Reference no: EM133160073

Donna's Diabetes

For the past 2 or 3 years, Donna has always had fasting blood sugar levels in the 100-120 mg/dL range. When she presents in your clinic however, her fasting blood sugar is 137 and her hemoglobin A1c is 8.3%. Donna is 58 years old, does not have a history of diabetes, is 5'4" and weighs 165# and she is on medication for hypertension. She says she has tried to lose weight many times in the past and often has success, but she always gains it back. She reports that she eats a "fairly healthy" diet but just loves to bake and often indulges in sweets. She does not know much about diabetes, except that it requires you to give yourself shots-and she hates needles, saying "Don't expect me to give myself a shot!" Donna's 24-hr recall includes:

• Breakfast: English muffin with 2 t. butter, 1 slice American cheese, 1 Jimmy Dean sausage patty, 20 oz. water
• Snack: 1 large (4x4") brownie
• Lunch: chicken salad sandwich on 2 slices wheat bread with lettuce, tomato, and mayonnaise, 1 oz. BBQ chips, 12 oz. orange soda
• Dinner: Lean Cuisine Alfredo Pasta with Chicken & Broccoli, 16 oz. sweet tea
• Snack: 2 c. chocolate Haagen-Dazs ice cream

Monitoring and Evaluation

Identify 3-5 SMART goals for this patient.

Discuss why you would recommend these particular goals and strategies you might suggest for your patient. Describe what the monitoring and follow-up for the patient will be, and how you expect these goals to develop and evolve over time.