 mg/dL.Glycohemoglobin (HbA1c) 16.4%.The day after Doctor’s visit:Fasting Blood Sugar: 216 mg/dL2 hour OGTT – 407 mg/dLHospitalization Course:Simon came in for another doctor’s visit with complaints of feeling extremely weak and tired. He also presents with a swollen left leg that is very painful. Upon examination, the nurse noted heat and tenderness to the left lower extremity with 2+ pitting edema. Simon admits to having stubbed his toe three or four days ago but didn’t think it was of any concern. When the physician checked his random blood sugar, it was 352 mg/dL. The physician then admitted him to the hospital in the medical surgical floor with the following admitting orders:Admit to Med-surgical floor: Diagnosis – Left leg cellulitis, DM Type 2Orders:Diet 2000cal ADA dietActivity: BRPIV Fluids: 1L NS at 75 mL/hrAccucheck AC & HSMedication Orders:Ancef 1 g IVPB every 8 hoursGlyburide 5 mg PO daily Metformin 500 mg PO BIDSliding Scale AC & HS Insulin with Regular Humulin insulin as follows:BS 141-170 3 units 171-210 4 units 211-250 6 units 251-290 8 units 291-320 10 units 321-350 12 units > or equal to 351 14 units and call MD if recheck is greater or equal to 351CASESTUDY Activities
A. Read the Case Study, then analyze the above MD orders and give the rationale for each order.
Order rationale
Diet 2000cal ADA dietto control blood glucose and lose Wight
Activity: BRP
IV Fluids: 1L NS at 75 mL/hr
Accucheck AC & HS

d. Specifythesignsandsymptomsofthisacutecomplication?
Thenextmorning,theMDchangedSimon’sinsulinslidingscale orderto Insulinlispro.