Problem
Scenario:
Sarah Green is a 64-year-old Aboriginal woman who has been transferred to Perth from a Kimberley town for management of complications of Type 2 Diabetes Mellitus.
On arrival, her observations are as follows:
1) Temperature 37.8° C
2) Heart Rate/Pulse 102 BPM
3) Respiratory Rate 22
4) Blood Pressure 180/95
5) SP02 95%
6) BGL 24 mmol/L
7) Height 155cm
8) Weight 85kg
Other relevant medical history includes Angina, with previous stents x 5 and Chronic Renal Failure. She does not yet require renal dialysis. She has an ulcer on her left ankle which has been present for four months - she has been attending the health centre near her home for regular dressings. She wears thongs on her feet when walking around her community. However, the skin on her heels is cracked and dry. She says she has very little feeling in her feet.
Her regular medications are: Metformin 1000 BD and Sitagliptin 25mg daily.
• Explain how Ms Green's presenting symptoms and observations are relevant to her diagnosis of Type 2 Diabetes.
• Refer to the scenario. Consider Ms Green's medical history, and identify two macrovascular complications and two microvascular complications that the patient has developed (include the impact - if any - on her vital signs).
• What would be a healthy hip-to-weight ratio for a woman like Sarah Green?