Critical Thinking Prescription Case Study

Critical Thinking Prescription Assignment #4 Mr. Griffin is a 55-year-old African-American male recently diagnosed with type II diabetes, which is characterized by, “insulin resistance and β-cell dysfunction” (Edmunds & Mayhew, 2013, p. 590). Mr. Griffin’s hemoglobin A1C is 9.6% and glucose level is 353. According to the American Diabetes Association (ADA) (as cited in ClinicalKey, 2008), diabetes is defined by, “glycosylated hemoglobin (HbA1c) ≥6.5%, a fasting plasma glucose level ≥126 mg/dL, a random plasma glucose level ≥200 mg/dL with symptoms of hyperglycemia, or a 2-hour plasma glucose level ≥200 mg/dL following a standard challenge of 75 g of glucose in water.” Mr. Griffin’s lab results fit the diagnosis of diabetes, which is made by interpreting results of his lab work and his current symptoms (ClinicalKey, 2008). He has a past medical history of obesity, seasonal allergies, and degenerative disc disease. He takes Zyrtec 10 mg by mouth as needed for seasonal allergies and ibuprofen 600 mg by mouth as needed for back pain. Mr. Griffin’s LDL are 140, total cholesterol

Metformin is Category B, which means that studies in animals did not show harm to the fetus but there are not adequate, controlled studies that have been conducted in pregnant women making it difficult to determine the possible risk to the fetus (Edmunds & Mayhew, 2013). According to Edmunds and Mayhew (2013), “diet, exercise, and insulin therapy as needed remain the gold standard of care” (p.80) in the pregnant woman with diabetes. Some obstetricians are treating pregnant women with diabetes with oral antihyperglycemic medications, however until more studies can be conducted and benefit and risk of metformin established, a patient, “who intend to become pregnant should switch to insulin” (Edmunds & Mayhew, 2013, p.