This document presents a case study of a 75-year-old patient with diabetes mellitus, chronic asthma, and heart failure. The patient's current medications were interacting and not well-controlled. The presenting doctor assessed the patient and created a new treatment plan including Dapagliflozin, insulin glargine, pantoprazole, salbutamol, beclomethasone, prednisolone, and ibuprofen. The doctor also provided counseling to the patient on lifestyle modifications, medication adherence, and monitoring of blood sugar, heart rate, and response to the new treatment plan.

1. CASE PRESENTATION
ON
DIABETES MELLITUS
BY
MS. VARSHA R WADNERE
(PD539)

2. INTRODUCTION
A disease in which the body’s ability to produce or respond to the hormone insulin is impaired, resulting in
abnormal metabolism of carbohydrates and elevated levels of glucose in the blood.
Sign and symptoms-
Excessive Thirst, Frequent Urination, Ongoing Fatigue, Delayed Healing, Vision Problems, Mood Swings, Numbness
and Tingling in Extremities, Food Cravings.
Types-
• Type I Diabetes Mellitus
• Type II Diabetes Mellitus
Risk Factors-
• Obesity
• Poor diet stress
• Family history of DM
• High BP

3. SUBJECTIVE DATA
Name- xyzzy, age- 75 years
C/O-
Feeling unwell and lethargic, breathlessness at night and kept awake, pain in knee
OBJECTIVE DATA
• Glycosuria
• Last two glycosylated hemoglobin- 11.3% and 12.0% ( less than 5.7 and more than 6.5 indicates diabetes
mellitus)
Personal data-
Lives alone and has poor eyesight

4. TREATMENT CHART
Current medication for chronic asthma , heart failure, and knee pain is-
1. BENDROFLUMETHIAZIDE 10MG EACH MORNING
2. PREDNISOLONE 20MG DAILY
3. SALBUTAMOL INHALER 2 PUFFS- 6 HOURLY
4. BECLOMETHASONE INHALER 2 PUFFS- 6 HOURLY
5. MAGNESIUM TRISILICATE 10 ML S.O.S
6. GLIPIZIDE 15MG Q8H
7. METFORMIN 850MG 3 TIMES DAILY
8. NAPROXEN 750MG QH
• Patient was on non insulin dependent DM treatment(since 15 years) now doctor has advised insulin therapy.

5. ASSESSMENT
• Diagnosis- diabetes mellitus, chronic asthma, heart failure

6. INTERVENTION
• PREDNISOLONE INTERACT WITH MAGNESIUM TRISILICATE
• BENDROFLUMETHIAZIDE INTERACT WITH PREDNISOLINE, SALBUTAMOL, GLIPIZIDE
• GLIPIZIDE INTERACT WITH METFORMIN
INDICATION- THIS THERAPY NEEDED TO BE MONITORED

7. MY PLAN
1. DAPAGLIFLOZIN- 5MG- 1-0-0
2. INSULIN GLARGINE- 0.2MG/KG- 0-0-1
3. PANTOPRAZOLE -40 MG 1-0-0
4. SALBUTAMOL- INHALER- 2 PUFFS- 6 HOURLY
5. BECLOMETHASONE- INHALER- 2 PUFFS- 6 HOURLY
6. PREDNISOLONE- 20MG- DAILY- 1-0-0
7. IBUPROFEN- 400MG- 0-1-0

8. MONITORING PARAMETERS
• BLOOD SUGAR LEVEL
• HEART RATE
• PATIENT RESPONSE TO THERAPY (ACCORDING TO MY PLAN)
• MONITOR RESPONSE OF CURRENT THERAPY

9. PATIENT COUNSELLING
On drugs-
• Do not repeat the dose if missed
• Take medication on time
On disease-
• Drink jamun and karela juice
• Drink sabza soaked in water

10. PATIENT COUNSELLING
Lifestyle modification-
• Drink jamun and karela juice.
• Drink sabza soaked in water.
• Consume healthy fats- almond, tuna, salmon, walnuts, flax seeds.
• Have a balanced diet.
• consume 8 glasses of water.
• Consume seasonal and local fruits and vegetables.
• Take a walk after dinner.

11. REFERENCE
• Lexicomp app

12. THANK YOU