Diabetes management involves a comprehensive approach to control blood sugar levels, prevent
complications, and improve overall health. Key components include regular monitoring of blood glucose,
following a balanced diet low in refined sugars and rich in fiber, engaging in consistent physical activity,
and taking prescribed medications such as insulin or oral hypoglycemics. Education and self-
management are crucial, empowering individuals to understand their condition and make informed
lifestyle choices. Routine check-ups with healthcare providers help monitor progress and detect any
early signs of complications like neuropathy, kidney damage, or vision issues. For effective management,
a multidisciplinary team—often including nurse practitioners, dietitians, endocrinologists, and educators
—works closely with the patient to create a personalized care plan.
Maria presents to the clinic for a follow-up on her type 2 diabetes. Her recent labs show an
HbA1c of 8.4%. She reports feeling tired, frequent urination, and increased thirst. She has not
been consistently taking her metformin due to gastrointestinal side effects and struggles with
meal planning since she cares for her grandchildren.
Management Plan (Patient-Centered):
1. Assessment & Education:
The NP reviews Maria’s blood sugar logs and listens to her concerns about side effects
and her caregiving challenges. Education is provided on the importance of glycemic
control, the role of diet, and how stress can affect blood sugar.
2. Medication Adjustment:
The NP switches Maria from metformin immediate-release to the extended-release form
to reduce GI symptoms and discusses the possibility of adding a GLP-1 receptor agonist
in the future if A1c goals are not met.
3. Nutrition Support:
Maria is referred to a registered dietitian who can help her create a flexible meal plan that
fits her family routine. Educational handouts on simple, affordable, diabetic-friendly
meals are given.
4. Monitoring:
She is advised to monitor her fasting and postprandial glucose daily and bring her log to
the next visit. The NP orders repeat labs in 3 months to check her HbA1c, kidney
function, and lipid panel.
5. Behavioral & Social Support:
The NP connects her with a community diabetes support group and schedules a follow-up
call in 2 weeks to check on medication tolerance and lifestyle changes.
