Eileen Year Woman Explained for Students (Easy Guide)
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Original Question
Eileen is a 54-year old woman who works full time as an art teacher in a local high school. She also teaches art courses on the weekends at the local senior center. She visited her healthcare provider last week for her annual physical examination and to update her TB screening (PPD) for the coming school year. The office called her back this morning and requested that she make an appointment to return tomorrow to discuss the results of her laboratory tests. Her serum glucose level was elevated at 224 mg/dl and she will need further testing to rule out type 2 diabetes. Eileen has follow-up testing with the results of a fasting serum glucose level at 131 mg/dL and a 2 hour 75g oral glucose test of 242 mg/dL. A diagnosis of new onset type 2 diabetes is confirmed. Eileen expresses disbelief and tells you, the nurse, “I can’t believe it! I watch what I eat; I don’t eat a lot of sugar, cookies or candy. I drink only diet soda. I don’t have any of the symptoms you hear about. And no one in my family has ever had diabetes.” A health history and the results of Eileen’s recent physical examination confirm overall good health. Her height is 5ft 6 inches, her weight is 175 lbs with a BMI of 28.2, placing her in the “overweight” category. Vital signs, physical examination, and all other laboratory work are within acceptable limits. Eileen admits that she has been thirstier lately, “But it’s summertime and I always drink more when it’s hot.” She has also been urinating more frequently but attributes that to her increased fluid intake. Eileen’s provider will start her on glyburide and metformin and will recheck her serum glucose in 1 month. In the meantime, she is to begin capillary blood glucose testing before meals and at bedtime, and bring her log to the next visit. She is given dietary instructions and you will be providing instruction on her medications. Why are two oral anti diabetic drugs prescribed for Eileen? What essential teaching does Eileen need about her glyburide and metformin medications? Eileen tells you that she occasionally enjoys a glass of wine with her dinner and wants to know if this is allowed. How will you answer?
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