Case Presentations

Case 1

C.K. is a 21-year-old man who has had type 1 diabetes since the age of 8. A sophomore in college, he has been a patient of a comprehensive diabetes care and education program in the Midwest since his diagnosis.

Upon arrival at his latest diabetes refresher course, he handed the nurse educator his business card, which read “Guitarist.” The educator asked C.K. if he had been performing self-monitoring of blood glucose (SMBG) at home, and he responded by showing his bruised, tender fingertips.

C.K. is passionate about playing the guitar but had been hindered in this pursuit because frequent SMBG had left his fingertips very sensitive. An insulin pump user, C.K. tests his blood glucose levels at least four times a day, 7 days a week. His careful monitoring of diet, exercise, and insulin has helped him keep his glycemia under control despite his hectic college schedule.

The educator demonstrated the new Freestyle (Therasense) alternate site meter. C.K. was so excited about alternate site testing that he asked his mother to buy him a new meter that evening.

At his next clinic visit, C.K.’s HbA_1c concentration was 7.3% and reported that alternate site testing was improving his guitar playing.

Case 2

B.T. is a 52-year-old man who was recently diagnosed with type 2 diabetes and prescribed two oral agents. He works as a market analyst and spends much of his days at a computer keyboard. Upon diagnosis, he was obese, hypertensive, and hyperlipidemic.

B.T. was extremely anxious about his diagnosis …