Elly Kurniawan - Type 2 Diabetes (Indonesia) Post on March 29, 2012

Name: Elly Kurniawan                       
Sex: Female
Country: Indonesia
Age: 51
Diagnoses: 1.Type 2 Diabetes, peripheral neuropathy 2. Hypertension, level 2, very high risk.
Admission Date: March 2, 2012
Days Admitted to Hospital: 20

Elly has had high blood sugar levels for the past 4 years. The Fasting Blood Glucose level was 8.9mmol/L, 4 years ago. She was given a glucose tolerance test at her local hospital and the test results showed a Fasting Blood Glucose level of 8.3mmol/L. The blood sugar level 2 hours after eating was about 16.7mmol/l. Elly was diagnosed with type 2 Diabetes and was prescribed 500mgs of metformin hydrochloride, taken twice daily. The blood sugar levels remained unregulated. About a year ago, Elly began feeling pain in her feet which affected her walking ability. Another symptom that developed was blurred vision.
Admission PE:
Bp: 126/96mmHg; Hr: 78/min. FBG was about 11mmol/l. The blood sugar level 2 hours after eating was about 16mmol/l. The mucous membrane and skin throughout the body was intact. There was skin pigmentation on both lower limbs. There was pain in the metacarpophalangeal joint of the middle finger of the right hand causing limited movement ability. The thorax was symmetrical. The respiratory sounds in both lungs were clear, with no dry or moist rales. Through auscultation it was determined that the heart sounds were strong, with no murmur in the valve area. The abdomen was distended and soft, with no palpable masses. The liver and spleen were not palpable under the ribs.

Nervous System Examination:
Elly was alert and her speech was clear. Her memory, calculation abilities and orientation were normal. Both pupils were equal in size and round. The diameter was 3.0 mms, and the pupils had normal reactions to light stimuli. The binocular vision was slightly poor through the coarseness scale. Both eyeballs had normal movement. The muscle strength of all four limbs was level 5. The muscle tone and muscle strength of all four limbs was normal. The tendon reflexes of all four limbs were almost normal. The bilateral Hoffmann's sign and bilateral palm jaw reflex were negative.The bilateral Babinski's sign was negative. The sensation in the first toe of both feet was diminished. The other bilateral deep, shallow, and epicritic sensation was normal. The coordinated movement test results were normal.

Elly received all of the relevant examinations and she was diagnosed with: 1.Type 2 Diabetes, peripheral neuropathy, 2. hypertension level 2, very high risk. She received treatment to control the blood sugar levels, and had her blood pressure lowered. She also received treatment to expand the blood vessels and nourishment for the neurons. This was combined with physical rehabilitation training.

Elly's fasting blood sugar level is stable at 4.5mmol/l. Two hours after eating, the blood sugar level is stable at 7mmol/l. The blood pressure is between 110-120/70-80mmHg. The sensation in the first toe of both feet has increased. At present Elly's condition is stable.




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