Deviation in the Standard of Care When Treating a Diabetic Patient (Diabetes)

Evaluate breaches in the standard of care when evaluating whether or not there has been a Deviation in the Standard of Care When Treating a Diabetic Patient (Diabetes)

Answer the following questions to find out if the standard of care was followed for your case.

  • With which of the following symptoms did the patient present? (Choose all that apply)
    Sudden loss of weight
    Polyuria (increased urination)
    Polydipsia (Increased thirst)
    Polyphagia (increased hunger)
    Blurred vision
    Fatigue/malaise
    None of the above
    None elicited
    Answer unknown
    Why is this important?
    Clinical and physical symptoms of diabetes vary between Type I and Type II diabetes. A thorough medical history is invaluable for detection.
    (2011) 5 EPRICD 3 151-158

  • Which of the following risk factors did the patient possess? (Choose all that apply) Why is this important?
    Answer this question
    A risk factor is a variable that has a causal association with a disease or disease process; the presence of the variable in an individual or a population is associated with an increased risk of the presence or future development of the disease. Thus, risk factors may be useful for identifying subjects at increased risk for a disease or for a particular outcome that results from a disease process.
    Click here for additional information at ClinicalKey.com

  • Was a medical history obtained? Why is this important?
    Answer this question
    A complete medical history and carefully focused physical examination serve as the core of the diagnostic process. The information obtained guides the further direction of the patient's examination, enables the clinician to make educated evaluations, and be better equipped to advise the patient.
    Click here for additional information at ClinicalKey.com

  • Was a physical examination performed? Why is this important?
    Answer this question
    A complete medical evaluation should be performed to classify the diabetes, detect the presence of diabetes complications, review previous treatment and risk factor control in patients with established diabetes, assist in formulating a management plan, and provide a basis for continuing care.
    Click here for additional information at ClinicalKey.com

  • Which of the following diagnostic laboratory investigations were performed? (Choose all that apply) Why is this important?
    Answer this question
    Routine laboratory studies can provide important clues to diagnosis.
    Click here for additional information at ClinicalKey.com

  • With which of the following types of diabetes was the patient diagnosed? Why is this important?
    Answer this question
    Most patients with diabetes can be classified into one of two broad categories: type 1 diabetes or type 2 diabetes. Pre-diabetes is defined as hyperglycemia not sufficient to meet the diagnostic criteria for diabetes, but that which is associated with an increased risk of progression to type 2 diabetes mellitus.
    Click here for additional information at ClinicalKey.com

  • Was patient education and lifestyle intervention provided? Why is this important?
    Answer this question
    Patients who are identified with prediabetes should be referred for education and lifestyle interventions. Health care clinicians should follow up with pre-diabetes patients on an annual basis to monitor their progress and review treatment goals.
    Click here for additional information at ClinicalKey.com

  • Did the patient respond to lifestyle interventions? Why is this important?
    Answer this question
    Patients who respond to lifestyle interventions should have annual follow-up and reassessment of risks for developing diabetes. Intensive lifestyle change programs have been proven effective in delaying or preventing the onset of diabetes by about 50 percent.
    Click here for additional information at ClinicalKey.com

  • Were follow-up evaluations advised? Why is this important?
    Answer this question
    Routine follow-up evaluations are necessary to offset any complications that may arise.
    Click here for additional information at ClinicalKey.com

  • Which of the following actions were initiated? (Choose all that apply) Why is this important?
    Answer this question
    Intensifying education and counseling on lifestyle interventions are advised for patients who are at high risk for developing diabetes and not responding to lifestyle interventions. Pharmacotherapy with Biguanides and Alpha glycosidase inhibitors is also given for prevention of diabetes. Pharmacotherapy, such as metformin, is effective in some patients with pre-diabetes.
    Click here for additional information at ClinicalKey.com

  • Which of the following measures were initiated? (Choose all that apply) Why is this important?
    Answer this question
    The primary long term goals in type II patients are to minimize complications and to preserve the patient’s sense of clinical well being. Lifestyle modification should be primary focus of the patient’s care. Aggressive lowering of lipids and blood pressure should be routinely incorporated into the treatment program.
    Click here for additional information at ClinicalKey.com

  • Was the patient's status reviewed periodically? Why is this important?
    Answer this question
    Review should include assessment of the treatment regimen, frequency and severity of hypoglycemia and hyperglycemia, blood glucose test results, self adjustments of the treatment regimen, compliance and psychosocial issue, complications, additional medical illnesses and other medications.
    Click here for additional information at ClinicalKey.com

  • Which of the following acute clinical complications did the patient develop? (Choose all that apply) Why is this important?
    Answer this question
    Acute clinical complications include infection, diabetic ketoacidosis, and hypoglycemia. Diabetes is a risk factor for bacterial infection with staphylococcus, Klebsiella and streptococcus pneumoniae species. Diabetic ketoacidosis is a medical emergency requiring urgent hospital admission. Hypoglycemia is confirmed by a plasma glucose level less than 54 mg/dL.
    Click here for additional information at ClinicalKey.com

  • Which of the following diagnostic investigations did the specialist perform to rule out diabetic retinopathy? (Choose all that apply) Why is this important?
    Answer this question
    Diabetic retinopathy is the leading cause of blindness in the United States for persons younger than 75 years.
    (2005) 76 JNLAOA 11 636-646

  • Which of the following diagnostic investigations were performed by the specialist to rule out diabetic nephropathy? (Choose all that apply) Why is this important?
    Answer this question
    Nephropathy is a potential problem for all diabetic patients. The pathophysiology of diabetic nephropathy involves hyperglycemia-induced intra-glomerular hypertension and renal hyperperfusion. Increased glomerular pressure leads to renal failure.
    (1996) 80 EMEDCN 2 457-474

  • Which of the following diagnostic investigations were performed by the specialist to rule out diabetic neuropathy? (Choose all that apply) Why is this important?
    Answer this question
    Neuropathy in diabetes can manifest itself in several ways. Once neuropathy is present, the primary care physician needs to treat its symptoms and monitor the patient closely.
    (2003) 114 CLNEPH7 1167-1175

  • Were risk factors for cardiovascular disease identified? Why is this important?
    Answer this question
    The greatest threat to the longevity of diabetics is vascular disease affecting the cardiac and cerebral circulations. Cardiovascular disease occurs at a younger age and more frequently in persons with diabetes than in non-diabetic persons.
    (1996) 80 EMEDCN 2 457-474

  • Which of the following chronic diabetic complications were diagnosed? (Choose all that apply) Why is this important?
    Answer this question
    Physicians should be vigilant for early signs of diabetes-related retinopathy, nephropathy, neuropathy, and vascular disease. Early detection and appropriate intervention can significantly reduce the progression of complications.
    (1996) 80 EMEDCN 2 457-474

  • Which of the following aspects of patient education was not provided? (Choose all that apply) Why is this important?
    Answer this question
    Education and support remains the cornerstone of management of patients with diabetes. They should be educated about the goals of management, including required screening, and should be encouraged to ensure that these goals are being adequately and appropriately addressed.
    Click here for additional information at ClinicalKey.com