Also called as diabetes mellitus. A group of diseases that result in too much sugar in the blood.Most common types of diabetes are; type 2 diabetes, type 1 diabetes, prediabetes, gestational diabetes.

1. CASE PRESENTATION ON
DIABETES MELLITUS
PRESENTED BY :
P.VIGNESWARI
Y17PHD0821
II/VI PHARMD
NIRMALA COLLEGE OF PHARMACY

2. BRIEF SUMMARY OF CASE
• A 50 years old male patient was admitted in
the hospital having chief complaints of
Dizziness & weakness,fatigue for 3 days and
chest pain & SOB . He is having history of
HTN & diabetes under therapy
• Above case was presented in the format of the
SOAP analysis

3. SUBJECTIVE EVIDENCE
A 50 years male old patient was
admitted in the hospital with chief complaints of
dizziness, weakness, fatigue ,chest pain and SOB
and having decreased sleep. He is having history
Htn .And have no h/o cough and sputum. His
bowel and bladder habits are normal& he is not
having any family history and social history.

4. OBJECTIVE EVIDENCE
• PHYSICAL EXAMINATION
P.R : 84/min
B.P : 110/70 mm of Hg
SPO2 : 98%
R.R : 18/min
• OBJECTIVE EXAMINATION
CVS : S1+S2+
CNS : Normal
P/A : Soft
R.R : Normal

5. LABARATORY INVESTIGATIONS
S.NO PARAMETERS OBSERVED VALUE NORMAL VALUE
1. Plasma glucose 219 mg/dl 70 - 40
2. WBC count 13300/cu.mm 4400 - 11000
3. Haemoglobin 13 g/dl 14.0 – 18.0
4. Haematocrit 39.7 % 42.0 – 54.0
5. PTT test 14.1 sec 10.5 – 13.1
6. Serum chloride 93.6 mmol 95 – 105.0
7. Serum globulin 3.5g/dl 1.8 – 3.4
8. Serum cholesterol 25 mg/dl 40 - 60

6. DIAGNOSTIC TEST
• 2D Echo Report : CAD
RWMA
Trivial MR/AR
• Coronary angiogram : CAD-TVD

7. ASSESMENT
• Based on the subjective data and the objective data the
final diagnosis of the patient was found to be having
DIABETES along with CAD
• Definition : It is a group of metabolic disorders
characterized by hyperglycaemia result from defects in
insulin secretion, insulin action or both
• Etiology : Idioathic in this patient
• Risk factors : Age
Htn
Sedantary life style

8. RISK FACTORS

10. CLINICAL PRESENTATIONS
 Excessive fatigue
 Dizziness, weakness
 Increased thirst
 Unexplained weight loss
 Blurred vision
 Frequent urination

11. PLAN
Goals : To prevent signs and symptoms by
symptomatic therapy
• To avoid the further complications
• To decrease the disease progression
• And to increase the patients quality of life
Standard treatment :
• Sulfonyl ureases – glimepiride
• Biguanides – Metformin
• Alpha glucosidase inhibitors – Acarbose,Miglitol

12. CURRENT DRUG CHART
S.NO BRAND
NAME
GENERIC
NAME
DOSE R.O.A FRE
Q
CATEGO
RY
USE
1 T.Zetagli
m
Glimperidi
ne
2mg P/o BD Sulfonyl
urea
To treat
DM - II
2 T.Cardivas Carvedilol 3.125mg p/o BD Betablocke
r
For HTN
3 T.Storvas Atorvastati
n
40mg p/o BD HMG-coA
reductase
inhibitor
To
cholester
ol levels
4 T.Nitrolon
g
Glyceryl
trinitrate
2.6mg p/o BD Vasodilator To treat
chestpai
n
5. T.Ecospiri
n
Aspirin 150 mg p/o OD Antiplatelet Prevent
platelet
aggregat
ion
6. Inj.heparin Heparin 5000 u s/c TID Anticoagul
ant
Prevents
clot

13. DRUG NAME M.O.A ADRs M.O.P
Glimperidine Stimulates insulin
release from beta
cells of pancreas
Dizziness,nausea,in
creased serum
ALT,AST
Hypoglycemia,bloo
d glucose,HbA1c
Carvedilol HR,myocardial
contractility & o2
demand
Hypotension,fatigu
e,weight gain
HR,BP,RFTs,LFT,Bloo
d glucose
Atorvastatin Inhibits HMG coa Diarrhea,athralgia,n
asopharrngitis
Lipid panel,hepatic
transminase levels
Glyceryl trinitrate Causes
dephosphorylation
Headche ,
dizziness,abdominal
pain
Monitor BP , HR
Aspirin Irreversibly inhibit
cox-1,2
Hemostasis,bleedin
g,edema
Signs of
bleeding,hb
heparin Inactivates
thrombin
&coagulation
Chestpain,chills,ulc
ers
Hb,hemotocrit,APP
TT

14. DRUG INTERACTIONS
• MODERATE :
1. Aspirin & heparin : Co-administration may potentiate
the risk of bleeding
Mng : Avoid in ptns,monitor for bleeding complications
2. GTN & carvedilol : Exhibit hypotensive effect
Mng : close monitoring for Bp
3.Aspirin &glimperdine : May increase risk of
hypoglycaemia
Mng : Monitor for development of hypoglycaemia

15. PATIENT COUNSELING
• ABOUT DISEASE : Is a group of metabolic disorders
characterised by the hyperglycaemia ,resulting from
defects in insulin secretion or action
• ABOUT DRUGS :
Glimperidine : take with breakfast or 1st main meal of day
Statin : Administer with or without food
Nitroglycerine : Donot crush,chew – swallow whole
Aspirin : Administer with food
Carvedilol : Should be taken with food to minimize the
risk of orthostatic hypotension

16. LIFE STYLE MODIFICATIONS
• Maintain your body weight
• Do physical exercise
• Reduce stress
• Manage diabetes
• Limit alcohol intake