blended learning pedagogy.

Diabetes type two is a disease that affects how the body handles glucose in the blood. About 27 million people in the USA have this1 diabetes type 2 (Weaver &Madhu, 2015). The pancreas makes insulin hormone that help sin converting the food eaten into glucose (Weaver &Madhu, 2015). People with this disease produce insulin but the body system does not use it properly; a condition known as insulin resistance. Other causes include extra weight and metabolic syndrome. Recent research also shows that some genetic conditions can also affects the way in which the body system makes insulin (Weaver &Madhu, 2015). Also, improper communication between the cells has been associated with this condition. The symptoms of type 2diabetes include weight loss, fatigue, increased hunger, increased thirst, blurred vision, frequent urination and frequent infections (American Diabetes Association. Standards of Medical Care in Diabetes, 2017)

Positive findings

According to the patient’s case, she reports to be very fatigued with less energy. She has gained have frequent urination. Patient urinalysis indicated free protein in the urine which measured as + 1 level as a result of proteinuria, the start of Diabetes Nephropathy and consequently lead to end-stage renal disease. Further, her analysis of the urine indicates pH 5, SpGr 1.013. Her blood test (CMP) indicates :Sodium 139, Potassium 4.3,Chloride 100,CO2 29, Glucose 126, BUN 12, Creatinine 0.7, GFRest non-AA 94 mL/min/1.73, GFRest AA 101 mL/min/1.73, Calcium 9.5, Total protein 7.6

Bilirubin, total 0.6, Alkaline phosphatase 72, AST 25, ALT 29, Anion gap 8.10, Bun/Creat 17.7, Hemoglobin A1C: 6.9 %, TSH: 2.35, Free T 4 0.8 ng/dL, Cholesterol: TC 230 mg/dl, LDL 144 mg/dl; VLDL 36 mg/dl; HDL 38mg/dl, Triglycerides 232. EKD normal sinus rhythm.

CBC: WBC 6,000/mm3 Hgb 12.5 gm/dl Hct 41% RBC 4.6 million MCV 88 flMCHC 34 g/dl RDW 13.8%. American Diabetes Association (ADA) specifies that with a HbA1c of 6.5% or grater is consistent with Diabetes.  This analysis was based was based upon sensitivity and specificity data from several studies (ADA, 2017).