Skip to Main Content

Case Introduction

You are a student-pharmacist on an interprofessional collaboration (IPC) team at the Family Diabetes Health Center Clinic. Dr. X has referred pt Marty Archuleta to discuss medication nonadherence. Marty Archuleta is a 50-year-old female/male new to the clinic, pt was seen by Dr. X twice in the past 4 months. Patient was a no-show last month for the appointment scheduled with Dr. X. The patient was referred to the pharmacist on the team and you are a student-pharmacist on rotation. The following are the patient’s vital signs for today:

  • BP 138/90 mm Hg, HR 76 bpm, RR 16, T 36.5°C; Wt 86.6 kg, Ht 5’1”, random blood glucose 286 mg/dL

Past Medical History (Appointment #1 with Dr. X)

“Chief complaint”

“I’m here from my diabetes appointment.”

HPI

The patient was diagnosed with prediabetes 8 years ago and 2 years ago diagnosed with type 2 diabetes mellitus (T2DM). The patient does not recall the medication prescribed at the time. Four months ago the patient was prescribed metformin 1000 mg po bid and Basaglar 20 units sq qhs. Pt filled the prescription for metformin for three times in the past 4 months and has never filled the prescription for Basaglar.

PMH

  • Prediabetes × 8 years

  • T2DM × 2 years

  • Hypertension × 2 years

FH

  • Mom—s/p MI age 66 years old

  • Dad—deceased at 54 years old secondary to MI

SH

Patient is employed at a job that is considered pleasant per the patient and the stress level is appropriate [no job title noted here].

  • Alcohol intake: 1–2 glasses wine weekly

  • Substance use considerations: none

  • Health insurance covers medication prescribed.

  • Pt has no financial barriers to pay for DM care costs.

  • Exercise: None

  • Diet: No particular diet

Current Medications Prescribed

  • Basaglar 20 units sq qhs

  • Metformin regular release 1000 mg tablet po bid

  • Glucometer, test strips, lancets: SMBG qam and qhs

Drug Allergies

NKDA

ROS

Patient’s mood is irritable.

Physical examination

  • Gen: Patient is 50-years-old, and comes in with complaints of fatigue, polyphagia, polyuria, polydipsia

  • VS: BP 145/98 mm Hg, HR 76 bpm, RR 14, T 36.5°C; Wt 86.6 kg, Ht 5’1”, random blood glucose 268 mg/dL

  • Neuro: CN II–XII intact, A & O × 3; normal motor strength in the upper extremities with reflexes 2+ and symmetric and normal sensation extremities, no CCE

  • Alert and oriented ×3

Labs

  • HbA1c 6.2% 8 years ago

  • HbA1c 9.2% 2 years ago

  • HbA1C 10.8% 4 months ...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.