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Melanie is distressed that her blood glucose level is elevated and asks you for help in understanding her

diabetes. She tells you that she has a friend who is very overweight, eats lots of cake and hardly ever

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exercises, and he does not have diabetes.

1. Describe the pathophysiology of T2DM with links to Melanie’s case. Include in your answer

risk factors for T2DM, the pathogenesis of T2DM, possible complications of T2DM and

outline the 3 levels of treatment options for T2DM. (600)

2. Differentiate between T2DM and T1DM (at least 6 differences). (100)

3. Identify at least 2 reasons Melanie’s BGL is high on admission. Discuss how each reason you identify effects

BGLs. (300)

Part 2 Questions (700 words)

The surgery is successful and Melanie comes to see you in the outpatient clinic for cortisone injections

(Kenacort-A 40). She has been commenced on metformin (APO-Metformin Tablets) and glipizide (Minidiab

Tablets) to help control her diabetes. Her blood test on this visit were BGL 8.8 mmol/L; HbA1c: 8%.

1. Discuss the three medications Melanie is on. Include in your answer the action, complications/side

effects and nursing considerations linked to Melanie’s situation. (500)