Older Adult Discussion Board

For this discussion, you will be focused on an older adult with Type 1 Diabetes. Make sure you read the article Type 1 Diabetes through the Life Span, and watch the videos on insulin therapies posted to Canvas. Patient: Mrs. Smith 75-year-old female with Type 1 Diabetes. Dx at 17 years of age in 1951. Mrs. Smith has lived alone in an apartment since her husband died 3 years ago. She has several friends and family members with whom she often spends time with. She is fairly active, going to retirement group activities once a week and church on Sunday. She is still able to drive, but not far distances. She can cook easy things, but prefers to buy prepared entrees at the grocery store and cook the sides at home herself. Her medical history includes Retinopathy, Osteoporosis, and Neuropathy in her fingers and feet. She administers her own insulin and checks her blood glucose every morning before breakfast. She takes NPH and Regular insulin twice a day. In the morning, around 7:00 am, and before supper, about 5:00 pm. Her A1C levels have been rising over the past year, 8.0%, 8.5%, and now 9.0%. Her fasting blood glucose has been consistently around 150 every morning. She has had some hypoglycemia in the afternoon and now carries candy in her purse every time she leaves the house. Since she has been living with diabetes for so long, she feels there is nothing new for her to learn. She states she feels well and is hesitant to change anything in her regimen. Her doctor is concerned about the increase in her A1C levels and that she is having hypoglycemia. He wants to change her insulin but wants to consult the RDN for your input before he makes any changes. Answer the following questions: 1) What are four questions you would ask Mrs. Smith regarding her Medical History? What is your reasoning for asking each question? 2) What education and support do you think Mrs. Smith needs? What is your reasoning for this? 3) Based on her current situation, what insulin regimen do you think would benefit her and why? 4) Provide 3 recommendations you would provide for Mrs. Smith’s glycemic control.